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Moraga-Llop F, Andradas E, Blesa-Baviera LC, Cantón R, González Del Castillo J, Martinón-Torres F, Moya E, Trilla A, Vazquez J, Villena RJ, Ruiz-Galiana J, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Bouza E. Meningococcal meningitis in Spain in the Horizon 2030: A position paper. Rev Esp Quimioter 2024:moraga22mar2024. [PMID: 38515374 DOI: 10.37201/req/023.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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2
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Martín Pérez C, Aguilar R, Jiménez A, Salmerón G, Canyelles M, Rubio R, Vidal M, Cuamba I, Barrios D, Díaz N, Santano R, Serra P, Santamaria P, Izquierdo L, Trilla A, Vilella A, Barroso S, Tortajada M, García-Basteiro AL, Moncunill G, Dobaño C. Correlates of protection and determinants of SARS-CoV-2 breakthrough infections 1 year after third dose vaccination. BMC Med 2024; 22:103. [PMID: 38454385 PMCID: PMC10921636 DOI: 10.1186/s12916-024-03304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The emergence of new SARS-CoV-2 variants and the waning of immunity raise concerns about vaccine effectiveness and protection against COVID-19. While antibody response has been shown to correlate with the risk of infection with the original variant and earlier variants of concern, the effectiveness of antibody-mediated protection against Omicron and the factors associated with protection remain uncertain. METHODS We evaluated antibody responses to SARS-CoV-2 spike (S) and nucleocapsid (N) antigens from Wuhan and variants of concern by Luminex and their role in preventing breakthrough infections 1 year after a third dose of mRNA vaccination, in a cohort of health care workers followed since the pandemic onset in Spain (N = 393). Data were analyzed in relation to COVID-19 history, demographic factors, comorbidities, vaccine doses, brand, and adverse events. RESULTS Higher levels of anti-S IgG and IgA to Wuhan, Delta, and Omicron were associated with protection against vaccine breakthroughs (IgG against Omicron S antigen HR, 0.06, 95%CI, 0.26-0.01). Previous SARS-CoV-2 infection was positively associated with antibody levels and protection against breakthroughs, and a longer time since last infection was associated with lower protection. In addition, priming with BNT162b2 followed by mRNA-1273 booster was associated with higher antibody responses than homologous mRNA-1273 vaccination. CONCLUSIONS Data show that IgG and IgA induced by vaccines against the original strain or by hybrid immunization are valid correlates of protection against Omicron BA.1 despite immune escape and support the benefits of heterologous vaccination regimens to enhance antibodies and the prioritization of booster vaccination in individuals without recent infections.
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Affiliation(s)
- Carla Martín Pérez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, 08036, Spain
| | - Gemma Salmerón
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Mar Canyelles
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Inocencia Cuamba
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- Centro de Investigação Em Saúde de Manhiça, Maputo, CP, 1929, Mozambique
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Natalia Díaz
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, 08036, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, 08036, Spain
| | - Pere Santamaria
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, 08036, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Sonia Barroso
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
- Centro de Investigação Em Saúde de Manhiça, Maputo, CP, 1929, Mozambique
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, 08036, Spain
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, 08036, Spain.
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, 08036, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, 08036, Spain.
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Mallafré-Larrosa M, Papi G, Trilla A, Ritchie D. Development and Promotion of an mHealth App for Adolescents Based on the European Code Against Cancer: Retrospective Cohort Study. JMIR Cancer 2023; 9:e48040. [PMID: 38015612 DOI: 10.2196/48040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/09/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Mobile health technologies, underpinned by scientific evidence and ethical standards, exhibit considerable promise and potential in actively engaging consumers and patients while also assisting health care providers in delivering cancer prevention and care services. The WASABY mobile app was conceived as an innovative, evidence-based mobile health tool aimed at disseminating age-appropriate messages from the European Code Against Cancer (ECAC) to adolescents across Europe. OBJECTIVE This study aims to assess the outcomes of the design, development, and promotion of the WASABY app through a 3-pronged evaluation framework that encompasses data on social media promotion, app store traffic, and user engagement. METHODS The WASABY app's content, cocreated with cancer-focused civil society organizations across 6 European countries, drew upon scientific evidence from the ECAC. The app's 10 modules were designed using the health belief model and a gamification conceptual framework characterized by spaced repetition learning techniques, refined through 2 rounds of testing. To evaluate the effectiveness of the app, we conducted a retrospective cohort study using the WASABY app's user database registered from February 4 to June 30, 2021, using a 3-pronged assessment framework: social media promotion, app store traffic, and user engagement. Descriptive statistics and association analyses explored the relationship between sociodemographic variables and user performance analytics. RESULTS After extensive promotion on various social media platforms and subsequent traffic to the Apple App and Google Play stores, a sample of 748 users aged between 14 and 19 years was included in the study cohort. The selected sample exhibited a mean age of 16.08 (SD 1.28) years and was characterized by a predominant representation of female users (499/748, 66.7%). Most app users identified themselves as nonsmokers (689/748, 92.1%), reported either no or infrequent alcohol consumption (432/748, 57.8% and 250/748, 33.4%, respectively), and indicated being physically active for 1 to 5 hours per week (505/748, 67.5%). In aggregate, the app's content garnered substantial interest, as evidenced by 40.8% (305/748) of users visiting each of the 10 individual modules. Notably, sex and smoking habits emerged as predictors of app completion rates; specifically, male and smoking users demonstrated a decreased likelihood of successfully completing the app's content (odds ratio 0.878, 95% CI 0.809-0.954 and odds ratio 0.835, 95% CI 0.735-0.949, respectively). CONCLUSIONS The development and promotion of the WASABY app presents a valuable case study, illustrating the effective dissemination of evidence-based recommendations on cancer prevention within the ECAC through an innovative mobile app aimed at European adolescents. The data derived from this study provide insightful findings for the implementation of Europe's Beating Cancer Plan, particularly the creation of the EU Mobile App for Cancer Prevention.
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Affiliation(s)
- Meritxell Mallafré-Larrosa
- Association of European Cancer Leagues, Brussels, Belgium
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ginevra Papi
- Association of European Cancer Leagues, Brussels, Belgium
| | - Antoni Trilla
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - David Ritchie
- Association of European Cancer Leagues, Brussels, Belgium
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López-Púa Y, Navasa M, Trilla A, Colmenero J, García R, López E, Durà A, Guash A, Ríos J. Implementation of a quality management system in a liver transplant programme. BMJ Open Qual 2023; 12:e002440. [PMID: 37748820 PMCID: PMC10533803 DOI: 10.1136/bmjoq-2023-002440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The management of liver transplantation has become a complex process involving different healthcare professionals. Teamwork, standardisation and definition of the best practices are essential for success, patient satisfaction and society's favourable perception of transplantation programmes.ISO 9001:2015 certification provides the necessary elements to help implement a quality management system (QMS) to ensure that patient care is performed with the highest guarantees of clinical quality and safety. The aim of this study is to describe the steps, strengths and limitations in the implementation of a QMS in a liver transplant programme (LTP). PROJECT MANAGEMENT METHOD This included analysing the starting point, setting up a working group, training, defining the scope of certification, preparing documentation, and conducting an internal and external audit, which culminated in the ISO 9001 quality certification award. The scope of QMS includes all the processes of LTP, from referral of candidates to long-term follow-up after transplantation. RESULTS The project was structured in seven phases that took place between 2008 and 2011. The implementation of QMS led to the generation of all the necessary documentation to meet the requirements of the standard, including internal and legal requirements related to the transplant activity. The establishment of indicators to measure the effectiveness of processes, risk management and the identification of incidents allows us to implement measures devoted to avoiding the deficiencies and to meet the established objectives. CONCLUSION ISO 9001:2015 certification has contributed to the adaptation of a new quality and safety culture focused on the patient. All activities are protocolised, everything is recorded, measured, and verified, and all steps are taken as planned. Work is carried out in terms of continuous improvement. This has led to less variability in daily clinical practice and a better understanding of work dynamics.
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Affiliation(s)
- Yolanda López-Púa
- Quality Unit, Biomedical Diagnostic Center, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Miquel Navasa
- Liver Transplant Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - Antoni Trilla
- Preventive Medicine Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - Jordi Colmenero
- Liver Unit, Hospital Clinic de Barcelona. IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Catalunya, Spain
| | - Raquel García
- Liver Transplant Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - Eva López
- Liver Transplant Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - Anna Durà
- Liver Transplant Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - Ana Guash
- Liver Transplant Unit, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Catalunya, Spain
| | - José Ríos
- Department of Clinical Farmacology, Hospital Clinic de Barcelona, Hospital Clinic and Medical Statistics Core Facility, IDIBAPS. Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Bouza E, Martin M, Alés JE, Aragonés N, Barragán B, de la Cámara R, Pozo JLD, García-Gutiérrez V, García-Sanz R, Gracia D, Guillem V, Jiménez-Yuste V, Martin-Delgado MC, Martínez J, López R, Rodríguez-Lescure Á, Galiana JR, Sureda AM, Tejerina-Picado F, Trilla A, Zapatero A, Palomo E, San-Miguel J. Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper. Rev Esp Quimioter 2023; 36:1-25. [PMID: 36322133 PMCID: PMC9910677 DOI: 10.37201/req/087.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
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Affiliation(s)
- Emilio Bouza
- CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), España. Patrono de la Fundación de Ciencias de la Salud. Servicio de Microbiología y Enfermedades Infecciosas Hospital General Universitario Gregorio Marañón. Catedrático de Medicina. Universidad Complutense. Madrid.,Correspondence: Emilio Bouza MD, PhD. Instituto de Investigación Sanitaria Gregorio Marañón. C/ Dr. Esquerdo, 46 28007 Madrid, España E-mail:
| | - Miguel Martin
- Universidad Complutense de Madrid. Jefe de Servicio de Oncología del Hospital Gregorio Marañón de Madrid
| | | | | | | | | | - José Luis Del Pozo
- Servicio de Enfermedades Infecciosas. Servicio de Microbiología. Clínica Universidad de Navarra. Pamplona España
| | | | - Ramón García-Sanz
- Laboratorio de HLA y biología molecular en hematología, Universidad de Salamanca. Sociedad Española de Hematología y Hemoterapia
| | | | - Vicente Guillem
- Servicio de Oncología Médica del Instituto Valenciano de Oncología (IVO)
| | | | - Mari Cruz Martin-Delgado
- Servicio Medicina Intensiva Hospital Universitario Torrejón. Universidad Francisco de Vitoria. Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva
| | - Joaquín Martínez
- Servicio de Hematología y Hemoterapia, Hospital 12 de Octubre, Madrid. Universidad Complutense. Madrid
| | - Rafael López
- Oncología Médica del Hospital Clínico Universitario, Santiago de Compostela
| | | | | | - Ana María Sureda
- Servicio de Hematología en Hospital Universitario Quiron Dexeus, Grupo Español de Trasplante y Terapia Celular, Electa del EBMT
| | | | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología del Hospital Clínic de Barcelona. Catedrático de Medicina (Salud Pública) Universidad de Barcelona
| | | | | | - Jesús San-Miguel
- Medicina Clínica y Traslacional de la Clínica Universidad de Navarra
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Llupià A, de la Torre‐Pérez L, Granés L, Olivé V, Baron‐Miras L, Torà I, Marin C, Grau J, Soriano I, Roel E, García‐Diez M, López‐Toribio M, Puig J, Guinovart C, Santana G, Fernández‐Torres P, García‐Basteiro AL, Prat A, Blanco‐Rojas BJ, Arquer M, Barroso S, Tortajada M, Varela P, Vilella A, Trilla A. SARS‐CoV2
hospital surveillance and control system with contact tracing for patients and health care workers at a large reference hospital in Spain during the first wave: An observational descriptive study. Health Sci Rep 2022; 5:e513. [PMID: 35237730 PMCID: PMC8881746 DOI: 10.1002/hsr2.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/27/2021] [Accepted: 01/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aims During the first peak of the COVID‐19 pandemic, the Preventive Medicine Department and the Occupational Health Department at Hospital Clinic de Barcelona (HCB), a large Spanish referral hospital, developed an innovative comprehensive SARS‐CoV2 Surveillance and Control System (CoSy‐19) in order to preserve patients' and health care workers' (HCWs) safety. We aim to describe the CoSy‐19 and to assess the impact in the number of contacts that new cases generated along this time. Methods Observational descriptive study of the findings of the activity of contact tracing of all cases received at the HCB during the first peak of COVID‐19 in Spain (February 25th‐May 3rd, 2020). Results A team of 204 professionals and volunteers performed 384 in‐hospital contact‐tracing studies which generated contacts, detecting 298 transmission chains which suggested preventive measures, generated around 22 000 follow‐ups and more than 30 000 days of work leave. The number of contacts that new cases generated decreased during the study period. Conclusion Coordination between Preventive Medicine and Occupational Health departments and agile information systems were necessary to preserve non‐COVID activity and workers safety.
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Affiliation(s)
- Anna Llupià
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
- School of Medicine Universitat de Barcelona Barcelona Spain
| | | | - Laura Granés
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Victòria Olivé
- Occupational Health Department Hospital Clínic Barcelona Spain
| | - Lourdes Baron‐Miras
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Isabel Torà
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Clara Marin
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Jaume Grau
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Inmaculada Soriano
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Elena Roel
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Marta García‐Diez
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - María López‐Toribio
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Joaquim Puig
- Department of Mathematics Universitat Politècnica de Catalunya Barcelona Spain
| | - Caterina Guinovart
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
| | - Gemina Santana
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | | | - Alberto L. García‐Basteiro
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
- International Health Department Hospital Clinic Barcelona Spain
- Centro de Investigação em Saúde de Manhiça (CISM) Maputo Mozambique
| | - Andreu Prat
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
- School of Medicine Universitat de Barcelona Barcelona Spain
| | | | - Maria Arquer
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
| | - Sonia Barroso
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
| | - Marta Tortajada
- Occupational Health Department Hospital Clínic Barcelona Spain
| | - Pilar Varela
- Occupational Health Department Hospital Clínic Barcelona Spain
| | - Anna Vilella
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
- School of Medicine Universitat de Barcelona Barcelona Spain
| | - Antoni Trilla
- Department of Preventive Medicine and Epidemiology Hospital Clínic Barcelona Spain
- Barcelona Institute for Global Health (ISGlobal) Hospital Clínic‐Universitat de Barcelona Barcelona Spain
- School of Medicine Universitat de Barcelona Barcelona Spain
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Redondo Margüello E, Trilla A, Munguira ILB, Jaramillo López-Herce A, Cotarelo Suárez M. Knowledge, attitudes, beliefs and barriers of healthcare professionals and adults ≥ 65 years about vaccine-preventable diseases in Spain: the ADult Vaccination drIverS and barriErs (ADVISE) study. Hum Vaccin Immunother 2022; 18:2025007. [PMID: 35172691 PMCID: PMC8993072 DOI: 10.1080/21645515.2021.2025007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since 2018, Spanish National Immunization Guidelines include vaccination recommendations for adults ≥65 years. To determine whether health-care professionals and the ≥65 years target group value the need for these recommendations, a cross-sectional study was conducted to capture and describe their knowledge, attitudes, beliefs and behaviors about vaccination. Online surveys were administered to representative groups of general practitioners (GPs), primary care nurses and adults ≥65 years from six major cities (and surrounding rural areas) in Spain. Main topics were attitudes and awareness of vaccines, perceptions about vaccination in adults ≥65 years, and impact of the COVID-19 pandemic on vaccination uptake. A total of 286 health-care professionals (185 GPs, 101 nurses) and 400 adults aged ≥65 years participated in the survey. GP and nurse groups agreed strongly about the importance of influenza and pneumococcal vaccination in the target population. Longer patient visit times were identified as a key factor toward promoting vaccination. The ≥65 years sample group, especially those ≥75+ years and/or with chronic diseases, was reasonably positive about the effectiveness and benefits of vaccines. Lower vaccination rates for the pneumococcal than influenza vaccine (29% vs. 80%) in the ≥65 years sample group suggest that efforts are needed to improve pneumococcal vaccine uptake. Aligning with other published works, GPs have a key role in promoting vaccination in the target population. The COVID-19 pandemic appears to have heightened awareness about the importance of vaccination among health-care professionals and adults ≥65 years.
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Affiliation(s)
| | - Antoni Trilla
- Servicio de Medicina Preventiva del Hospital Clinic de Barcelona, Barcelona, Spain
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8
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Trilla A, Vilella A. Vaccination against COVID 19: One world, one health. Farm Hosp 2022; 46:1-2. [PMID: 35379084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Instituto de Salud Global de Barcelona (ISGlobal), Barcelona. España..
| | - Anna Vilella
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Instituto de Salud Global de Barcelona (ISGlobal), Barcelona. España..
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9
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Moncunill G, Aguilar R, Ribes M, Ortega N, Rubio R, Salmerón G, Molina MJ, Vidal M, Barrios D, Mitchell RA, Jiménez A, Castellana C, Hernández-Luis P, Rodó P, Méndez S, Llupià A, Puyol L, Rodrigo Melero N, Carolis C, Mayor A, Izquierdo L, Varela P, Trilla A, Vilella A, Barroso S, Angulo A, Engel P, Tortajada M, García-Basteiro AL, Dobaño C. Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers. EBioMedicine 2022; 75:103805. [PMID: 35032961 PMCID: PMC8752368 DOI: 10.1016/j.ebiom.2021.103805] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Two doses of mRNA vaccination have shown >94% efficacy at preventing COVID-19 mostly in naïve adults, but it is not clear if the second dose is needed to maximize effectiveness in those previously exposed to SARS-CoV-2 and what other factors affect responsiveness. METHODS We measured IgA, IgG and IgM levels against SARS-CoV-2 spike (S) and nucleocapsid (N) antigens from the wild-type and S from the Alpha, Beta and Gamma variants of concern, after BNT162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna) vaccination in a cohort of health care workers (N=578). Neutralizing capacity and antibody avidity were evaluated. Data were analyzed in relation to COVID-19 history, comorbidities, vaccine doses, brand and adverse events. FINDINGS Vaccination induced robust IgA and IgG levels against all S antigens. Neutralization capacity and S IgA and IgG levels were higher in mRNA-1273 vaccinees, previously SARS-CoV-2 exposed, particularly if symptomatic, and in those experiencing systemic adverse effects (p<0·05). A second dose in pre-exposed did not increase antibody levels. Smoking and comorbidities were associated with 43% (95% CI, 19-59) and 45% (95% CI, 63-18) lower neutralization, respectively, and 35% (95% CI, 3-57%) and 55% (95% CI, 33-70%) lower antibody levels, respectively. Among fully vaccinated, 6·3% breakthroughs were detected up to 189 days post-vaccination. Among pre-exposed non-vaccinated, 90% were IgG seropositive more than 300 days post-infection. INTERPRETATION Our data support administering a single-dose in pre-exposed healthy individuals as primary vaccination. However, heterogeneity of responses suggests that personalized recommendations may be necessary depending on COVID-19 history and life-style. Higher mRNA-1273 immunogenicity would be beneficial for those expected to respond worse to vaccination and in face of variants that escape immunity such as Omicron. Persistence of antibody levels in pre-exposed unvaccinated indicates maintenance of immunity up to one year. FUNDING This work was supported by Institut de Salut Global de Barcelona (ISGlobal) internal funds, in-kind contributions from Hospital Clínic de Barcelona, the Fundació Privada Daniel Bravo Andreu, and European Institute of Innovation and Technology (EIT) Health (grant number 20877), supported by the European Institute of Innovation and Technology, a body of the European Union receiving support from the H2020 Research and Innovation Programme. We acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. L. I. work was supported by PID2019-110810RB-I00 grant from the Spanish Ministry of Science & Innovation. Development of SARS-CoV-2 reagents was partially supported by the National Institute of Allergy and Infectious Diseases Centers of Excellence for Influenza Research and Surveillance (contract number HHSN272201400008C). The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.
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Affiliation(s)
- Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; CIBER de Enfermedades Infecciosas, Madrid, Spain.
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribes
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Ortega
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Gemma Salmerón
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - María José Molina
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Département Biologie, Université Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Cristina Castellana
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Pablo Hernández-Luis
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pau Rodó
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Susana Méndez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Carlo Carolis
- Biomolecular screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Pilar Varela
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | | | - Ana Angulo
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pablo Engel
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; CIBER de Enfermedades Infecciosas, Madrid, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain; CIBER de Enfermedades Infecciosas, Madrid, Spain.
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Kuznetsova L, Cortassa G, Trilla A. Effectiveness of Mandatory and Incentive-Based Routine Childhood Immunization Programs in Europe: A Systematic Review of the Literature. Vaccines (Basel) 2021; 9:vaccines9101173. [PMID: 34696280 PMCID: PMC8538772 DOI: 10.3390/vaccines9101173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/25/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
There is a lack of comprehensive and systematic data and evidence regarding the effectiveness of mandatory and incentive-based vaccination schemes. The results of such programs in some countries have not been adequately studied. A number of countries have recently introduced tightening vaccination measures, and it is important to analyze and assess the results of these programs. The unprecedented situation due to the COVID-19 pandemic and mass vaccination made the topic of the effectiveness of vaccination policies and mandates even more relevant. The aim of the study is to assess childhood vaccination programs implemented in selected countries. The study focuses on initiatives implemented in the European Region of the World Health Organization (WHO). A total of 466 full-text articles were assessed for eligibility, and 26 articles on seven countries were included in the synthesis. Additionally, we obtained and performed an analysis of data on the impact of COVID-19 on vaccine coverage and incidence of vaccine-preventable diseases, and the implementation of vaccine mandates in the selected countries. The evidence collected and analyzed in this review allowed us to conclude that the introduction of children routine vaccination mandates increases vaccine coverage and reduces the incidence of vaccine-preventable diseases when compared to the situation before the introduction of the mandates.
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Affiliation(s)
- Lidia Kuznetsova
- Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
- Correspondence:
| | - Giorgio Cortassa
- Emergency Department, Hospital Santa Corona, 17027 Pietra Ligure, Italy;
| | - Antoni Trilla
- Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
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11
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Bellver M, Ferrer-Roca V, Del Rio L, Jovell E, Gomez-Chereguini L, Drobnic F, Trilla A. Bone variables and body composition in former artistic swimmers teams. Jump program effects during Covid-19 confinement: A randomized controlled study. Apunts Sports Medicine 2021. [DOI: 10.1016/j.apunsm.2021.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stoehr F, Müller L, Brady A, Trilla A, Mähringer-Kunz A, Hahn F, Düber C, Becker N, Wörns MA, Chapiro J, Hinrichs JB, Akata D, Ellmann S, Huisman M, Koff D, Brinkmann S, Bamberg F, Zimmermann O, Traikova NI, Marquardt JU, Chang DH, Rengier F, Auer TA, Emrich T, Muehler F, Schmidberger H, Baeßler B, dos Santos DP, Kloeckner R. How COVID-19 kick-started online learning in medical education-The DigiMed study. PLoS One 2021; 16:e0257394. [PMID: 34547031 PMCID: PMC8454930 DOI: 10.1371/journal.pone.0257394] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/01/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic led to far-reaching restrictions of social and professional life, affecting societies all over the world. To contain the virus, medical schools had to restructure their curriculum by switching to online learning. However, only few medical schools had implemented such novel learning concepts. We aimed to evaluate students' attitudes to online learning to provide a broad scientific basis to guide future development of medical education. METHODS Overall, 3286 medical students from 12 different countries participated in this cross-sectional, web-based study investigating various aspects of online learning in medical education. On a 7-point Likert scale, participants rated the online learning situation during the pandemic at their medical schools, technical and social aspects, and the current and future role of online learning in medical education. RESULTS The majority of medical schools managed the rapid switch to online learning (78%) and most students were satisfied with the quantity (67%) and quality (62%) of the courses. Online learning provided greater flexibility (84%) and led to unchanged or even higher attendance of courses (70%). Possible downsides included motivational problems (42%), insufficient possibilities for interaction with fellow students (67%) and thus the risk of social isolation (64%). The vast majority felt comfortable using the software solutions (80%). Most were convinced that medical education lags behind current capabilities regarding online learning (78%) and estimated the proportion of online learning before the pandemic at only 14%. In order to improve the current curriculum, they wish for a more balanced ratio with at least 40% of online teaching compared to on-site teaching. CONCLUSION This study demonstrates the positive attitude of medical students towards online learning. Furthermore, it reveals a considerable discrepancy between what students demand and what the curriculum offers. Thus, the COVID-19 pandemic might be the long-awaited catalyst for a new "online era" in medical education.
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Affiliation(s)
- Fabian Stoehr
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lukas Müller
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Adrian Brady
- Radiology Department, Mercy University Hospital, Cork, Ireland
- Department of Radiology, School of Medicine, University College Cork, Cork, Ireland
| | - Antoni Trilla
- Preventive Medicine and Epidemiology, Hospital Clínic of Barcelona Hospital, Barcelona, Spain
| | - Aline Mähringer-Kunz
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix Hahn
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christoph Düber
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Nicole Becker
- Center for Quality Assurance and Development, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Marcus-Alexander Wörns
- Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Julius Chapiro
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, United States of America
| | - Jan Bernd Hinrichs
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Deniz Akata
- Department of Radiology, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Stephan Ellmann
- Institute of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Merel Huisman
- Institute of Radiology, Meander Medical Center, Amersfoort, Utrecht, Netherlands
| | - David Koff
- Department of Radiology, McMaster University, Hamilton, ON, Canada
| | - Sebastian Brinkmann
- Department of General, Visceral, Tumor and Transplantation Surgery, University Hospital Cologne, Cologne, Germany
| | - Fabian Bamberg
- Department of Radiology, Medical Center—University of Freiburg, Freiburg, Germany
| | | | | | - Jens U. Marquardt
- Department of Internal Medicine 1, University Hospital Schleswig-Holstein (UKSH), Lübeck, Germany
| | - D.-H. Chang
- Department of Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Rengier
- Department of Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Timo A. Auer
- Department of Radiology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Tilman Emrich
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States of America
- German Centre for Cardiovascular Research, Partner site Rhine-Main, Mainz, Germany
| | | | - Heinz Schmidberger
- Department of Radiation Oncology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Bettina Baeßler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Roman Kloeckner
- Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Bellver M, Drobnic F, Jovell E, Ferrer-Roca V, Abalos X, Del Rio L, Trilla A. Jumping rope and whole-body vibration program effects on bone values in Olympic artistic swimmers. J Bone Miner Metab 2021; 39:858-867. [PMID: 33839950 DOI: 10.1007/s00774-021-01224-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/18/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Artistic swimming seems not to benefit bone development like other out-of-water physical activities. To increase bone acquisition, artistic swimming should combine water training with weight-bearing impact or strength activities. Artistic swimmers can be a population at risk of developing osteopenia and osteoporosis in later life. The aim of the present study was to evaluate the effects of a training program on bone mineral density (BMD), bone mineral content (BMC) and body composition in an Olympic artistic swimming team. METHODS Sixteen women aged 17-21 years, who train 30 h/week, at the Olympic Training Centre (Barcelona, Spain), were followed up over two seasons. The 1st season involved regular artistic swimming training without specific training to reduce the risk of osteopenia. The exercise intervention, jumping rope and whole-body vibration, was added in the 2nd season. The protocol included 20 min of training 2 days per week, over a 22-week period. Dual energy x-ray absorptiometry measured the bone variables and body composition. The daily diet, medical history and bone turnover markers were evaluated. RESULTS The intervention program increased BMD on lumbar spine (2.10%, p = 0.002), total hip (2.07%, p = 0.001), and femoral neck (2.39%, p = 0.02). Lower limb's fat mass decreased (10.17%, p = 0.038). No significant differences were found for any of the measured anthropometric characteristics between both time points in the 1st season. In conclusions, combined jump rope and vibration should be considered to reduce the risk of bone damage in artistic swimmers.
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Affiliation(s)
- Montse Bellver
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain.
- Consorci Sanitari de Terrassa (CST), Carretera de Torrebonica s/n, 08227, Terrassa, Barcelona, Spain.
- , c/Via Augusta 114, 7º1ª, 08006, Barcelona, Spain.
| | - Franchek Drobnic
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain
- Shenhua Greenland FC, Hunan Highway 2600, Shanghai, China
| | - Esther Jovell
- Consorci Sanitari de Terrassa (CST), Carretera de Torrebonica s/n, 08227, Terrassa, Barcelona, Spain
| | - Ventura Ferrer-Roca
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/nSant Cugat del Valles, 08173, Barcelona, Spain
| | - Xavier Abalos
- LCAFE School of Physical Education and Sports Sciences, Sc Wiesbaden 1911 e.v, Wiesbaden, Germany
| | - Luis Del Rio
- CETIR Centre Medic, c/Londres, 6, 08029, Barcelona, Spain
| | - Antoni Trilla
- Hospital Clinic, University of Barcelona, c/Villarroel, 170, 08036, Barcelona, Spain
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14
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Ortega N, Ribes M, Vidal M, Rubio R, Aguilar R, Williams S, Barrios D, Alonso S, Hernández-Luis P, Mitchell RA, Jairoce C, Cruz A, Jimenez A, Santano R, Méndez S, Lamoglia M, Rosell N, Llupià A, Puyol L, Chi J, Melero NR, Parras D, Serra P, Pradenas E, Trinité B, Blanco J, Mayor A, Barroso S, Varela P, Vilella A, Trilla A, Santamaria P, Carolis C, Tortajada M, Izquierdo L, Angulo A, Engel P, García-Basteiro AL, Moncunill G, Dobaño C. Seven-month kinetics of SARS-CoV-2 antibodies and role of pre-existing antibodies to human coronaviruses. Nat Commun 2021; 12:4740. [PMID: 34362897 PMCID: PMC8346582 DOI: 10.1038/s41467-021-24979-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
Unraveling the long-term kinetics of antibodies to SARS-CoV-2 and the individual characteristics influencing it, including the impact of pre-existing antibodies to human coronaviruses causing common cold (HCoVs), is essential to understand protective immunity to COVID-19 and devise effective surveillance strategies. IgM, IgA and IgG levels against six SARS-CoV-2 antigens and the nucleocapsid antigen of the four HCoV (229E, NL63, OC43 and HKU1) were quantified by Luminex, and antibody neutralization capacity was assessed by flow cytometry, in a cohort of health care workers followed up to 7 months (N = 578). Seroprevalence increases over time from 13.5% (month 0) and 15.6% (month 1) to 16.4% (month 6). Levels of antibodies, including those with neutralizing capacity, are stable over time, except IgG to nucleocapsid antigen and IgM levels that wane. After the peak response, anti-spike antibody levels increase from ~150 days post-symptom onset in all individuals (73% for IgG), in the absence of any evidence of re-exposure. IgG and IgA to HCoV are significantly higher in asymptomatic than symptomatic seropositive individuals. Thus, pre-existing cross-reactive HCoVs antibodies could have a protective effect against SARS-CoV-2 infection and COVID-19 disease.
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Affiliation(s)
- Natalia Ortega
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribes
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Rocío Rubio
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sarah Williams
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Pablo Hernández-Luis
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Angeline Cruz
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jimenez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Susana Méndez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Montserrat Lamoglia
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- School of Health Sciences TecnoCampus Universitat Pompeu Fabra, Mataró, Spain
| | - Neus Rosell
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Jordi Chi
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Rodrigo Melero
- Biomolecular screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Daniel Parras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Pau Serra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Edwards Pradenas
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, UAB, Badalona, Catalonia, Spain
| | - Benjamin Trinité
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, UAB, Badalona, Catalonia, Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, UAB, Badalona, Catalonia, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Sonia Barroso
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Varela
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pere Santamaria
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
- Julia McFarlane Diabetes Research Centre, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Carlo Carolis
- Biomolecular screening and Protein Technologies Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Luis Izquierdo
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Ana Angulo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Pablo Engel
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Immunology Unit, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
- Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain.
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15
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Cucchiari D, Egri N, Bodro M, Herrera S, Del Risco-Zevallos J, Casals-Urquiza J, Cofan F, Moreno A, Rovira J, Banon-Maneus E, Ramirez-Bajo MJ, Ventura-Aguiar P, Pérez-Olmos A, Garcia-Pascual M, Pascal M, Vilella A, Trilla A, Ríos J, Palou E, Juan M, Bayés B, Diekmann F. Cellular and humoral response after MRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients. Am J Transplant 2021; 21:2727-2739. [PMID: 34036720 PMCID: PMC8222867 DOI: 10.1111/ajt.16701] [Citation(s) in RCA: 171] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 01/25/2023]
Abstract
According to preliminary data, seroconversion after mRNA SARS-CoV-2 vaccination might be unsatisfactory in Kidney Transplant Recipients (KTRs). However, it is unknown if seronegative patients develop at least a cellular response that could offer a certain grade of protection against SARS-CoV-2. To answer this question, we prospectively studied 148 recipients of either kidney (133) or kidney-pancreas (15) grafts with assessment of IgM/IgG spike (S) antibodies and ELISpot against the nucleocapside (N) and the S protein at baseline and 2 weeks after receiving the second dose of the mRNA-1273 (Moderna) vaccine. At baseline, 31 patients (20.9%) had either IgM/IgG or ELISpot positivity and were considered to be SARS-CoV-2-pre-immunized, while 117 (79.1%) patients had no signs of either cellular or humoral response and were considered SARS-CoV-2-naïve. After vaccination, naïve patients who developed either humoral or cellular response were finally 65.0%, of which 29.9% developed either IgG or IgM and 35.0% S-ELISpot positivity. Factors associated with vaccine unresponsiveness were diabetes and treatment with antithymocytes globulins during the last year. Side effects were consistent with that of the pivotal trial and no DSAs developed after vaccination. In conclusion, mRNA-1273 SARS-CoV-2 vaccine elicits either cellular or humoral response in almost two thirds of KTRs.
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Affiliation(s)
- David Cucchiari
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Egri
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Marta Bodro
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - Sabina Herrera
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | | | | | - Frederic Cofan
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Asunción Moreno
- Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain
| | - Jordi Rovira
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Elisenda Banon-Maneus
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Maria J. Ramirez-Bajo
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Red de Investigación Renal (REDINREN), Madrid, Spain
| | - Pedro Ventura-Aguiar
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Pérez-Olmos
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Marta Garcia-Pascual
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Mariona Pascal
- Department of Immunology, Hospital Clínic, Barcelona, Spain,Immunoal·lergia Clínica Respiratoria i Experimental (IRCE), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Red Nacional de Alergia, Asma, Reacciones Adversas y Alérgicas (ARADyAL), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Anna Vilella
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Trilla
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - José Ríos
- Medical Statistics Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eduard Palou
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Manel Juan
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Beatriu Bayés
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain
| | - Fritz Diekmann
- Department of Nephrology and Kidney Transplantation, Hospital Clínic, Barcelona, Spain,Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Red de Investigación Renal (REDINREN), Madrid, Spain,Correspondence Dr. Fritz Diekmann, Department of Nephrology and Kidney Transplantation, Hospital Clínic of Barcelona, Carrer Villarroel, 170 - 08036 Barcelona, Spain.
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16
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Abstract
Purpose of Review The ongoing COVID-19 pandemic is a matter of great concern worldwide. After the first wave, several countries, notably in the European Union, are suffering a very rapid increase in the number of cases in the pandemic second wave. Health systems are under stress; hospital beds and ICU beds are increasingly occupied by COVID-19 patients, and hospitals are struggling to keep their normal operations. We review some basic epidemiological data of this new disease, regarding its appearance, reproductive rate, ways of transmission, number of cases, death rate, usefulness of diagnostic tests, basic treatment options, and prevention and control strategies, including vaccines. Recent Findings The basic control strategy falls into two well established categories: active attack (control) or organized defense (mitigation). The control strategy relies on classic testing, tracing, and tracking possible cases of COVID-19. Those actions draw from classical epidemiology: to actively find and detect cases, isolate if positive for 10 days and treat when needed. At the same time, the search for close contacts, test them when needed and quarantine and monitor for 10 to 14 days in order to break chains of transmission. The mitigation strategy include basic measures to protect people at increased risk of severe illness, like social distancing, wearing a mask when social distancing is not possible, avoiding crowds, avoiding indoor crowded spaces, increase ventilation indoors and washing or sanitizing hands often. They include also targeted restrictions in people’s mobility, and lock-downs, widely used during the first wave in order to spare the health system, become overwhelmed and increasingly used in Europe once more in the current strong second wave. Summary Waiting for effective and safe vaccines and treatments, stopping the ongoing COVID-19 transmission is our only defense wall. We do not know yet which strategy or strategies worked best. We all must work as a team to give an adequate response to this pandemic. We have just one world and one health. Nobody will be safe until everybody is safe.
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Affiliation(s)
- Anna Vilella
- Preventive Medicine and Epidemiology Department, Hospital Clínic-Universitat de Barcelona-ISGlobal, Barcelona, Spain.
| | - Antoni Trilla
- Preventive Medicine and Epidemiology Department, Hospital Clínic-Universitat de Barcelona-ISGlobal, Barcelona, Spain
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17
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Sisó-Almirall A, Brito-Zerón P, Conangla Ferrín L, Kostov B, Moragas Moreno A, Mestres J, Sellarès J, Galindo G, Morera R, Basora J, Trilla A, Ramos-Casals M. Long Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management. Int J Environ Res Public Health 2021; 18:4350. [PMID: 33923972 PMCID: PMC8073248 DOI: 10.3390/ijerph18084350] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/02/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023]
Abstract
Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The growing number of patients worldwide will have an impact on health systems. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors' clinical experience. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups.
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Affiliation(s)
- Antoni Sisó-Almirall
- Permanent Board of the Catalan Society of Family and Community Medicine (CAMFiC), 08009 Barcelona, Spain; (L.C.F.); (J.M.)
- Primary Care Centre Les Corts, Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE), 08028 Barcelona, Spain;
- Primary Healthcare Transversal Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Pilar Brito-Zerón
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, 08036 Barcelona, Spain; (P.B.-Z.); (M.R.-C.)
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, 08034 Barcelona, Spain
- Department of Autoimmune Diseases, ICMiD, Hospital Clínic, 08036 Barcelona, Spain
| | - Laura Conangla Ferrín
- Permanent Board of the Catalan Society of Family and Community Medicine (CAMFiC), 08009 Barcelona, Spain; (L.C.F.); (J.M.)
| | - Belchin Kostov
- Primary Care Centre Les Corts, Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE), 08028 Barcelona, Spain;
- Primary Healthcare Transversal Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Department of Statistics and Operations Research, Universitat Politècnica de Catalunya (UPC), 08034 Barcelona, Spain
| | - Anna Moragas Moreno
- Jaume I Health Centre, Institut Català de la Salut, Universitat Rovira i Virgili, 43005 Tarragona, Spain;
| | - Jordi Mestres
- Permanent Board of the Catalan Society of Family and Community Medicine (CAMFiC), 08009 Barcelona, Spain; (L.C.F.); (J.M.)
| | | | - Gisela Galindo
- Permanent Board of the Spanish Society of Family and Community Medicine (semFYC), 08009 Barcelona, Spain;
| | - Ramon Morera
- Board of Spanish Society of Managers of Primary Care (SEDAP), 28026 Madrid, Spain;
| | | | - Antoni Trilla
- Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain;
| | - Manuel Ramos-Casals
- Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, 08036 Barcelona, Spain; (P.B.-Z.); (M.R.-C.)
- Department of Autoimmune Diseases, ICMiD, Hospital Clínic, 08036 Barcelona, Spain
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18
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Pou N, Peix T, Trias S, Trilla A, Varela P, Martínez G, Castells A. [Management of elective surgical activity in a tertiary hospital during the SARS-CoV-2 pandemic]. J Healthc Qual Res 2021; 36:136-141. [PMID: 33727004 PMCID: PMC7874944 DOI: 10.1016/j.jhqr.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/15/2020] [Accepted: 01/20/2021] [Indexed: 12/27/2022]
Abstract
Introducción Durante la pandemia por SARS-CoV-2 la actividad quirúrgica electiva se redujo a su mínima expresión. A medida que disminuyeron tanto el número de casos, como las necesidades de hospitalización para esta patología creímos oportuno proceder a recuperar progresivamente la actividad quirúrgica programada. El presente trabajo describe como, aún con el estado de alarma vigente, pudimos prácticamente normalizar dicha actividad en pocas semanas. Metodología Dos semanas antes de la intervención quirúrgica, se contactó telefónicamente con los pacientes incluidos en las listas de espera. Tras comprobar su estado de salud y manifestar su deseo de ser intervenidos quirúrgicamente se les proporcionaron recomendaciones para disminuir el riesgo de infección por coronavirus. Asimismo, se estableció un circuito exclusivo para llevar a cabo, 48 horas antes de la intervención, la detección de SARS-CoV-2 mediante reacción en cadena de la polimerasa (PCR) de exudado nasofaríngeo. Los resultados fueron valorados por cada servicio quirúrgico y el de anestesiología. Además, los profesionales del Área Quirúrgica asintomáticos podían someterse a un cribado semanal para la detección de coronavirus, según las recomendaciones de Salud Laboral. Resultados En plena pandemia, la actividad quirúrgica electiva se redujo un 85%. A partir de la semana del 13 de abril, se fueron recuperando los quirófanos disponibles, lo que permitió recobrar la práctica total de la actividad quirúrgica la semana del 25 de mayo. Conclusiones La creación de circuitos y procedimientos para agilizar la actividad quirúrgica, aún en plena vigencia del estado de alarma, nos ha permitido, en pocas semanas, recuperar la práctica total de la misma.
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Affiliation(s)
- N Pou
- Dirección del Área Quirúrgica, Hospital Clínico de Barcelona, Barcelona, España.
| | - T Peix
- Dirección del Área Quirúrgica, Hospital Clínico de Barcelona, Barcelona, España
| | - S Trias
- Dirección del Área Quirúrgica, Hospital Clínico de Barcelona, Barcelona, España
| | - A Trilla
- Servició de Medicina Preventiva, Hospital Clínico de Barcelona, Barcelona, España
| | - P Varela
- Dirección para las Personas, Hospital Clínico de Barcelona, Barcelona, España
| | - G Martínez
- Dirección de Enfermería, Hospital Clínico de Barcelona, Barcelona, España
| | - A Castells
- Dirección Médica, Hospital Clínico de Barcelona, Barcelona, España
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19
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Moncunill G, Mayor A, Santano R, Jiménez A, Vidal M, Tortajada M, Sanz S, Méndez S, Llupià A, Aguilar R, Alonso S, Barrios D, Carolis C, Cisteró P, Chóliz E, Cruz A, Fochs S, Jairoce C, Hecht J, Lamoglia M, Martínez MJ, Moreno J, Mitchell RA, Ortega N, Pey N, Puyol L, Ribes M, Rosell N, Figueroa-Romero A, Sotomayor P, Torres S, Williams S, Barroso S, Vilella A, Trilla A, Varela P, Dobaño C, Garcia-Basteiro AL. SARS-CoV-2 Seroprevalence and Antibody Kinetics Among Health Care Workers in a Spanish Hospital After 3 Months of Follow-up. J Infect Dis 2021; 223:62-71. [PMID: 33175145 PMCID: PMC7717341 DOI: 10.1093/infdis/jiaa696] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/29/2020] [Indexed: 01/01/2023] Open
Abstract
Background At the COVID-19 spring 2020 pandemic peak in Spain, prevalence of SARS-CoV-2 infection in a cohort of 578 randomly selected health care workers (HCWs) from Hospital Clínic de Barcelona was 11.2%. Methods A follow-up survey 1 month later (April-May 2020) measured infection by rRT-PCR and IgM, IgA, and IgG to the receptor-binding domain of the spike protein by Luminex. Antibody kinetics, including IgG subclasses, was assessed until month 3. Results At month 1, the prevalence of infection measured by rRT-PCR and serology was 14.9% (84/565) and seroprevalence 14.5% (82/565). We found 25 (5%) new infections in 501 participants without previous evidence of infection. IgM, IgG, and IgA levels declined in 3 months (antibody decay rates 0.15 [95% CI, .11–.19], 0.66 [95% CI, .54–.82], and 0.12 [95% CI, .09–.16], respectively), and 68.33% of HCWs had seroreverted for IgM, 3.08% for IgG, and 24.29% for IgA. The most frequent subclass responses were IgG1 (highest levels) and IgG2, followed by IgG3, and only IgA1 but no IgA2 was detected. Conclusions Continuous and improved surveillance of SARS-CoV-2 infections in HCWs remains critical, particularly in high-risk groups. The observed fast decay of IgA and IgM levels has implications for seroprevalence studies using these isotypes.
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Affiliation(s)
- Gemma Moncunill
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Sergi Sanz
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain.,Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Méndez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Carlo Carolis
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Pau Cisteró
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Eugenia Chóliz
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Angeline Cruz
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Silvia Fochs
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Jochen Hecht
- Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Montserrat Lamoglia
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Faculty of Health Sciences of Blanquerna, Universitat Ramon Llull de Barcelona, Barcelona, Spain
| | - Mikel J Martínez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Department of Microbiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Javier Moreno
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Natalia Ortega
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Nuria Pey
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribes
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Neus Rosell
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | | | - Patricia Sotomayor
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sara Torres
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sarah Williams
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sonia Barroso
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Varela
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain
| | - Alberto L Garcia-Basteiro
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Spanish Consortium for Research in Epidemiology and Public Health, Madrid, Spain.,International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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20
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Garcia-Basteiro AL, Moncunill G, Tortajada M, Vidal M, Guinovart C, Jiménez A, Santano R, Sanz S, Méndez S, Llupià A, Aguilar R, Alonso S, Barrios D, Carolis C, Cisteró P, Chóliz E, Cruz A, Fochs S, Jairoce C, Hecht J, Lamoglia M, Martínez MJ, Mitchell RA, Ortega N, Pey N, Puyol L, Ribes M, Rosell N, Sotomayor P, Torres S, Williams S, Barroso S, Vilella A, Muñoz J, Trilla A, Varela P, Mayor A, Dobaño C. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun 2020; 11:3500. [PMID: 32641730 PMCID: PMC7343863 DOI: 10.1038/s41467-020-17318-x] [Citation(s) in RCA: 264] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/19/2020] [Indexed: 01/19/2023] Open
Abstract
Health care workers (HCW) are a high-risk population to acquire SARS-CoV-2 infection from patients or other fellow HCW. This study aims at estimating the seroprevalence against SARS-CoV-2 in a random sample of HCW from a large hospital in Spain. Of the 578 participants recruited from 28 March to 9 April 2020, 54 (9.3%, 95% CI: 7.1-12.0) were seropositive for IgM and/or IgG and/or IgA against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) was 11.2% (65/578, 95% CI: 8.8-14.1). Among those with evidence of past or current infection, 40.0% (26/65) had not been previously diagnosed with COVID-19. Here we report a relatively low seroprevalence of antibodies among HCW at the peak of the COVID-19 epidemic in Spain. A large proportion of HCW with past or present infection had not been previously diagnosed with COVID-19, which calls for active periodic rRT-PCR testing in hospital settings.
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Affiliation(s)
- Alberto L Garcia-Basteiro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sergi Sanz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Méndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Carlo Carolis
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Eugenia Chóliz
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Angeline Cruz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Silvia Fochs
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Jochen Hecht
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Montserrat Lamoglia
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Faculty of Health Sciences of Blanquerna, Universitat Ramon Llull de Barcelona, Barcelona, Spain
| | - Mikel J Martínez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Microbiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Natalia Ortega
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Nuria Pey
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Ribes
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Neus Rosell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Sara Torres
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sarah Williams
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sonia Barroso
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - José Muñoz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Varela
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Grau JJ, Caballero M, Garrido C, Canalda S, Trilla A. Neck mass and tracheostomy in a young lady depicted by Piero di Cosimo. Hormones (Athens) 2020; 19:261-264. [PMID: 31696448 DOI: 10.1007/s42000-019-00146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
Among surgical procedures currently in use, tracheostomy has a particularly long history. The first written description of the procedure is due to Brasavola, and dates from 1546. Piero di Cosimo (1462-1522) was an early Renaissance painter who painted a work traditionally known as Cephalus and Procris or The Death of Procris (1495-1500). In this painting, a vertical tracheostomy can be observed in a young woman lying on the ground. A giant mass can be seen in the lower left neck with superficial venous vessels, suggesting a thyroid malignancy. This appears to be the first detailed depiction of a malignant cervical mass and a possibly therapeutic tracheostomy. We discuss the clinical differential diagnosis and also make some comments from an art history perspective.
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Affiliation(s)
- Juan J Grau
- Medical Oncology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel Street 170, 08036, Barcelona, Spain.
| | - Miguel Caballero
- Head and Neck Surgery Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Cristina Garrido
- Art History Department, University of Barcelona, Barcelona, Spain
| | - Sílvia Canalda
- Art History Department, University of Barcelona, Barcelona, Spain
| | - Antoni Trilla
- Epidemiology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
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Sainz-de-la-Maza M, Adan A, Ruiz I, Beltran E, Yago I, Jimenez R, Gomez Á, Martin A, Trilla A. Quality standards for Comprehensive Care Units for patients with uveitis of the Spanish Society of Ocular Inflammation (SEIOC). Med Clin (Barc) 2020; 156:76-80. [PMID: 32444325 DOI: 10.1016/j.medcli.2020.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | - Alfredo Adan
- Instituto Clínico de Oftalmología, Hospital Clínic, Barcelona, España
| | - Iona Ruiz
- Departamento de Medicina Interna, Hospital de Cruces, Bilbao, España
| | - Emma Beltran
- Departamento de Reumatología, Hospital del Mar, Barcelona, España
| | - Inés Yago
- Departamento de Oftalmología, Hospital Virgen de la Arrixaca, Murcia, España
| | - Rosa Jimenez
- Departamento de Oftalmología, Hospital Virgen de la Salud, Toledo, España
| | - Ángela Gomez
- Departamento de Oftalmología, Hospital de Araba, Vitoria, España
| | - Ana Martin
- Departamento de Enfermería, Hospital General, Valencia, España
| | - Antoni Trilla
- Departamento de Medicina Preventiva y Epidemiología, Hospital Clínic, Barcelona, España
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García-Basteiro AL, Chaccour C, Guinovart C, Llupià A, Brew J, Trilla A, Plasencia A. Monitoring the COVID-19 epidemic in the context of widespread local transmission. Lancet Respir Med 2020; 8:440-442. [PMID: 32247325 PMCID: PMC7198847 DOI: 10.1016/s2213-2600(20)30162-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 01/14/2023]
Affiliation(s)
- Alberto L García-Basteiro
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain; Centro de Investigação em Saude de Manhiça, Maputo, Mozambique.
| | - Carlos Chaccour
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain; Centro de Investigação em Saude de Manhiça, Maputo, Mozambique
| | - Caterina Guinovart
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain
| | - Anna Llupià
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain; Preventive Medicine and Epidemiology Department, Hospital Clínic, Barcelona, Spain
| | | | - Antoni Trilla
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain; Preventive Medicine and Epidemiology Department, Hospital Clínic, Barcelona, Spain
| | - Antoni Plasencia
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona 08036, Spain
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24
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Affiliation(s)
- Antoni Trilla
- Hospital Clínic de Barcelona, Universidad de Barcelona, ISGlobal, Barcelona, Spain
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25
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Affiliation(s)
- Antoni Trilla
- Hospital Clínic de Barcelona, Universidad de Barcelona, ISGlobal, Barcelona, España.
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27
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Bellver M, Del Rio L, Jovell E, Drobnic F, Trilla A. Bone mineral density and bone mineral content among female elite athletes. Bone 2019; 127:393-400. [PMID: 31271933 DOI: 10.1016/j.bone.2019.06.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/29/2019] [Accepted: 06/29/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Exercise is a protective factor for the appearance of osteoporosis, but not all physical activities have the same effect on bones. Low-impact sports, like swimming, may a have a negative or no effect. The aim of the present study is to evaluate bone mineral density (BMD, g/cm2) and bone mineral content (BMC, kg) among female high performance athletes from aquatic and non-aquatic sports and to assess possible differences with sedentary controls. METHODS Participants are elite female athletes over 18 years, from the Spanish Olympic teams, with at least 12-15 h of weekly training on aquatic sports: swimming (n = 19), synchronized swimming (n = 24) and water polo (n = 14), and elite female athletes from non-aquatic sports: professional football players of Futbol Club Barcelona team (n = 92), Spanish national volleyball (n = 26) and field hockey teams (n = 29) as well as sedentary controls (n = 126). Bone mineral density scans was performed using dual-energy X-ray absorptiometry for whole body, segmental analysis, proximal femur and lumbar spine. RESULTS Non-aquatic female athletes have total and segments BMC and BMD values higher than those of aquatic athletes, that in turn show similar BMD values compared to controls. BMD in lumbar spine and proximal femur was higher in non-aquatic sports compared to aquatic sports athletes and both were higher than controls. CONCLUSION BMD is not negatively compromised by the practice of aquatic sports at a highly competitive level. However, non-aquatic female athletes show a higher BMD. Time training out of the water improves BMD. Our findings suggest that swimming and synchronized swimming should be combined with weight-bearing, impact or strength activities, as they do not seem to be osteogenic sports.
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Affiliation(s)
- Montse Bellver
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/n, 08173 Sant Cugat del Valles, Barcelona, Spain; Consorcio Sanitario de Terrassa, Carretera de Torrebonica s/n, 08227 Terrassa, Spain.
| | - Luis Del Rio
- CETIR Centre Medic, c/Londres, 6, 08029 Barcelona, Spain
| | - Esther Jovell
- Consorcio Sanitario de Terrassa, Carretera de Torrebonica s/n, 08227 Terrassa, Spain
| | - Franchek Drobnic
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/n, 08173 Sant Cugat del Valles, Barcelona, Spain; Futbol Club Barcelona (FCB), Av. Onze de Setembre, s/n, 08970 Sant Joan Despí, Barcelona, Spain
| | - Antoni Trilla
- Hospital Clínic, University of Barcelona, c/Villarroel 170, 08036 Barcelona, (Spain)
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Trilla A. Pharmacists and the reluctance to vaccines. Farm Hosp 2019; 43:149-150. [PMID: 31469626 DOI: 10.7399/fh.11286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- Antoni Trilla
- Preventive Medicine and Epidemiology, Clínic Hospital, Barcelona.
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Affiliation(s)
- Federico Martinón-Torres
- Servicio de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo de Genética, Vacunas, Infecciones y Pediatría, Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, España.
| | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clinic - Universidad de Barcelona - ISGlobal
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30
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Trilla A, Aldea M. La vacunación de la gripe en el personal sanitario: auctoritas y potestas. Med Clin (Barc) 2019; 152:59-61. [DOI: 10.1016/j.medcli.2018.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
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31
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Serra-Picamal X, Roman R, Escarrabill J, García-Altés A, Argimón JM, Soler N, Faner R, Carbonell EM, Trilla A, Agusti A. Hospitalizations due to exacerbations of COPD: A big data perspective. Respir Med 2018; 145:219-225. [DOI: 10.1016/j.rmed.2018.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/12/2018] [Indexed: 01/08/2023]
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32
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Carvalho E, Castro P, León E, Del Río A, Crespo F, Trigo L, Fernández S, Trilla A, Varela P, Nicolás JM. Multi-professional simulation and risk perception of health care workers caring for Ebola-infected patients. Nurs Crit Care 2018; 24:256-262. [PMID: 30460729 DOI: 10.1111/nicc.12396] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 09/23/2018] [Accepted: 09/30/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Treatment of infections that require high-level isolation can cause anxiety and fear among health care workers. Adequate and complete multi-professional simulation-based training could reduce those feelings and improve patient care. OBJECTIVE The purpose of this study was to assess the impact of multi-professional simulation-based training on the risk perception and preparedness of health care workers (registered nurses, doctors and ancillary staff) who care for patients assessed to be at risk or confirmed to have Ebola, level 3-4 biohazard. METHODS A prospective before-after study was designed. Health care workers who participated in a multi-professional simulation training course to improve the care of patients potentially infected with Level 3 and 4 biohazards were evaluated about their risk perception. The training was based on clinical scenarios. The evaluation was conducted using questionnaire based on Likert scale. After the training, a satisfaction survey about the most important aspects of the course was also conducted. RESULTS Fifty-eight health care workers participated in the training course, 22 of whom were registered nurses. Participants presented positive changes after the training, increasing their sense of security, predisposition and confidence (p < 0.000001 for all). CONCLUSION Multi-professional simulation-based training significantly improves the perception of safety and preparedness of health care workers regarding the care of patients potentially infected with Ebola virus and other Level 3-4 biohazards. RELEVANCE TO CLINICAL PRACTICE The implementation of educational training strategies - such as simulations - is beneficial in improving the capacity of response and coping, as well as in reducing feelings of fear and insecurity.
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Affiliation(s)
- Eva Carvalho
- Clinical Simulation Laboratory, School of Medicine, University of Barcelona, Barcelona, Spain.,CAPES Foundation Ministry of Education of Brazil, Brasília, Brazil
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, Spain.,IDIBAPS, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Esther León
- Clinical Simulation Laboratory, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ana Del Río
- Infectious Diseases Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Félix Crespo
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Laura Trigo
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Sara Fernández
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Antoni Trilla
- IDIBAPS, Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Department of Preventive Medicine and Epidemiology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Pilar Varela
- Department of Human Resources, Hospital Clinic of Barcelona, Barcelona, Spain.,Department of Occupational Hazard Prevention, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Jose Maria Nicolás
- IDIBAPS, Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Medical Intensive Care Unit, Hospital Clinic of Barcelona, Barcelona, Spain
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Trilla A. Vacuna intradérmica de la gripe (microagujas solubles): un parche, una solución…. Med Clin (Barc) 2018; 150:307-309. [DOI: 10.1016/j.medcli.2017.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 11/25/2022]
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34
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Trilla A. Flu transmission in emergency departments. Emergencias 2018; 30:5-6. [PMID: 29437303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic, Universidad de Barcelona - ISGlobal, Barcelona, España
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35
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Rubio E, Martínez MJ, Gonzalo V, Barrachina J, Torner N, Martínez AI, Jané M, Vilella A, Del Rio A, Rodriguez-Valero N, Pinazo MJ, Muñoz J, Soriano A, Trilla A, Vila J, Marcos MÁ. Definitive diagnosis in suspected Middle East Respiratory Syndrome Coronavirus cases. J Travel Med 2018; 25:4711105. [PMID: 29232459 PMCID: PMC7107577 DOI: 10.1093/jtm/tax084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/16/2017] [Indexed: 01/23/2023]
Abstract
We evaluated the microbiological diagnosis in 14 patients with epidemiological and clinical suspicion of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) attended in a non-endemic area between June 2015 and January 2017. While no MERS-CoV was detected, other respiratory viruses were identified in 12 cases and Mycoplasma pneumoniae in 1 case.
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Affiliation(s)
- Elisa Rubio
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Miguel J Martínez
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Verónica Gonzalo
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Josep Barrachina
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Núria Torner
- Agencia de Salud Pública de Cataluña, Ciber de Epidemiología y Salud Pública CIBERESP, Spain
| | - Ana I Martínez
- Agencia de Salud Pública de Cataluña, Ciber de Epidemiología y Salud Pública CIBERESP, Spain
| | - Mireia Jané
- Agencia de Salud Pública de Cataluña, Ciber de Epidemiología y Salud Pública CIBERESP, Spain
| | - Anna Vilella
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.,Public Health Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ana Del Rio
- Department of Infectious Diseases, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Natalia Rodriguez-Valero
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.,Centre for Research in International Health (CRESIB), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maria Jesús Pinazo
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.,Centre for Research in International Health (CRESIB), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - José Muñoz
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.,Centre for Research in International Health (CRESIB), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Alex Soriano
- Department of Infectious Diseases, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Antoni Trilla
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain.,Public Health Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Vila
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Ma Ángeles Marcos
- Department of Clinical Mirobiology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
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Garrido JM, Sánchez-Moreno J, Vázquez M, Hidalgo D, Valentí M, Goikolea JM, Benabarre A, Ylla A, Grande I, Vieta E, Trilla A. Evaluation of Patient Satisfaction in a State Reference Center of Bipolar Disorder. J Behav Health Serv Res 2017; 46:319-329. [DOI: 10.1007/s11414-017-9561-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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37
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Pantoja P, Gomez-Junyent J, Serret N, Muñoz-Gutierrez J, Vilella A, Trilla A. Utility, feasibility and acceptance of an online platform for tropical diseases contact tracing. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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38
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Llupià A, Puig J, Mena G, Bayas JM, Trilla A. The social network around influenza vaccination in health care workers: a cross-sectional study. Implement Sci 2016; 11:152. [PMID: 27881186 PMCID: PMC5122207 DOI: 10.1186/s13012-016-0522-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Influenza vaccination coverage remains low among health care workers (HCWs) in many health facilities. This study describes the social network defined by HCWs’ conversations around an influenza vaccination campaign in order to describe the role played by vaccination behavior and other HCW characteristics in the configuration of the links among subjects. Methods This study used cross-sectional data from 235 HCWs interviewed after the 2010/2011 influenza vaccination campaign at the Hospital Clinic of Barcelona (HCB), Spain. The study asked: “Who did you talk to or share some activity with respect to the seasonal vaccination campaign?” Variables studied included sociodemographic characteristics and reported conversations among HCWs during the influenza campaign. Exponential random graph models (ERGM) were used to assess the role of shared characteristics (homophily) and individual characteristics in the social network around the influenza vaccination campaign. Results Links were more likely between HCWs who shared the same professional category (OR 3.13, 95% CI = 2.61–3.75), sex (OR 1.34, 95% CI = 1.09–1.62), age (OR 0.7, 95% CI = 0.63–0.78 per decade of difference), and department (OR 11.35, 95% CI = 8.17–15.64), but not between HCWs who shared the same vaccination behavior (OR 1.02, 95% CI = 0.86–1.22). Older (OR 1.26, 95% CI = 1.14–1.39 per extra decade of HCW) and vaccinated (OR 1.32, 95% CI = 1.09–1.62) HCWs were more likely to be named. Conclusions This study finds that there is no homophily by vaccination status in whom HCWs speak to or interact with about a workplace vaccination promotion campaign. This result highlights the relevance of social network analysis in the planning of health promotion interventions. Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0522-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Llupià
- Hospital Clínic-Universitat de Barcelona-ISGlobal, C/ Villarroel 170, 08036, Barcelona, Spain.
| | - Joaquim Puig
- Department of Mathematics, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain
| | - Guillermo Mena
- Hospital Clínic-Universitat de Barcelona-ISGlobal, C/ Villarroel 170, 08036, Barcelona, Spain
| | - José M Bayas
- Hospital Clínic-Universitat de Barcelona-ISGlobal, C/ Villarroel 170, 08036, Barcelona, Spain
| | - Antoni Trilla
- Hospital Clínic-Universitat de Barcelona-ISGlobal, C/ Villarroel 170, 08036, Barcelona, Spain
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Miró O, Burbano Santos P, Trilla A, Casademont J, Fernandez Pérez C, Martín-Sánchez F. [Analysis of scientific production and bibliometric impact of a group of Spanish clinical researchers]. An Sist Sanit Navar 2016; 39:213-25. [PMID: 27599949 DOI: 10.23938/assn.0272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND To study the behaviour of several indicators of scientific production and repercussion in a group of Spanish clinical researchers and to evaluate their possible utility for interpreting individual or collective scientific pathways. METHOD We performed a unicentric, ecological pilot study involving a group of physicians with consolidated research experience. From the Science Citation Index Expanded (SCI-Expanded) database, we obtained the number of publications of each author (indicator of production) and the number of citations, impact factor and h index (indicators of repercussion). These indicators were calculated individually for each of the years of research experience and we assessed the relationship between the experience of the researcher and the value of the indicator achieved, the relationship between these indicators themselves, and their temporal evolution, both individually and for the entire group. RESULTS We analysed 35 researchers with a research experience of 28.4 (9.6) years. The h index showed the lowest coefficient of variance. The relationship between the indicators and research experience was significant, albeit modest (R2 between 0.15-0.22). The 4 indicators showed good correlations. The temporal evolution of the indicators, both individual and collective, adjusted better to a second grade polynomial than a linear function: individually, all the authors obtained R2>0.90 in all the indicators; together the best adjustment was produced with the h index (R2=0.61). Based on the indicator used, substantial variations may be produced in the researchers' ranking. CONCLUSIONS A model of the temporal evolution of the indicators of production and repercussion can be described in a relatively homogeneous sample of researchers and the h index seems to demonstrate certain advantages compared to the remaining indicators. This type of analysis could become a predictive tool of performance to be achieved not only for a particular researcher, but also for a homogeneous group of resear-chers corresponding to a specific scientific niche.
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Affiliation(s)
- O Miró
- Área de Urgencias, Hospital Clinic, Barcelona, 08036, Spain.
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Trilla A, Gatell JM, Mensa J, Latorre X, Almela M, Soriano E, Jimenez de Anta MT, San Miguel JG. Risk Factors for Nosocomial Bacteremia in a Large Spanish Teaching Hospital: A Case-Control Study. Infect Control Hosp Epidemiol 2016. [DOI: 10.2307/30146931] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AbstractObjective:Identify independent risk factors associated with the development of nosocomial bacteremia.Design:Exploratory, unmatched, case-control study.Setting:A 970-bed Spanish university hospital.Patients:All non-neutropenic adult patients with nosocomial bacteremia admitted during a 12-month period were eligible as cases. All adult non-neutropenic patients without nosocomial bacteremia were eligible as controls.Results:The incidence of bacteremia in the study population was 6.9/1000 admissions/ year. One hundred eighty cases and 180 controls were analyzed. Multivariate analysis (stepwise logistic regression techniques) identified seven risk factors independently associated with nosocomial bacteremia: age above 65 years; prior admission (within six months) to the hospital; underlying diseases that were ultimately or rapidly fatal; indwelling urethral catheter in place for more than three days; intravenous central lines or peripheral venous lines (if in place for more than four days); “high-risk surgery” (i.e., lower abdominal, cardiac or thoracic); and admission to an intensive care unit.Conclusions:Although five variables are not modifiable, the remaining two relate to the use and duration of devices. Our data give strong support for the value of testing strict guidelines for limiting vascular catheters and evaluating the need for prolonged urethral catheterization. If effective infection control measures are identified, we could target hospital-wide surveillance to patients whose risk factors are amenable to intervention.
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Affiliation(s)
- Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiologia, Hospital Clinic de Barcelona, Profesor de Salud Pública, Universidad de Barcelona, Research Professor-ISGlobal.
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Affiliation(s)
- Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic; Departamento de Salud Pública, Universidad de Barcelona; Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, España.
| | - Anna Vilella
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic; Departamento de Salud Pública, Universidad de Barcelona; Instituto de Salud Global de Barcelona (ISGlobal), Barcelona, España
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Bori G, Gómez-Durán E, Combalia A, Trilla A, Prat A, Bruguera M, Arimany-Manso J. Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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45
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Velasco Munoz C, Sequera VG, Vilajeliu A, Aldea M, Mena G, Quesada S, Varela P, Olivé V, Bayas JM, Trilla A. Sistema de autodeclaración de acontecimientos adversos y cobertura de vacunación antigripal en profesionales sanitarios en un hospital universitario de tercer nivel. Med Clin (Barc) 2016; 146:155-9. [DOI: 10.1016/j.medcli.2015.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/27/2015] [Accepted: 11/05/2015] [Indexed: 10/22/2022]
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Soto M, Sampietro-Colom L, Vilella A, Pantoja E, Asenjo M, Arjona R, Hurtado JC, Trilla A, Alvarez-Martínez MJ, Mira A, Vila J, Marcos MA. Economic Impact of a New Rapid PCR Assay for Detecting Influenza Virus in an Emergency Department and Hospitalized Patients. PLoS One 2016; 11:e0146620. [PMID: 26788921 PMCID: PMC4720278 DOI: 10.1371/journal.pone.0146620] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/18/2015] [Indexed: 12/27/2022] Open
Abstract
Seasonal influenza causes significant morbidity and mortality and has a substantial economic impact on the healthcare system. The main objective of this study was to compare the cost per patient for a rapid commercial PCR assay (Xpert® Flu) with an in-house real-time PCR test for detecting influenza virus. Community patients with influenza like-illness attending the Emergency Department (ED) as well as hospitalized patients in the Hospital Clínic of Barcelona were included. Costs were evaluated from the perspective of the hospital considering the use of resources directly related to influenza testing and treatment. For the purpose of this study, 366 and 691 patients were tested in 2013 and 2014, respectively. The Xpert® Flu test reduced the mean waiting time for patients in the ED by 9.1 hours and decreased the mean isolation time of hospitalized patients by 23.7 hours. This was associated with a 103€ (or about $113) reduction in the cost per patient tested in the ED and 64€ ($70) per hospitalized patient. Sensitivity analyses showed that Xpert® Flu is likely to be cost-saving in hospitals with different contexts and prices.
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Affiliation(s)
- Marcelo Soto
- Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain
- * E-mail:
| | - Laura Sampietro-Colom
- Health Technology Assessment Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Anna Vilella
- Public Health Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Efraín Pantoja
- Public Health Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - María Asenjo
- Emergency Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ruth Arjona
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
- Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Juan Carlos Hurtado
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
- Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antoni Trilla
- Public Health Department, Hospital Clínic, University of Barcelona, Barcelona, Spain
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
| | - Míriam José Alvarez-Martínez
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
- Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Aurea Mira
- Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Vila
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
- Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - María Angeles Marcos
- ISGlobal Barcelona Institute for Global Health, Barcelona, Spain
- Department of Clinical Microbiology, Biomedical Diagnostic Centre (CDB), Hospital Clínic, University of Barcelona, Barcelona, Spain
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Bori G, Gómez-Durán EL, Combalia A, Trilla A, Prat A, Bruguera M, Arimany-Manso J. [Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 60:89-98. [PMID: 26769486 DOI: 10.1016/j.recot.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 10/20/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022] Open
Abstract
The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients.
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Affiliation(s)
- G Bori
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - E L Gómez-Durán
- Servicio de Responsabilidad Profesional, Colegio Oficial de Médicos de Barcelona, Consejo General de Colegios de Médicos de Cataluña, Barcelona, España; Grupo Hestia, Barcelona, España; Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Barcelona, España.
| | - A Combalia
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - A Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España; Unidad de Medicina Legal, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España
| | - A Prat
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España; Unidad de Medicina Legal, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España
| | - M Bruguera
- Servicio de Responsabilidad Profesional, Colegio Oficial de Médicos de Barcelona, Consejo General de Colegios de Médicos de Cataluña, Barcelona, España
| | - J Arimany-Manso
- Servicio de Responsabilidad Profesional, Colegio Oficial de Médicos de Barcelona, Consejo General de Colegios de Médicos de Cataluña, Barcelona, España; Unidad de Medicina Legal, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España
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48
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Piron M, Plasencia A, Fleta-Soriano E, Martinez A, Martinez JP, Torner N, Sauleda S, Meyerhans A, Escalé J, Trilla A, Pumarola T, Martinez MJ. Low Seroprevalence of West Nile Virus in Blood Donors from Catalonia, Spain. Vector Borne Zoonotic Dis 2015; 15:782-4. [PMID: 26581013 DOI: 10.1089/vbz.2015.1787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
West Nile virus (WNV) is an emerging arbovirus first recognized in Europe in the 1950s. Since then, outbreaks have been reported in several European countries. In 2010, the first WNV outbreak was recorded in Spain, affecting the southern part of the country. We conducted a seroprevalence study in the Catalonia region (northeastern Spain), an area considered at high risk of arbovirus transmission. A total of 800 serum samples from blood donors were collected and screened for antibodies against WNV by enzyme-linked immunosorbent assay (ELISA) and confirmed by a microneutralization assay. More than 50 samples tested positive by ELISA, but only one sample contained neutralizing antibodies against WNV and was obtained from a donor native of Pakistan. The low seroprevalence detected may serve as reference baseline data for monitoring WNV activity in our region in future years.
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Affiliation(s)
- Maria Piron
- 1 Transfusion Safety Laboratory, Catalonian Blood and Tissue Bank (BST) , Barcelona, Spain
| | - Antoni Plasencia
- 2 ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona , Barcelona, Spain
| | - Eric Fleta-Soriano
- 3 Infection Biology Group, Department of Experimental and Health Sciences, Universitat Pompeu Fabra , Barcelona, Spain
| | - Ana Martinez
- 4 Public Health Agency of Catalonia, Generalitat of Catalonia , Barcelona, Spain
| | - Javier P Martinez
- 3 Infection Biology Group, Department of Experimental and Health Sciences, Universitat Pompeu Fabra , Barcelona, Spain
| | - Nuria Torner
- 4 Public Health Agency of Catalonia, Generalitat of Catalonia , Barcelona, Spain
| | - Silvia Sauleda
- 1 Transfusion Safety Laboratory, Catalonian Blood and Tissue Bank (BST) , Barcelona, Spain
| | - Andreas Meyerhans
- 3 Infection Biology Group, Department of Experimental and Health Sciences, Universitat Pompeu Fabra , Barcelona, Spain .,5 Institució Catalana de Recerca i Estudis Avançats (ICREA) , Barcelona, Spain
| | - Josefina Escalé
- 6 Department of Clinical Microbiology, Hospital Clínic , Barcelona, Spain
| | - Antoni Trilla
- 7 Department of Preventive Medicine, Hospital Clínic , Barcelona, Spain
| | - Tomás Pumarola
- 8 Microbiology Department, Hospital Universitario Vall d'Hebron , Barcelona, Spain
| | - Miguel Julian Martinez
- 2 ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona , Barcelona, Spain .,6 Department of Clinical Microbiology, Hospital Clínic , Barcelona, Spain
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Garin N, Velasco C, De Pourcq JT, Lopez B, Gutierrez MDM, Haro JM, Feliu A, Mangues MA, Trilla A. Corrigendum: Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations. Front Microbiol 2015; 6:1229. [PMID: 26579117 PMCID: PMC4630915 DOI: 10.3389/fmicb.2015.01229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/20/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Noe Garin
- Pharmacy Department, Institut d'Investigacions Biomèdiques Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona Barcelona, Spain ; Research and Development Unit, Parc Sanitari Sant Joan de Déu, University of Barcelona Barcelona, Spain ; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III Madrid, Spain
| | - Cesar Velasco
- Department of Preventive Medicine and Epidemiology, Hospital Clinic-IDIBAPS, University of Barcelona Barcelona, Spain ; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona Barcelona, Spain
| | - Jan T De Pourcq
- Pharmacy Department, Institut d'Investigacions Biomèdiques Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Belen Lopez
- Pharmacy Department, Hospital del Mar - Parc de Salut Mar Barcelona, Spain
| | | | - Josep M Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, University of Barcelona Barcelona, Spain ; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III Madrid, Spain
| | - Anna Feliu
- Pharmacy Department, Institut d'Investigacions Biomèdiques Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Maria A Mangues
- Pharmacy Department, Institut d'Investigacions Biomèdiques Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Antoni Trilla
- Department of Preventive Medicine and Epidemiology, Hospital Clinic-IDIBAPS, University of Barcelona Barcelona, Spain ; ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona Barcelona, Spain
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Velasco C, Vinasco AM, Trilla A. [Immigrant perceptions of the Spanish National Healthcare System and its services]. Aten Primaria 2015; 48:149-58. [PMID: 26388468 PMCID: PMC6877837 DOI: 10.1016/j.aprim.2015.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 01/13/2015] [Accepted: 01/22/2015] [Indexed: 12/03/2022] Open
Abstract
Objetivo Conocer la percepción, la utilización y la satisfacción en relación con los servicios sanitarios de un grupo de inmigrantes residentes en Barcelona en relación con su género, procedencia y clase social. Diseño Estudio descriptivo transversal. Emplazamiento Ciudad de Barcelona, España. Participantes Doscientos veinticinco inmigrantes usuarios de servicios sociosanitarios residentes en la ciudad de Barcelona, de junio a julio del 2012. Mediciones principales Se analizaron el nivel de acceso y la relación de los inmigrantes residentes con el sistema sanitario público, a partir de una encuesta realizada en población inmigrante. Las respuestas obtenidas fueron analizadas en relación con los ejes: género, edad, clase social, salud autopercibida, país de origen, tiempo desde la llegada y estado civil. Resultados El 89% de la población encuestada dijo «haber sido tratada con respeto» al acudir a los servicios de salud, siendo considerado este el aspecto más importante. Sin embargo, el 59,4% refirió una percepción de «discriminación hacia los inmigrantes» y el 68,4% manifestó que las diferencias culturales afectan «total o parcialmente» la calidad de la atención recibida. Para el 66,7% la atención sanitaria recibida en Barcelona es mejor que la recibida en su país de origen, principalmente por su calidad científico-técnica y por el acceso universal. Conclusiones Pese a la buena valoración del sistema sanitario público universal este estudio mostró deficiencias del sistema en cuanto a los aspectos psicosociales de la atención sanitaria a inmigrantes en Barcelona. Es necesario profundizar en el estudio de los conocimientos y percepciones de colectivos minoritarios en el contexto actual.
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Affiliation(s)
- César Velasco
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Barcelona, España/ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic, Barcelona, España.
| | - Ana Maria Vinasco
- Universidad Barcelona, Máster de Gestión Hospitalaria y de Centros Sanitarios, Barcelona, España
| | - Antoni Trilla
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Barcelona, España/ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic, Barcelona, España
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