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Guiriguet C, Alberny M, Mora N, Rebagliato O, Roca C, Fina F, Fàbregas M, Benítez M, de la Poza M, Medina M, Flayeh S, Pedrazas D, Sabatés M, Coma E. Sexually transmitted infections, the epidemic that persists after the COVID-19 pandemic: an analysis of the primary care electronic health records covering about 5 million people in Catalonia. BMC Prim Care 2024; 25:150. [PMID: 38704552 DOI: 10.1186/s12875-024-02395-4] [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] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 04/17/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The aim of our study is to analyse the trends in the diagnosis of sexually transmitted infections (STIs) during the COVID-19 pandemic. METHODS We conducted an observational retrospective population-based study using data from primary care electronic health records spanning from January 2016 to December 2022 (involving 5.1 million people older than 14 years). We described the daily number of new STI diagnoses from 2016 to 2022; as well as the monthly accumulation of new STI diagnoses for each year. We compared the monthly averages of new diagnoses in 2019, 2020, 2021 and 2022 using the T-test. Finally, we performed a segmented regression analysis of the daily number of STI diagnoses. RESULTS We analysed 200,676 new STI diagnoses. The number of diagnoses abruptly decreased coinciding with the lockdown. Overall in 2020, we observed a reduction of 15%, with higher reductions for specific STIs such as gonorrhoea (-21%), chlamydia (-24%), and HIV (-31%) compared to 2019. Following this drastic drop, which was temporarily associated with the lockdown, we observed a rapid rebound. In 2021, the number of STI diagnoses was similar to that of 2019. Notably, we found a considerable increase in 2022, particularly for non-specific STI, which lack laboratory confirmation (67% increase). HIV was the only STI with a reduction of up to -38% in diagnoses at the end of 2022 compared to 2019. CONCLUSIONS After a significant reduction in 2020, the number of STIs recorded in primary care rapidly rebounded, and the current trend is similar to that of 2019, except for HIV. These findings underscore the dynamic impact of the COVID-19 pandemic on STI diagnoses and highlight the importance of ongoing monitoring and public health interventions in the post-pandemic period.
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Affiliation(s)
- Carolina Guiriguet
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain.
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain.
- University of Barcelona, Barcelona, Spain.
| | - Mireia Alberny
- Medical Management of Primary Care Services, STI/HIV Area, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Oriol Rebagliato
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Carme Roca
- El Clot Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Mireia Fàbregas
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Mència Benítez
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Mariam de la Poza
- University of Barcelona, Barcelona, Spain
- Doctor Carles Riba Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Manuel Medina
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - Souhel Flayeh
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
| | - David Pedrazas
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Montserrat Sabatés
- Gotic Primary Care Centre, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Ermengol Coma
- Primary Care Services Information Systems (SISAP), Institut Català de La Salut (ICS), Gran Via de Les Corts Catalanes, 587. 08007, Barcelona, Spain
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Gual-Gonzalez L, Cantillo-Barraza O, Torres ME, Quintero-Vélez JC, Medina M, Self SCW, Nolan MS. Antibody Seroprevalence to Spotted Fever Group Rickettsiae in Miraflores, Colombia: A Cross-Sectional Study in Humans and Dogs. Am J Trop Med Hyg 2024:tpmd230593. [PMID: 38593790 DOI: 10.4269/ajtmh.23-0593] [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] [Received: 08/28/2023] [Accepted: 01/25/2024] [Indexed: 04/11/2024] Open
Abstract
Tick-borne disease burdens are increasing globally, impacting mostly rural and vulnerable communities. Among the most important emerging tick-borne pathogens are the Rickettsia species within the spotted fever group (SFGR) because of their genetic diversity and high lethality rate. Colombia is highly affected by SFGR despite not being reportable diseases; thus, research and clinical management are neglected. Although some departments have demonstrated high seroprevalence rates, in others, such as Boyacá Department, seroprevalence is unknown. Rickettsioses have not been described in Boyacá since 1943, and conversations with local physicians raised suspicions of recent undiagnosed disease compatible with rickettsiosis in some rural areas of the department, warranting epidemiological investigation. Using biobanked human and canine samples from a previous 2021 vector-borne disease study in Miraflores municipality, Boyacá, we had an opportunity to unearth SFGR's exposure in the region. Samples were evaluated using IgG indirect fluorescent assays against SFGR and complemented by survey questionnaires evaluating associated factors. Findings yielded first-time SFGR serological evidence in Boyacá with a 26.5% seroprevalence among dogs and a 20.4% among humans. Human and dog seroprevalences were positively associated, suggesting the presence of domestic transmission. Owning a greater number of domestic animals (prevalence ratio adjusted for all measured factors [aPR], 1.52) and living near crop fields (aPR, 7.77) were associated with an increased likelihood of household seropositivity. Our findings are consistent with the literature in Colombia, uncovering a suspected region where the disease is endemic. Future studies are warranted to continue defining high-risk areas to determine public health intervention plans.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - Omar Cantillo-Barraza
- Grupo Biología y Control Enfermedades Infecciosas, Universidad de Antioquia, Medellín, Colombia
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | | | - Manuel Medina
- Unidad de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Stella C W Self
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - Melissa S Nolan
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
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Sánchez A, Rodríguez O, Medina M, Vegas L, Couto F, Mogollon I, Inchausti C, Galvis L. Is YouTube a reliable tool for approaching robotic assisted transabdominal preperitoneal surgery? A critical review of the available resources. Cir Esp 2024; 102:188-193. [PMID: 38224772 DOI: 10.1016/j.cireng.2023.08.007] [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: 06/11/2023] [Accepted: 08/08/2023] [Indexed: 01/17/2024]
Abstract
INTRODUCTION The robotic transabdominal preperitoneal approach (rTAPP) is a relatively recent technique for the treatment of inguinal hernia. To achieve optimal results, the 10 golden rules described must be followed. Surgeons in training often review videos to familiarize themselves with new techniques, YouTube being one of the most used platforms. The objective of this study is to carry out an evaluation of the 10 most viewed videos on YouTube of inguinal hernia repair by transabdominal preperitoneal approach (rTAPP) to determine if the 10 golden rules are met. METHODS Identify and evaluate the 10 videos with the highest number of views related to rTAPP. Three experienced Surgeons evaluated compliance with the 10 golden rules using a Likert scale. Data were analyzed in Excel (Microsoft) and plotted with Tableau (Tableau Inc). The consistency between evaluators was determined using Cronbach's alpha, considering a value >0.7 acceptable. RESULTS The average overall evaluation was 3.63 with a range of 2.6 to 4.9. The scores related to compliance with the rules 1, 2, 9, 10 were satisfactory; on the other hand, rules 3, 4, 5, 7 and 8 were weak, particularly rule number 7. Internal consistency was observed between raters with a Cronbach's alpha of 0.98. CONCLUSIONS The lack of compliance with the 10 golden rules in most of the videos demonstrates that the use of videos (YouTube) is not an adequate resource for learning robot-assisted inguinal hernia cure.
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Affiliation(s)
- Alexis Sánchez
- Director Programa de Cirugía Robótica. Orlando Health, Orlando, USA
| | - Omaira Rodríguez
- Programa de Cirugía Robótica, Hospital de Clínicas Caracas. Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Manuel Medina
- Departamento de Cirugía, Hospital Universitario del Henares, Madrid, Spain
| | - Liumariel Vegas
- Departamento de Cirugía, Hospital de Linares, Linares, Chile
| | - Francisco Couto
- Cirujano General, Grupo de Cirugía General. Orlando Health, Orlando, USA
| | - Ivan Mogollon
- Research Fellow, Programa de Cirugía Robótica ORMC, Orlando Health, Orlando, EE.UU
| | - Cristina Inchausti
- Research Fellow, Programa de Cirugía Robótica ORMC, Orlando Health, Orlando, EE.UU.
| | - Luz Galvis
- Unidad de Cirugía Robótica e Invasión minima, Caracas, Venezuela
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Eichholz K, Fukazawa Y, Peterson CW, Haeseleer F, Medina M, Hoffmeister S, Duell DM, Varco-Merth BD, Dross S, Park H, Labriola CS, Axthelm MK, Murnane RD, Smedley JV, Jin L, Gong J, Rust BJ, Fuller DH, Kiem HP, Picker LJ, Okoye AA, Corey L. Anti-PD-1 chimeric antigen receptor T cells efficiently target SIV-infected CD4+ T cells in germinal centers. J Clin Invest 2024; 134:e169309. [PMID: 38557496 PMCID: PMC10977982 DOI: 10.1172/jci169309] [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: 01/31/2023] [Accepted: 02/09/2024] [Indexed: 04/04/2024] Open
Abstract
Programmed cell death protein 1 (PD-1) is an immune checkpoint marker commonly expressed on memory T cells and enriched in latently HIV-infected CD4+ T cells. We engineered an anti-PD-1 chimeric antigen receptor (CAR) to assess the impact of PD-1 depletion on viral reservoirs and rebound dynamics in SIVmac239-infected rhesus macaques (RMs). Adoptive transfer of anti-PD-1 CAR T cells was done in 2 SIV-naive and 4 SIV-infected RMs on antiretroviral therapy (ART). In 3 of 6 RMs, anti-PD-1 CAR T cells expanded and persisted for up to 100 days concomitant with the depletion of PD-1+ memory T cells in blood and tissues, including lymph node CD4+ follicular helper T (TFH) cells. Loss of TFH cells was associated with depletion of detectable SIV RNA from the germinal center (GC). However, following CAR T infusion and ART interruption, there was a marked increase in SIV replication in extrafollicular portions of lymph nodes, a 2-log higher plasma viremia relative to controls, and accelerated disease progression associated with the depletion of CD8+ memory T cells. These data indicate anti-PD-1 CAR T cells depleted PD-1+ T cells, including GC TFH cells, and eradicated SIV from this immunological sanctuary.
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Affiliation(s)
- Karsten Eichholz
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Yoshinori Fukazawa
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Christopher W. Peterson
- Stem Cell and Gene Therapy Program, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and
| | - Francoise Haeseleer
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Manuel Medina
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Shelby Hoffmeister
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Derick M. Duell
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Benjamin D. Varco-Merth
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Sandra Dross
- Washington National Primate Research Center (WaNPRC), Seattle, Washington, USA
- Department of Microbiology, University of Washington, Seattle, Washington, USA
| | - Haesun Park
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Caralyn S. Labriola
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Michael K. Axthelm
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Robert D. Murnane
- Washington National Primate Research Center (WaNPRC), Seattle, Washington, USA
| | - Jeremy V. Smedley
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Lei Jin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jiaxin Gong
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Blake J. Rust
- Stem Cell and Gene Therapy Program, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Deborah H. Fuller
- Washington National Primate Research Center (WaNPRC), Seattle, Washington, USA
- Department of Microbiology, University of Washington, Seattle, Washington, USA
| | - Hans-Peter Kiem
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Stem Cell and Gene Therapy Program, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Louis J. Picker
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Afam A. Okoye
- Vaccine and Gene Therapy Institute and Oregon National Primate Research Center (ONPRC), Oregon Health & Science University, Beaverton, Oregon, USA
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Gutiérrez SA, Jaimes-Dueñez J, Cruz-Saavedra L, Hernández C, Cantillo-Barraza O, Álvarez F, Blanco M, Leal B, Martínez L, Medina M, Medina M, Valdivieso S, Ramírez JD. An Outbreak of Acute Chagas Disease Possibly Spread through Oral Transmission Involving Animal Reservoirs in Eastern Colombia. Am J Trop Med Hyg 2024; 110:36-39. [PMID: 37956445 DOI: 10.4269/ajtmh.23-0380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/13/2023] [Indexed: 11/15/2023] Open
Abstract
Chagas disease (CD) is a parasitic infection caused by the parasite Trypanosoma cruzi. Reports of CD cases associated with oral transmission have increased, particularly in Colombia, Brazil, and Venezuela. In this investigation, parasitological, serological, and molecular tests were conducted on samples obtained from humans, mammal reservoirs, and hosts involved in the assessment of a suspected oral transmission outbreak in Cubara, Boyaca, Colombia. Seropositivity was observed in 60% (3 of 5) of index patients and 6.4% (5 of 78) of close contacts. Trypanosoma cruzi DNA was detected by quantitative polymerase chain reaction in 100% of index cases, 6.4% (5 of 78) of close contacts, 60% (6 of 10) of canines, and 100% (5 of 5) of opossums. In all index cases, the TcI lineage was identified, along with two cases of mixed infection (TcI/TcII-TcVI). Hemoculture revealed a flagellate presence in 80% of opossums, whereas all triatomine bugs tested negative. Our findings suggest a potential oral transmission route through contamination with opossum secretions.
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Affiliation(s)
- Stivenn A Gutiérrez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Jeiczon Jaimes-Dueñez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Grupo de Investigación en Ciencias Animales, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Centro de Tecnología en Salud, Innovaseq SAS, Bogota, Colombia
| | | | - Francisco Álvarez
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - María Blanco
- Secretaría Departamental de Salud de Arauca, Arauca, Colombia
| | - Bernardo Leal
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Lida Martínez
- Grupo de Vigilancia en Salud Pública, Secretaría de Salud de Boyacá, Colombia
| | - Manuel Medina
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Mabel Medina
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | | | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Coma E, Pino D, Mora N, Fina F, Perramon A, Prats C, Medina M, Planella A, Mompart A, Mendioroz J, Cabezas C. Mortality in Catalonia during the summer of 2022 and its relation with high temperatures and COVID-19 cases. Front Public Health 2023; 11:1157363. [PMID: 37275503 PMCID: PMC10235629 DOI: 10.3389/fpubh.2023.1157363] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose To analyse the association between the mortality during the summer 2022 and either high temperatures or the COVID-19 wave with data from the Catalan Health Care System (7.8 million people). Methods We performed a retrospective study using publicly available data of meteorological variables, influenza-like illness (ILI) cases (including COVID-19) and deaths. The study comprises the summer months of the years 2021 and 2022. To compare the curves of mortality, ILI and temperature we calculated the z-score of each series. We assessed the observed lag between curves using the cross-correlation function. Finally, we calculated the correlation between the z-scores using the Pearson correlation coefficient (R2). Results During the study period, 33,967 deaths were reported in Catalonia (16,416 in the summer of 2021 and 17,551 in the summer of 2022). In 2022, the observed lag and the correlation between the z-scores of temperature and all-cause deaths was 3 days and R2 = 0.86, while between ILI and all-cause deaths was 22 days and R2 = 0.21. This high correlation between temperature and deaths increased up to 0.91 when we excluded those deaths reported as COVID-19 deaths, while the correlation between ILI and non-COVID-19 deaths decreased to -0.19. No correlation was observed between non-COVID deaths and temperature or ILI cases in 2021. Conclusion Our study suggests that the main cause of the increase in deaths during summer 2022 in Catalonia was the high temperatures and its duration. The contribution of the COVID-19 seems to be limited.
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Affiliation(s)
- Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - David Pino
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Aida Perramon
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Antoni Planella
- Department of Health, Generalitat de Catalunya, Direcció General de Planificació i Recerca en Salut, Barcelona, Spain
| | - Anna Mompart
- Department of Health, Generalitat de Catalunya, Direcció General de Planificació i Recerca en Salut, Barcelona, Spain
| | - Jacobo Mendioroz
- Department of Health, Public Health Secretariat, Generalitat de Catalunya, Barcelona, Spain
| | - Carmen Cabezas
- Department of Health, Public Health Secretariat, Generalitat de Catalunya, Barcelona, Spain
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De Sousa JM, Machado LD, Woellner C, Medina M, Autreto PADS, Galvão DS. Boron nitride nanotube peapods at ultrasonic velocity impacts: A fully atomistic molecular dynamics investigation. J Phys Condens Matter 2023; 35. [PMID: 37172601 DOI: 10.1088/1361-648x/acd50b] [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] [Received: 03/14/2023] [Accepted: 05/12/2023] [Indexed: 05/15/2023]
Abstract
Boron nitride nanotube peapods (BNNT-peapod) are composed of linear chains of C60
molecules encapsulated inside boron nitride nanotubes, they were first synthesized in 2003.
In this work, we investigated the mechanical response and fracture dynamics of BNNT-
peapods under ultrasonic velocity impacts (from 1 km/s up to 6 km/s) against a solid target.
We carried out fully atomistic reactive molecular dynamics simulations using a ReaxFF
forcefield. We have considered the case of horizontal and vertical shootings. Depending on
the velocity values, we observed nanotube bending, nanotube fracture, and C60 ejection.
Furthermore, the nanotube unzips for horizontal impacts at certain speeds, forming bi-layer
nanoribbons "incrusted" with C60 molecules. The methodology used here is applicable to
other nanostructures. We hope it motivates other theoretical investigations on the behavior
of nanostructures at ultrasonic velocity impacts and aid in interpreting future experimental
results. It should be stressed that similar experiments and simulations were carried out
on carbon nanotubes trying to obtain nanodiamonds. The present study expands these
investigations to include BNNT.
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Affiliation(s)
- José Moreira De Sousa
- Física, Instituto Federal de Educação Ciência e Tecnologia do Piauí, R. Álvaro Mendes, 94, Centro (Sul), Teresina, 64000-040, BRAZIL
| | - L D Machado
- Departamento de Física Teórica e Experimental, UFRN, Av. Sen. Salgado Filho, 3000 - Lagoa Nova, Natal - RN, 59078-970, Natal, RN, 59078-970, BRAZIL
| | - Cristiano Woellner
- Instituto de Física, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves 9500 Porto Alegre, RS, Brazil., Porto Alegre, RS, 90040-060, BRAZIL
| | - M Medina
- UFABC, UFABC Campus Santo André. Av. dos Estados, 5001, Santo André, SP, CEP: 09210-580, Brasil, Santo Andre, SP, 09210-170, BRAZIL
| | - Pedro Alves da Silva Autreto
- Center of Natural Human Science, UFABC, Av. dos Estados, 5001 - Bangú, Santo André - SP, 09210-580, Santo Andre, SP, 09210-580, BRAZIL
| | - Douglas S Galvão
- Instituto de Fisica 'Gleb Wataghin', Universidade Estadual de Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo CEP 13083-970, CP 6165 Campinas SP, Campinas, Sao Paulo, 13083-959, BRAZIL
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Fetten K, van Zyl J, Felius J, Hall S, Medina M, Meyer D. Comparison of Patient Characteristics and Outcomes of Left Ventricular Assist Devices before and after the Heart Transplant Allocation Change. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1594] [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: 04/05/2023] Open
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Medina M, Mora N, Coma E, Mas A. [Evolution of the screening and control quality indicators of patients with type 2 diabetes mellitus over 16 years (2007-2022)]. Aten Primaria 2023; 55:102588. [PMID: 36889129 PMCID: PMC9992944 DOI: 10.1016/j.aprim.2023.102588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Affiliation(s)
- Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, España
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, España
| | - Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, España.
| | - Ariadna Mas
- Direcció d'Atenció Primària, Institut Català de la Salut (ICS), Barcelona, España
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10
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Mora N, Guiriguet C, Cantenys R, Méndez-Boo L, Marzo-Castillejo M, Benítez M, Fina F, Fàbregas M, Hermosilla E, Mercadé A, Medina M, Coma E. Cancer diagnosis in primary care after second pandemic year in Catalonia: a time-series analysis of primary care electronic health records covering about 5 million people. Fam Pract 2023; 40:183-187. [PMID: 35861148 PMCID: PMC9384533 DOI: 10.1093/fampra/cmac083] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the incidence of chronic disease had drastically been reduced due to health care interruptions. The aim of this study is to analyse cancer diagnosis during the last 2 years of the COVID-19 pandemic. METHODS Time-series study of cancer diagnoses recorded in primary care settings, using data from the primary care electronic health records from January 2014 to December 2021. We obtained the expected monthly rate per 100,000 inhabitants using a time regression adjusted by trend and seasonality. We additionally compared rates of cancer diagnoses in 2019 with those of 2020 and 2021 using the t-test. We performed the analysis globally, by sex and by type of cancer. RESULTS In 2020, the rate of cancer diagnoses had reduced by -21% compared to 2019 (P < 0.05). Greater reductions were observed during the lockdown in early 2020 (>40%) and with some types of cancers, especially prostate and skin cancers (-29.6% and -26.9%, respectively, P < 0.05). Lung cancers presented statistically non-significant reductions in both years. Cancer diagnosis returned to expected around March 2021, and the rate in 2021 was similar to that of 2019 (overall difference of 0.21%, P = 0.967). However, an 11% reduction was still found when comparing the pandemic months of 2020-2021 with pre-pandemic months. CONCLUSIONS Although primary care cancer diagnoses in 2021 have returned to pre-pandemic levels, missing diagnoses during the last 2 years have not been fully recovered.
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Affiliation(s)
- Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Carolina Guiriguet
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain.,Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Roser Cantenys
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mercè Marzo-Castillejo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Unitat de Suport a la Recerca Metropolitana Sud, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, Spain
| | - Mència Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain.,Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Eduardo Hermosilla
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Albert Mercadé
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
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11
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Coma E, Català M, Méndez-Boo L, Alonso S, Hermosilla E, Alvarez-Lacalle E, Pino D, Medina M, Asso L, Gatell A, Bassat Q, Mas A, Soriano-Arandes A, Fina Avilés F, Prats C. Unravelling the role of the mandatory use of face covering masks for the control of SARS-CoV-2 in schools: a quasi-experimental study nested in a population-based cohort in Catalonia (Spain). Arch Dis Child 2023; 108:131-136. [PMID: 35999036 DOI: 10.1136/archdischild-2022-324172] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/05/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To assess the effectiveness of mandatory use of face covering masks (FCMs) in schools during the first term of the 2021-2022 academic year. DESIGN A retrospective population-based study. SETTING Schools in Catalonia (Spain). POPULATION 599 314 children aged 3-11 years attending preschool (3-5 years, without FCM mandate) and primary education (6-11 years, with FCM mandate). STUDY PERIOD From 13 September to 22 December 2021 (before Omicron variant). INTERVENTIONS A quasi-experimental comparison between children in the last grade of preschool (5 years old), as a control group, and children in year 1 of primary education (6 years old), as an interventional group. MAIN OUTCOME MEASURES Incidence of SARS-CoV-2, secondary attack rates (SARs) and effective reproductive number (R*). RESULTS SARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an increasing trend with age was observed. Six-year-old children showed higher incidence than 5 year olds (3.54% vs 3.1%; OR 1.15 (95% CI 1.08 to 1.22)) and slightly lower but not statistically significant SAR (4.36% vs 4.59%; incidence risk ratio 0.96 (95% CI 0.82 to 1.11)) and R* (0.9 vs 0.93; OR 0.96 (95% CI 0.87 to 1.09)). Results remained consistent using a regression discontinuity design and linear regression extrapolation approaches. CONCLUSIONS We found no significant differences in SARS-CoV-2 transmission due to FCM mandates in Catalonian schools. Instead, age was the most important factor in explaining the transmission risk for children attending school.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Martí Català
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Sergio Alonso
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Catalonia, Spain
| | - Eduardo Hermosilla
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Catalonia, Spain.,IDIAP Jordi Gol, Barcelona, Catalonia, Spain
| | - Enric Alvarez-Lacalle
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Catalonia, Spain
| | - David Pino
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Catalonia, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Laia Asso
- Departament de Salut, Generalitat de Catalunya, Barcelona, Catalonia, Spain
| | - Anna Gatell
- Equip Pediatria Territorial Alt Penedès-Garraf, Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Manhica, Maputo, Mozambique.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues (Barcelona), Catalonia, Spain.,ICREA, Catalan Institution for Research and Advanced Studies, Barcelona, Catalonia, Spain
| | - Ariadna Mas
- Direcció Assistencial d'Atenció Primària i a la Comunitat, Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain .,Department of Infectious Diseases, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain
| | - Francesc Fina Avilés
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut, Barcelona, Catalonia, Spain
| | - Clara Prats
- Department of Physics, Universitat Politècnica de Catalunya, Barcelona, Catalonia, Spain
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12
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Simpson S, Bettauer V, Ramachandran A, Kraemer S, Mahon S, Medina M, Vallès Y, Dumeaux V, Vallès H, Walsh D, Hallett MT. A metagenomic-based study of two sites from the Barbadian reef system. Coral Reefs 2023; 42:359-366. [PMID: 37009568 PMCID: PMC10060342 DOI: 10.1007/s00338-022-02330-y] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/05/2022] [Indexed: 06/19/2023]
Abstract
UNLABELLED We study the microbiome of sea water collected from two locations of the Barbadian coral reefs. The two sites differ in several environmental and ecological variables including their endogenous benthic community and their proximity to urban development and runoffs from inland watersheds. The composition of the microbial communities was estimated using whole genome DNA shotgun sequencing with adjuvant measurements of chemical and environmental qualities. Although both sites exhibit a similar degree of richness, the less urbanized site (Maycocks reef at Hangman's Bay) has a strong concentration of phototrophs whereas the more urbanized location (Bellairs reef at Folkstone) is enriched for copiotrophs, macroalgal symbionts and marine-related disease-bearing organisms from taxa scattered across the tree of life. Our results are concordant with previous profiles of warm ocean surface waters, suggesting our approach captures the state of each coral reef site, setting the stage for longitudinal studies of marine microbiome dynamics in Barbados. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s00338-022-02330-y.
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Affiliation(s)
- S. Simpson
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - V. Bettauer
- Department of Computer Science and Software Engineering, Concordia University, Montreal, Canada
| | - A. Ramachandran
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Kraemer
- Department of Biology, Concordia University, Montreal, Canada
| | - S. Mahon
- Coral Reef Restoration Alliance (CORALL), Bridgetown, Barbados
| | - M. Medina
- Department of Biology, Pennsylvania State University, University Park, PA USA
| | - Y. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - V. Dumeaux
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Canada
| | - H. Vallès
- Department of Biology and Chemical Sciences, University of the West Indies, Cave Hill, Barbados
| | - D. Walsh
- Department of Biology, Concordia University, Montreal, Canada
| | - M. T. Hallett
- Department of Biochemistry, University of Western Ontario, London, Canada
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13
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Mora N, Fina F, Méndez-Boo L, Cantenys R, Benítez M, Moreno N, Balló E, Hermosilla E, Fàbregas M, Guiriguet C, Cos X, Rodoreda S, Mas A, Lejardi Y, Coma E, Medina M. "Decline and uneven recovery from 7 common long-term conditions managed in the Catalan primary care after two pandemic years: an observational retrospective population-based study using primary care electronic health records". BMC Prim Care 2023; 24:9. [PMID: 36641483 PMCID: PMC9840158 DOI: 10.1186/s12875-022-01935-0] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND The incidence of chronic diseases during the COVID-19 pandemic has drastically been reduced worldwide due to disruptions in healthcare systems. The aim of our study is to analyse the trends in the incidence of 7 commonly managed primary care chronic diseases during the last 2 years of the COVID-19 pandemic in Catalonia. METHODS We performed an observational retrospective population-based study using data from primary care electronic health records from January 2018 to August 2022 (5.1 million people older than 14 years). We divided the study period into two: a pre-pandemic period (before 14 March 2020) and a pandemic period. We performed a segmented regression analysis of daily incidence rates per 100,000 inhabitants of 7 chronic diseases: type 2 diabetes mellitus (T2DM), asthma, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD), heart failure (HF), hypertension and hypercholesterolemia. In addition, we compared annual incidence between pandemic years (2020, 2021 and 2022) and 2019. Associated incidence rate ratios (IRR) were also calculated. Finally, we estimated the number of expected diagnoses during the pandemic period using data from 2019 and we compared it with the observed data. RESULTS We analysed 740,820 new chronic diseases' diagnoses. Daily incidence rates of all 7 chronic diseases were drastically interrupted on 14 March 2020, and a general upward trend was observed during the following months. Reductions in 2020 were around 30% for all conditions except COPD which had greater reductions (IRR: 0.58 [95% CI: 0.57 to 0.6]) and HF with lesser drops (IRR: 0.86 [95% CI: 0.84 to 0.88]). Some of the chronic conditions have returned to pre-pandemic diagnosis levels, except asthma, COPD and IHD. The return to pre-pandemic diagnosis levels compensated for the drops in 2020 for T2DM and HF, but not for hypertension which presented an incomplete recovery. We also observed an excess of hypercholesterolemia diagnoses of 8.5% (95%CI: 1.81% to 16.15%). CONCLUSIONS Although primary care has recovered the pre-pandemic diagnosis levels for some chronic diseases, there are still missing diagnoses of asthma, COPD and IHD that should be addressed.
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Affiliation(s)
- Núria Mora
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Francesc Fina
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Leonardo Méndez-Boo
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Roser Cantenys
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Mència Benítez
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain ,grid.22061.370000 0000 9127 6969Equip d’Atenció Primària de Gòtic, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Nemesio Moreno
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Elisabet Balló
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Eduardo Hermosilla
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain ,grid.452479.9Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Mireia Fàbregas
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Carolina Guiriguet
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain ,grid.22061.370000 0000 9127 6969Equip d’Atenció Primària de Gòtic, Institut Català de la Salut (ICS), Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
| | - Xavier Cos
- grid.22061.370000 0000 9127 6969Direcció Assistencial d’Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain ,grid.22061.370000 0000 9127 6969DAP_Cat Research Group, Gerència Territorial Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Universitat Autònoma de Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBERDEM, ISCIII , Madrid, Spain
| | - Sara Rodoreda
- grid.22061.370000 0000 9127 6969Direcció Assistencial d’Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Ariadna Mas
- grid.22061.370000 0000 9127 6969Direcció Assistencial d’Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Yolanda Lejardi
- grid.22061.370000 0000 9127 6969Direcció Assistencial d’Atenció Primària i a la Comunitat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Ermengol Coma
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
| | - Manuel Medina
- grid.22061.370000 0000 9127 6969Primary Care Services Information Systems (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007 Barcelona, Spain
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14
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Velásquez-Ortiz N, Hernández C, Cantillo-Barraza O, Ballesteros N, Cruz-Saavedra L, Herrera G, Buitrago LS, Soto H, Medina M, Palacio J, González MS, Cuervo A, Vallejo G, Zuleta Dueñas L, Urbano P, Muñoz M, Ramírez JD. Trypanosoma cruzi Parasite Burdens of Several Triatomine Species in Colombia. Trop Med Infect Dis 2022; 7:tropicalmed7120445. [PMID: 36548700 PMCID: PMC9782637 DOI: 10.3390/tropicalmed7120445] [Citation(s) in RCA: 5] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Trypanosoma cruzi, the causal agent of Chagas disease, is mainly transmitted by insects of the Triatominae subfamily. In Colombia, there are 26 triatomine species, and 16 of them are naturally infected with the parasite. The parasite loads of naturally infected vectors can be significant in targeting specific species that can affect the epidemiology of the disease. Studying their ecology and behavior is vital to understand their role in T. cruzi transmission dynamics. We evaluated the parasite loads of 182 field-collected triatomines corresponding to 10 species in 13 departments across Colombia. We standardized a methodology to quantify T. cruzi DNA in these insects. We obtained a LOD (limit of detection) of 3.05 p-eq/mL. The 82% of triatomines we evaluated were positive for T. cruzi infection, with loads ranging from hundreds to millions of equivalent parasites per milliliter. Panstrongylus geniculatus, Rhodnius prolixus, and Triatoma dimidiata were the species with the highest loads of T. cruzi; however, other species whose role as vectors is still unknown were also found with high loads of parasites. Our results suggest the relevance of secondary species for T. cruzi transmission in Colombia. We hope our data can help improve entomological surveillance and vector control programs in the country and the region.
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Affiliation(s)
- Natalia Velásquez-Ortiz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia
| | - Omar Cantillo-Barraza
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Grupo BCEI, Universidad de Antioquia, Medellín, Colombia
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Giovanny Herrera
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | | | - Hugo Soto
- Laboratorio de Salud Pública del Cesar, Valledupar, Colombia
| | - Manuel Medina
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Jatney Palacio
- Laboratorio Departamental de Salud Pública del Departamento del Chocó, Quibdó, Colombia
| | | | - Andrés Cuervo
- Secretaría Departamental de Salud de Arauca, Arauca, Colombia
| | - Gustavo Vallejo
- Laboratorio de Investigaciones en Parasitología Tropical, Facultad de Ciencias, Universidad del Tolima, Ibagué, Colombia
| | - Liliana Zuleta Dueñas
- Grupo de Vigilancia en Salud Pública, Secretaría de Salud de Casanare, Yopal, Colombia
| | - Plutarco Urbano
- Grupo de Investigaciones Biológicas de la Orinoquia, Universidad Internacional del Trópico Americano (Unitrópico), Yopal, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Correspondence: or
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15
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Gual-Gonzalez L, Medina M, Valverde-Castro C, Beltrán V, Caro R, Triana-Chávez O, Nolan MS, Cantillo-Barraza O. Laboratory Evaluation and Field Feasibility of Micro-Encapsulated Insecticide Effect on Rhodnius prolixus and Triatoma dimidiata Mortality in Rural Households in Boyacá, Colombia. Insects 2022; 13:insects13111061. [PMID: 36421964 PMCID: PMC9697714 DOI: 10.3390/insects13111061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 06/02/2023]
Abstract
Chagas disease is a neglected vector-borne zoonosis caused by the parasite Trypanosoma cruzi that is primarily transmitted by insects of the subfamily Triatominae. Although control efforts targeting domestic infestations of Rhodnius prolixus have been largely successful, with several regions in Boyacá department certified free of T. cruzi transmission by intradomicile R. prolixus, novel native species are emerging, increasing the risk of disease. Triatoma dimidiata is the second most important species in Colombia, and conventional control methods seem to be less effective. In this study we evaluated the efficacy and usefulness of micro-encapsulated insecticide paints in laboratory conditions and its applicability in rural communities to avoid triatomine domiciliation. Laboratory conditions measured mortality at 6 months and 12 months, with an average mortality between 93-100% for T. dimidiata and 100% for R. prolixus. Evaluation of triatomine infestation in rural households was measured after one year, with an overall perception of effectiveness in reducing household domiciliation. Although triatomines were still spotted inside and around the homes, our findings demonstrate the ability of micro-encapsulated insecticide to prevent colonization inside the households when comparing infestation rates from previous years. Current control measures suggest insecticide spraying every six months, which implies great economic cost and logistical effort. Complementary triatomine control measures with insecticide spraying and micro-encapsulated insecticide paint would make public health efforts more efficient and reduce the frequency of treatment.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Manuel Medina
- Unidad de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Boyacá, Tunja 150001, Colombia
| | - César Valverde-Castro
- Grupo de Investigación en Medicina Tropical, Universidad del Magdalena, Santa Marta 470003, Colombia
- Grupo Biología y Control Enfermedades Infecciosas, Universidad Antioquia, Medellín 050010, Colombia
| | - Virgilio Beltrán
- Unidad de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Boyacá, Tunja 150001, Colombia
| | - Rodrigo Caro
- Unidad de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Boyacá, Tunja 150001, Colombia
| | - Omar Triana-Chávez
- Grupo Biología y Control Enfermedades Infecciosas, Universidad Antioquia, Medellín 050010, Colombia
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Omar Cantillo-Barraza
- Grupo Biología y Control Enfermedades Infecciosas, Universidad Antioquia, Medellín 050010, Colombia
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16
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Català M, Coma E, Alonso S, Andrés C, Blanco I, Antón A, Bordoy AE, Cardona PJ, Fina F, Martró E, Medina M, Mora N, Saludes V, Prats C, Prieto-Alhambra D, Alvarez-Lacalle E. Corrigendum: Transmissibility, hospitalization, and intensive care admissions due to omicron compared to delta variants of SARS-CoV-2 in Catalonia: A cohort study and ecological analysis. Front Public Health 2022; 10:1060328. [PMID: 36743167 PMCID: PMC9894245 DOI: 10.3389/fpubh.2022.1060328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 01/20/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2022.961030.].
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Affiliation(s)
- Martí Català
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Sergio Alonso
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Blanco
- Clinical Genetics Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni E. Bordoy
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Pere-Joan Cardona
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Prats
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Enrique Alvarez-Lacalle
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain,*Correspondence: Enrique Alvarez-Lacalle
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17
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García Ureña MÁ, Martínez Caballero J, Medina M, Avilés A, Rial X, Robin A, Muñoz J, López-Monclús J, Blazquez-Hernando LA. V-049 E-TEP RIVES-STOPPA AND OPEN REVERSE TRANVERSUS ABDOMINIS RELEASE (TAR): A HYBRID APPROACH FOR LARGE LATERAL-INFERIOR INCISIONAL HERNIAS. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.301] [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: 11/12/2022]
Abstract
Abstract
Aim
To present hybrid approach with open/endoscopic extraperitoneal dissection for large lateral-inferior incisional hernias
Material and Methods
64 years-old man who underwent left laparoscopic nephrectomy (2019) due to hypernephroma with specimen extraction by a left oblique iliac incision. He presents L3–4 W3 incisional hernia (14×10 cm)
Technique description
Results
After 48 hours ICU admission patient was discharged to hospital ward. Drainages were removed at 2nd-4thpostoperative day and hospital stay was 5 days.
Conclusion
The hybrid approach to large lateral incisional hernias allowed us to use a large sublay mesh with an increased overlap beyond the hernia defect, trying to reduce hernia recurrence rate.
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Affiliation(s)
- M Á García Ureña
- General and Digestive Surgery, Henares University Hospital , Madrid , Spain
| | | | - M Medina
- General and Digestive Surgery, Henares University Hospital , Madrid , Spain
| | - A Avilés
- General and Digestive Surgery, Henares University Hospital , Madrid , Spain
| | - X Rial
- General and Digestive Surgery, Henares University Hospital , Madrid , Spain
| | - A Robin
- General and Digestive Surgery, Henares University Hospital , Madrid , Spain
| | - J Muñoz
- General and Digestive Surgery, Puerta de Hierro Hospital , Madrid , Spain
| | - J López-Monclús
- General and Digestive Surgery, Puerta de Hierro Hospital , Madrid , Spain
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18
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Garcia-Urena MA, Lopez-Monclus J, Medina M, Aviles A, Blazquez Hernando LA, Robin Valle De Lersundi A, Munoz-Rodriguez J, Rial X, Minaya A, Sanchez A. P-100 ANATOMICAL STUDY ON THE PREPERITONEAL FAT DISTRIBUTION IN EXTENDED RETROMUSCULAR PREPERITONEAL DISSECTION: FROM THE FATTY TRIANGLE TO THE FATTY TRIDENT. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.198] [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: 11/14/2022]
Abstract
Abstract
Aim
Extended retromuscular dissection performed for abdominal wall reconstruction in complex abdominal wall repair has progressively exposed the anatomy between the peritoneal layer and abdominal wall muscles. This study aimed to assess the morphology and distribution of preperitoneal fat in a cadaveric model.
Material and methods
Thirty frozen cadaver torsos were dissected by posterior component separation. The shape of the preperitoneal fat was identified, and the dimensions and more significant distances were calculated.
Results
The results showed that the preperitoneal fat resembles a trident, exists along the midline under the linea alba, and expands in the epigastric area into a rhomboid shape. The fatty triangle was found to be a part of this rhomboid. The mean rhomboid area was 35 cm2. Caudally, the midline preperitoneal fat widened under the arcuate line to reach the Retzius space. Laterally, the Bogros space communicated the root of the trident with the paracolic gutters, Toldt's fascia, and pararenal fats, forming the lateral prong of the trident. The mean width of the midline prong at the umbilicus was 2.8 cm. It was easier to tear the peritoneum outside the area reinforced by the fatty trident.
Conclusions
The concept of preperitoneal fatty trident may be of practical assistance to perform various hernia procedures, from the simple ventral hernia repair to the more complex preperitoneal ventral repair or posterior component separation techniques. The consistency of this layer allows us to follow our plane between the peritoneum and muscle layers to extend the preperitoneal dissection.
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Affiliation(s)
| | | | - M Medina
- Surgery, Henares University Hospital , Madrid , Spain
| | - A Aviles
- Surgery, Henares University Hospital , Madrid , Spain
| | | | | | | | - X Rial
- Surgery, Henares University Hospital , Madrid , Spain
| | - A Minaya
- Surgery, Henares University Hospital , Madrid , Spain
| | - A Sanchez
- Surgery, Henares University Hospital , Madrid , Spain
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19
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Medina M, Garcia-Urena MA, Aviles A, Robin Valle De Lersundi A, Cruz A, Munoz-Rodriguez J, Blazquez Hernando LA, Martinez J, Perez-Flecha M, Lopez-Monclus J. V-018 PREOPERATIVE OPTIMIZATION AND POSTERIOR COMPONENT SEPARATION WITH INTRAOPERATIVE MONITORING OF RECTUS MUSCLE INERVATION FOR LOSS OF DOMAIN INCISIONAL HERNIA. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.270] [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: 11/13/2022]
Abstract
Abstract
Aim
The importance of an appropriate patient optimization (botulin toxin and pneumoperitoneum) and adequate surgical technique is highlighted.The possibility of intraoperative monitoring of the nerves that may be injured during posterior component separation is explained
Material and methods
We present a 74 years old man, past smoker, with history of hypertension, steatohepatitis and chronic bronchopathy
Results
This is a disastrous but unfortunately not so uncommon story of a failed repair of a simple umbilical hernia with 3 previous unsuccessful attempts of repair with and without mesh. After the last surgery the patient developed a giant incisional hernia with loss of domain. Optimization consisted of improving nutritional status, respiratory physiotherapy, botulin toxin and pneumoperitoneum. The surgery was made using previous skin scar. After dissecting the retrorectus space, a posterior component separation was made with the aid of monitoring the nerves that come to innervate the rectus abdominis. An overextended overlapped was obtained. A patch of absorbable mesh was used to completely close the peritoneum. A combination of absorbable and permanent synthetic mesh was used as giant reinforcement of the visceral sac. The only points of fixation were the Cooper Ligaments. The patient had a satisfactory recovery without complications and was discharged on the 8th postoperative day.
Conclusions
Loss of domain incisional hernias is a real surgical challenge. The combination of a good preoperative strategy (preoperative neumoperitoneum) and surgical technique (TAR and pannniculectomy) gives a great opportunity to solve very complex cases of incisional hernia.
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Affiliation(s)
- M Medina
- Surgery, Henares University Hospital , Madrid , Spain
| | | | - A Aviles
- Surgery, Henares University Hospital , Madrid , Spain
| | | | - A Cruz
- Surgery, Henares University Hospital , Madrid , Spain
| | | | | | - J Martinez
- Surgery, Henares University Hospital , Madrid , Spain
| | | | - J Lopez-Monclus
- Surgery, Puerta de Hierro University Hosptial , Madrid , Spain
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20
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Garcia Urena MA, Medina M, Aviles A, Robin A, Martinez J, Muñoz J, Lopez-Monclus J, Morejon S, Blazquez-Hernando LA. V-007 LESSONS LEARNED DURING THE ABDOMINAL WALL RECONSUTRCTION FOR A MULTIRECURRENT LUMBAR HERNIA AFTER BONE GRAFT HARVESTING. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.259] [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: 11/13/2022]
Abstract
Abstract
The best approach for lateral incisional hernia is not known. Among these difficult hernias, those arising from iliac crest harvesting can be particularly challenging. The objective of this video is to illustrate the surgical approach of a multirecurrent case with the need of adding a posterior component separation
A 70 years old woman with 2 previous attempts of repair was referred to our center. With the patient in a 45 degrees lateral decubitus, a posterior lumbar approach was initiated through the previous scar. The retromuscular preperitoneal plane was accessed with difficulty due to previous meshes in the subdiaphragmatic, iliac and posterior areas. A big tear on the medial peritoneum changed our plan to add a posterior component separation. As we did not want to enlarge the lumbar incision to denervate more the lateral abdominal wall, we decided to make an accessory midline incision. Probably, an ETEP approach could have been better even before making the posterior incision. Once the retromuscular plane was dissected, the hole in the peritoneum could be closed. The reconstructive phase consisted in making a taco configuration using the combination of a permanent and absorbable mesh.
We have learned from this case, that an eTEP dissection of the retromuscular plane could have helped to avoid the accessory midline incision. It is also important to consider the potential iatrogenic denervation we could add in case of enlargement of the incision.
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Affiliation(s)
| | - M Medina
- Surgery, Henares University Hospital , Madrid , Spain
| | - A Aviles
- Surgery, Henares University Hospital , Madrid , Spain
| | - A Robin
- Surgery, Henares University Hospital , Madrid , Spain
| | - J Martinez
- Surgery, Henares University Hospital , Madrid , Spain
| | - J Muñoz
- Surgery, Puerta de Hierro Hospital , Madrid , Spain
| | | | - S Morejon
- Surgery, Henares University Hospital , Madrid , Spain
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21
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Medina M, Zuluaga S, Martínez MF, Bermúdez JC, Hernández C, Beltrán V, Velásquez-Ortiz N, Muñoz M, Ramírez JD, Triana O, Cantillo-Barraza O. Interrogating the transmission dynamics of Trypanosoma cruzi (Trypanosomatida, Trypanosomatidae) by Triatoma venosa (Hemiptera: Reduviidae) after the elimination of vector transmission by Rhodnius prolixus in Boyacá eastern Colombia. Front Cell Infect Microbiol 2022; 12:998202. [PMID: 36275020 PMCID: PMC9582133 DOI: 10.3389/fcimb.2022.998202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/19/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Chagas disease (CD) is a parasitic zoonosis (Trypanosoma cruzi) that is endemic in Colombia. Vector control of Rhodnius prolixus, the main domestic T. cruzi vector, has been achieved in a large part of the area with historically vector transmission of CD. It is necessary to understand the ecological behavior characteristics of local native vectors to ensure sustainability of the vector control programs. To evaluate the long-term success of a recent vector control campaign in the Boyacá department (Colombia), we used a combined strategy of entomological surveillance with co-existing canine surveillance from ten rural villages within six municipalities of the Tenza valley region (Boyacá, Colombia): Chinavita, Garagoa, Guateque, Somondoco, Sutatenza and Tenza, with historical reports of R. prolixus and secondary vectors. Collected triatomines and canine whole blood were analyzed for T. cruzi infection and genotyping. Triatomine bugs specimens were evaluated for blood meal source. Canine serology was performed using two distinct antibody assays. In total, 101 Triatoma venosa were collected by active search in domestic and peridomestic habitats. A natural infection prevalence of 13.9% (14/101) and four feeding sources were identified: human, dog, rat, and hen. A frequency infection of 46.5% (40/87) was observed from two independent serological tests and T. cruzi DNA was detected in 14 dogs (16.4%). Only TcIsylvatic DTU was detected. The results suggest that T. venosa present eco-epidemiological characteristics to maintain the transmission of T. cruzi in Tenza valley. This species has reinfested the intervened households and it has an active role in domestic and peridomestic transmission of T. cruzi due to their infection rates and feeding behavior. Therefore, this species should be considered as epidemiologically relevant for vector control strategies. Moreover, there is a need for human serological studies to have a close up of risk they are exposed to.
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Affiliation(s)
- Manuel Medina
- Programa de Control de Vectores, Secretaría de Salud Departamental, Tunja, Colombia
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas (BCEI), Universidad de Antioquia, Medellín, Colombia
| | | | - Juan Carlos Bermúdez
- Programa de Control de Vectores, Secretaría de Salud Departamental, Tunja, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología – UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Virgilio Beltrán
- Programa de Control de Vectores, Secretaría de Salud Departamental, Tunja, Colombia
| | - Natalia Velásquez-Ortiz
- Centro de Investigaciones en Microbiología y Biotecnología – UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología – UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología – UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Omar Triana
- Grupo Biología y Control de Enfermedades Infecciosas (BCEI), Universidad de Antioquia, Medellín, Colombia
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas (BCEI), Universidad de Antioquia, Medellín, Colombia
- *Correspondence: Omar Cantillo-Barraza,
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22
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Català M, Coma E, Alonso S, Andrés C, Blanco I, Antón A, Bordoy AE, Cardona PJ, Fina F, Martró E, Medina M, Mora N, Saludes V, Prats C, Prieto-Alhambra D, Alvarez-Lacalle E. Transmissibility, hospitalization, and intensive care admissions due to omicron compared to delta variants of SARS-CoV-2 in Catalonia: A cohort study and ecological analysis. Front Public Health 2022; 10:961030. [PMID: 36033822 PMCID: PMC9412031 DOI: 10.3389/fpubh.2022.961030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose We aim to compare the severity of infections between omicron and delta variants in 609,352 SARS-CoV-2 positive cases using local hospitalization, vaccination, and variants data from the Catalan Health Care System (which covers around 7. 8 million people). Methods We performed a substitution model to establish the increase in transmissibility of omicron using variant screening data from primary care practices (PCP) and hospital admissions. In addition, we used this data from PCP to establish the two periods when delta and omicron were, respectively, dominant (above 95% of cases). After that, we performed a population-based cohort analysis to calculate the rates of hospital and intensive care unit (ICU) admissions for both periods and to estimate reduction in severity. Rate ratios (RR) and 95% confidence intervals (95% CI) were calculated and stratified by age and vaccination status. In a second analysis, the differential substitution model in primary care vs. hospitals allowed us to obtain a population-level average change in severity. Results We have included 48,874 cases during the delta period and 560,658 during the omicron period. During the delta period, on average, 3.8% of the detected cases required hospitalization for COVID-19. This percentage dropped to 0.9% with omicron [RR of 0.46 (95% CI: 0.43 to 0.49)]. For ICU admissions, it dropped from 0.8 to 0.1% [RR 0.25 (95% CI: 0.21 to 0.28)]. The proportion of cases hospitalized or admitted to ICU was lower in the vaccinated groups, independently of the variant. Omicron was associated with a reduction in risk of admission to hospital and ICU in all age and vaccination status strata. The differential substitution models showed an average RR between 0.19 and 0.50. Conclusion Both independent methods consistently show an important decrease in severity for omicron relative to delta. The systematic reduction happens regardless of age. The severity is also reduced for non-vaccinated and vaccinated groups, but it remains always higher in the non-vaccinated population. This suggests an overall reduction in severity, which could be intrinsic to the omicron variant. The fact is that the RR in ICU admission is systematically smaller than in hospitalization points in the same direction.
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Affiliation(s)
- Martí Català
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Ermengol Coma
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Sergio Alonso
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Blanco
- Clinical Genetics Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain,Biomedical Research Networking Center in Infectious Diseases (CIBERINF), Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni E. Bordoy
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Pere-Joan Cardona
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
| | - Francesc Fina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Medina
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Núria Mora
- Primary Care Services Information System (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain,Biomedical Research Networking Center in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Clara Prats
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Enrique Alvarez-Lacalle
- Physics Department, Universitat Politècnica de Catalunya, Barcelona, Spain,*Correspondence: Enrique Alvarez-Lacalle
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23
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Velásquez-Ortiz N, Hernández C, Cantillo-Barraza O, Medina M, Medina-Alfonso M, Suescún-Carrero S, Muñoz M, Vega L, Castañeda S, Cruz-Saavedra L, Ballesteros N, Ramírez JD. Estimating the genetic structure of Triatoma dimidiata (Hemiptera: Reduviidae) and the transmission dynamics of Trypanosoma cruzi in Boyacá, eastern Colombia. PLoS Negl Trop Dis 2022; 16:e0010534. [PMID: 35816541 PMCID: PMC9302734 DOI: 10.1371/journal.pntd.0010534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/01/2022] [Revised: 07/21/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Chagas disease is considered a public health issue in Colombia, where many regions are endemic. Triatoma dimidiata is an important vector after Rhodnius prolixus, and it is gaining importance in Boyacá, eastern Colombia. Following the recent elimination of R. prolixus in the region, it is pivotal to understand the behavior of T. dimidiata and the transmission dynamics of T. cruzi. We used qPCR and Next Generation Sequencing (NGS) to evaluate T. cruzi infection, parasite load, feeding profiles, and T. cruzi genotyping for T. dimidiata specimens collected in nine municipalities in Boyacá and explored T. dimidiata population genetics. We found that T. dimidiata populations are composed by a single population with similar genetic characteristics that present infection rates up to 70%, high parasite loads up to 1.46 × 109 parasite-equivalents/mL, a feeding behavior that comprises at least 17 domestic, synanthropic and sylvatic species, and a wide diversity of TcI genotypes even within a single specimen. These results imply that T. dimidiata behavior is similar to other successful vectors, having a wide variety of blood sources and contributing to the circulation of different genotypes of the parasite, highlighting its importance for T. cruzi transmission and risk for humans. In the light of the elimination of R. prolixus in Boyacá and the results we found, we suggest that T. dimidiata should become a new target for vector control programs. We hope this study provides enough information to enhance surveillance programs and a future effective interruption of T. cruzi vector transmission in endemic regions. Chagas disease is a complex zoonotic infection caused by the protozoan Trypanosoma cruzi. This pathology is endemic in the Americas and causes a tremendous burden in terms of public health. The feces of triatomine bugs mainly transmit this parasite. A massive diversity of triatomines can be found in the north of South America, where Rhodnius is considered the most epidemiologically relevant genus. However, government efforts have attempted to control the vector transmission of specific regions. That is the case of Boyaca in eastern Colombia, which has several municipalities certified as free of R. prolixus transmission of the parasite. However, other species such as Triatoma dimidiata can occupy the left niche due to R. prolixus elimination. We explored the infection rate, parasite load, feeding preferences, and T. cruzi diversity in T. dimidiata specimens collected in municipalities with no R. prolixus infestation. Our results highlight the preponderant need for increasing serological surveillance and prevention in those communities due to the risk of a plausible reactivation of T. cruzi vector transmission due to T. dimidiata.
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Affiliation(s)
- Natalia Velásquez-Ortiz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Centro de Tecnología en Salud (CETESA), Innovaseq SAS, Bogotá, Colombia
| | - Omar Cantillo-Barraza
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Grupo BCEI Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Manuel Medina
- Programa de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Departamental, Tunja, Boyacá, Colombia
| | - Mabel Medina-Alfonso
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia
| | - Sandra Suescún-Carrero
- Grupo de Investigación del Laboratorio de Salud Pública de Boyacá, Secretaria de Salud de Boyacá, Tunja, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Laura Vega
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Nathalia Ballesteros
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York city, New York, United States of America
- * E-mail: ,
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Zavala A, Iglesias M, Caller V, Medina M, De Pawlikowski W. Free flap reconstruction of distal extremity necrosis after COVID-19-related multisystem inflammatory syndrome in a pediatric patient. Microsurgery 2022; 42:526-528. [PMID: 35666135 PMCID: PMC9348492 DOI: 10.1002/micr.30930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/18/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Abraham Zavala
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño - San Borja, Lima, Peru
| | - Martín Iglesias
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño - San Borja, Lima, Peru
| | - Verónica Caller
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño - San Borja, Lima, Peru
| | - Manuel Medina
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño - San Borja, Lima, Peru
| | - Wieslawa De Pawlikowski
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Salud del Niño - San Borja, Lima, Peru
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Gamboa Cárdenas RV, Huarcaya-Victoria J, Ugarte-Gil MF, Reategui Sokolova C, Pimentel-Quiroz V, Zevallos Miranda F, Medina M, Rodriguez Bellido Z, Perich Campos R, Pastor Asurza C, Alarcon GS. POS1493-HPR FACTORS ASSOCIATED WITH THE OCCURRENCE OF MENTAL DISORDERS IN PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES DURING THE COVID-19 PANDEMIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMental disorders constitute a serious and underestimated problem in Latin America and they could have worse features in comparison with Europe or North America (1); that was the case even before the COVID-19 epidemic ensued in 2020.ObjectivesThe objective of this study was to determine the factors associated with the occurrence of mental health disorders (MHD) in patients with autoimmune rheumatic disease (ARD) from Perú, a high COVID-19 incidence country.MethodsPatients with ARD from a single center (Hospital Guillermo Almenara -EsSalud, Lima-Perú) were included during the first and second waves of the COVID-19 pandemic (March to November 2020). Interviews, medical records reviews, and an electronic survey were performed. MHD explored were depression (assessed with the Patient Health Questionnaire 9: PHQ-9), anxiety (ascertained with the Generalized Anxiety Disorder-7: GAD-7) and post-traumatic stress disorder: PTSD (evaluated with the Event Scale-Revised: IES-R). Variables examined were sociodemographic (age, gender, educational level, marital status, living alone, job status, religiosity), previous diagnosis and treatment for mental disorders, living with a COVID-19 patient, COVID-19 diagnosis (current or past), fear of COVID-19 (assessed with the COVID-19 Scale: FCV-19S) and the ARD type. Multivariable logistic regression models using backward elimination procedure were performed to determine the variables associated with depression, anxiety, and PTSD. (See Table 1).Table 1.Variables associated with depression, anxiety an PSTD on ARD patients: Multivariable analysis.DepressionAnxietyPTSDvariablesOR (CI=95%)p valueOR (CI95%)p valueOR (CI95%)p valuePrevious treatment for mental disorders2.35 (1.37-4.0)30.0022.42 (1.37-4.26)0.0022.42 1.39-4.210.002Fear for COVID-191.07 (1.05-1.10)<0.0011.09 (1.06-1.12)<0.0011.41 1.11-1.17<0.001COVID-19 diagnosisNSNS1.75 1.06-2.890.028Educational level University/postgraduate High SchoolNS0.43 (0.82-0.21)0.009NS ElementaryNS0.52 (0.28-0,95) Ref.0.032NSMarital status SingleNSNS0.57 (0.34-0.96)0.033 Divorced/separateNSNS1.02 (0.73-1.41)0.919ResultsNine hundred and thirteen ARD patients were evaluated. The most frequent diagnosis was rheumatoid arthritis in 446(48.8%) patients followed by systemic lupus erythematosus in 279 (30.6%). Depression, anxiety, and PTSD were observed in 128 (14.0%), 112 (12.30%) and 485 (53.1%) patients, respectively. In the multivariable analyses, previous treatment for mental disorders and fear of COVID-19 were associated with depression: OR=2.35 (95% CI 1.37-4.03; p=0.002) and OR=1.07 (95% CI 1.05-1.10; p<0.001) respectively; also with anxiety: OR= 2.42 (95% CI 1.37-4.26; p=0.002) and OR=1.09 (95% CI 1.06-1.12; p <0.01) and with PSTD: OR=2.42 (95% CI 1.39-4.21;p=0.002) and OR=1.41 (95% CI=1.11-1.17; p<0.001). A diagnosis of COVID-19 was associated with PTSD: OR=1.75 (95% CI 1.06-2.89, p=0.028), while being single was associated with a decreased probability of PTSD occurrence: OR=0.57 (95% CI=0.35-0.96; p=0.03). Finally, having a high educational level was associated with less anxiety: OR=0.43 (95% CI=0.82-0.21; p=0.009), for university /postgraduate studies and OR=0.52 (CI 95%=0.28-0.95; p=0.032) for secondary studies.ConclusionFear of COVID-19 and previous treatment for mental disorder were associated with all MHD explored on our ARD patients during the COVID-19 pandemic.References[1]Zhang S. Eur J Psychotraumatol. 2021;12(1):2001192.Disclosure of InterestsNone declared
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Biarnés-Martínez M, Fàbregas M, Coma E, Pera G, Fina F, Rivera-Arco A, Guiriguet C, Méndez-Boo L, Medina M. [SARS-CoV-2 infection in occupational settings in Catalonia.]. Rev Esp Salud Publica 2022; 96:e202205040. [PMID: 35506485] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The aim of this paper was to estimate the SARS-CoV-2 infection incidence regarding the occupation in Catalonia, globally and in the different waves of the pandemic. METHODS We performed a retrospective cohort study. We included all people between 16 and 65 years old with an occupation identified from the sick leave recorded in the primary care electronic health records of the Institut Català de la Salut (ICS) (total n=2,199,745 people). The study period was from March 1st, 2020 to September 16th, 2021. RESULTS Healthcare workers had the highest incidence, with an age and sex adjusted cumulative rate of 27.7% [95% CI: 27.3%-28.1%]: 29.4% in nursing assistants, 27.3% in medical professions and 26.3% in nursing professionals; followed by the elementary occupations group with an adjusted incidence of 16.9% [95% CI: 16.7%-17%], such as the agricultural laborers (23% [95% CI: 21%-25.1%]) and rural occupations (19.1% [95% CI: 18.3%-19.8%) -especially during the 2020 summer period-, the domestic employees (20.5% [95% CI: 18.9%-22.2%]) and cleaning professionals (17.5% [95% CI: 17.2%-17.9%]). CONCLUSIONS Healthcare workers are the hardest hit during the pandemic. On the other hand, the less qualified professions have high incidences, highlighting the different inequities in access to telework, working conditions and other social determinants of health.
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Affiliation(s)
- Marta Biarnés-Martínez
- Unidad Docente de Medicina Preventiva y Salud Pública Parc de Salut Mar. Universitat Pompeu Fabra. Agència de Salut Pública de Barcelona. Barcelona. España
| | - Mireia Fàbregas
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Ermengol Coma
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord. Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol. Barcelona. España
| | - Francesc Fina
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Alejandro Rivera-Arco
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Carolina Guiriguet
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
| | - Manuel Medina
- Sistemes d'Informació dels serveis d'Atenció Primària (SISAP). Institut Català de la Salut (ICS). Barcelona. España
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Suñer C, Coma E, Ouchi D, Hermosilla E, Baro B, Rodríguez-Arias MÀ, Puig J, Clotet B, Medina M, Mitjà O. Association between two mass-gathering outdoor events and incidence of SARS-CoV-2 infections during the fifth wave of COVID-19 in north-east Spain: A population-based control-matched analysis. The Lancet Regional Health - Europe 2022; 15:100337. [PMID: 35237763 PMCID: PMC8883024 DOI: 10.1016/j.lanepe.2022.100337] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Many countries have resumed mass-gathering events like music festivals, despite the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreading. In this study, we aimed to assess the effect of two mass-gathering outdoor events, held during a peak of SARS-CoV-2 transmission, on COVID-19 incidence. Methods This was a retrospective, population-based control-matched analysis. The study population included attendees to two outdoor music festivals held in Catalonia (North-East Spain). The primary objective was to compare the incidence of COVID-19 within the 3-to-10 days following the event between attendees and a population-based control group. Findings The analysis included 18,275 and 27,347 attendees to the first and second festivals, respectively, and their corresponding controls. The post-festival 7-day cumulative COVID-19 incidence among attendees and controls was 4.14% (95% CI 3.86-4.44) vs. 1.69% (1.51-1.88) for the first festival (RR 2.46; 2.16-2.80), and 2.42% (2.35-2.61) and 1.10% (0.99-1.2) for the second festival (RR 2.19; 1.92-2.51). COVID-19 incidence among immunized individuals was also two-fold higher in attendees than in controls. Previous COVID-19 infection, vaccination, and adequate mask-wearing were significantly associated with a lower risk of COVID-19 infection after the events. Interpretation Despite the proven effectiveness of preventive measures such as Ag-RDT screening, mask-wearing and vaccination, caution should be taken when holding these events during a period of high community SARS-CoV-2 transmission. Funding Crowdfunding campaign YoMeCorono (https://www.yomecorono.com/) and the Generalitat de Catalunya.
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Quiros-Gomez O, Segura-Cardona Á, Flórez PA, Pinto N, Medina M, Henao-Martínez AF, Olivera MJ, Parra-Henao G. Risk factors and spatial analysis for domiciliary infestation with the Chagas disease vector Triatoma venosa in Colombia. Ther Adv Infect Dis 2022; 9:20499361221084164. [PMID: 35321343 PMCID: PMC8935413 DOI: 10.1177/20499361221084164] [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: 10/14/2021] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In Colombia, communities living in the Andean region are the most affected by Chagas disease due to the presence of the main vectors, the environmental and risk factors associated with house infestation. Triatoma venosa is classified as a secondary vector that is frequently found in the departments of Boyaca and Cundinamarca, but epidemiological information and its association with risk factors in domestic and peridomestic areas is unknown. The study aimed to evaluate housing and environmental characteristics associated with domestic and peridomestic infestation by T. venosa and a risk map was estimated. Methods: A cross-sectional study was conducted in municipalities of Boyaca and Cundinamarca, Colombia. From March to July 2015, triatomine infestation screening surveys were conducted in 155 households. Multivariate analysis was performed to evaluate associations with the infestation and ecological niche modeling was estimated using environmental variables. Results: No statistical association was found with any of the housing variables in the adjusted multivariate analysis. However, in raw relationship infestation was associated with bushes < 10 m (OR = 3; 95% CI: 1.3–7.3) and higher temperature p value < 0.05. The developed final risk map pointed to 12 municipalities with no previous report of the disease, which should be sampled for the presence of T. venosa. Conclusion: This study highlights the relationship between environmental factors and T. venosa in Colombia and the importance of modeling tools to improve mapping efforts. Additional studies are needed to verify the association with bushes and higher temperatures and to verify infestation in predicted risk area with no previous report of the species
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Affiliation(s)
- Oscar Quiros-Gomez
- Grupo de Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia
| | | | | | - Néstor Pinto
- Departamento de Cundinamarca, Secretaria de Salud, Bogotá, Colombia
| | - Manuel Medina
- Departamento de Boyacá, Secretaria de Salud, Tunja, Colombia
| | | | | | - Gabriel Parra-Henao
- Instituto Nacional de Salud, Bogotá, Colombia and Centro de Investigación en Salud para el Trópico, Universidad Cooperativa de Colombia, Santa Marta, Av. Cll 26 N° 51-20 Bogotá, 52162 Colombia
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Coma E, Vila J, Méndez-Boo L, Antón A, Mora N, Fina F, Fàbregas M, Medina M. Respiratory Syncytial Virus Infections in Young Children Presenting to Primary Care in Catalonia During the COVID-19 Pandemic. J Pediatric Infect Dis Soc 2022; 11:69-72. [PMID: 34922377 DOI: 10.1093/jpids/piab121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022]
Abstract
We observed an unusual pattern of respiratory syncytial virus (RSV) in children under 5 years in Catalonia (Spain). We observed a near absence of RSV during winter months and a subsequent surge during the late spring. Primary care electronic health records combined with hospital RSV laboratory confirmation could be used to monitor trends of respiratory pathogens.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Jorgina Vila
- Hospitalization Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Andrés Antón
- Respiratory Virus Unit, Virology Section, Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Barcelona, Spain
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Coma E, Miró Q, Medina M, Marin-Gomez FX, Cos X, Benítez M, Mas A, Fàbregas M, Fina F, Lejardi Y, Vidal-Alaball J. Association between the reduction of face-to-face appointments and the control of patients with type 2 diabetes mellitus during the Covid-19 pandemic in Catalonia. Diabetes Res Clin Pract 2021; 182:109127. [PMID: 34752800 PMCID: PMC8592525 DOI: 10.1016/j.diabres.2021.109127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/20/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022]
Abstract
AIM To analyse the relation between face-to-face appointments and management of patients with type 2 diabetes mellitus (T2DM) visited in primary care practices (PCP). METHODS Retrospective study in 287 primary care practices (PCPs) attending>300,000 patients with T2DM. We analysed the results of 9 diabetes-related indicators of the Healthcare quality standard, comprising foot and retinopathy screening, blood pressure (BP) and glycemic control; and the incidence of T2DM. We calculated each indicator's percentage of change in 2020 with respect to the results of 2019. RESULTS Indicators' results were reduced in 2020 compared to 2019, highlighting the indicators of foot and retinopathy screening (-51.6% and -25.7%, respectively); the glycemic control indicator (-21.2%); the BP control indicator (-33.7%) and the incidence of T2DM (-25.6%). Conversely, the percentage of type 2 diabetes patients with HbA1c > 10% increased by 34%. PCPs with<11 weekly face-to-face appointments offered per professional had greater reductions than those PCPs with more than 40. For instance, a reduction of -60.7% vs -38.2% (p-value < 0.001) in the foot screening's indicator; -27.5% vs -12.5% (p-value < 0.001) in glycemic control and -40.2 vs -24.3% (p-value < 0.001) in BP control. CONCLUSIONS Reducing face-to-face visits offered may impact T2DM patients' follow-up and thus worsen their control.
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Affiliation(s)
- Ermengol Coma
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain.
| | - Queralt Miró
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain
| | - Manuel Medina
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | - Francesc X Marin-Gomez
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain; Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Spain; Faculty of Medicine. University of Vic - Central University of Catalonia, Vic, Spain
| | - Xavier Cos
- DAP_Cat Research Group, Gerencia Territorial Barcelona Ciutat, Institut Català de la Salut, Spain; Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Universitat Autonoma de Barcelona, Spain; Institut Català de la Salut, Spain
| | - Mència Benítez
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain; Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | | | - Mireia Fàbregas
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Primary Care Services Information Systems, Institut Català de la Salut, Barcelona, Spain
| | | | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Spain; Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Spain; Faculty of Medicine. University of Vic - Central University of Catalonia, Vic, Spain
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Cantillo-Barraza O, Medina M, Zuluaga S, Blanco MI, Caro R, Jaimes-Dueñez J, Beltrán V, Xavier SCC, Triana-Chavez O. Distribution and natural infection status of synantrophic triatomines (Hemiptera: Reduviidae), vectors of Trypanosoma cruzi, reveals new epidemiological scenarios for chagas disease in the Highlands of Colombia. PLoS Negl Trop Dis 2021; 15:e0009574. [PMID: 34280203 PMCID: PMC8321397 DOI: 10.1371/journal.pntd.0009574] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/27/2020] [Revised: 07/29/2021] [Accepted: 06/17/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Updating the distribution and natural infection status of triatomine bugs is critical for planning, prioritizing, and implementing strategies to control Chagas disease (CD), especially after vector reduction programs. After carrying out a control program, the Department of Boyaca contains the highest number of Colombian municipalities certified by PAHO to be free of intradomiciliary transmission of Trypanosoma cruzi by Rhodnius prolixus. The present work describes the spatial distribution, natural infection (NI), and molecular characterization of T. cruzi in synanthropic triatomines from the Department of Boyaca in 2017 and 2018. MATERIALS AND METHODS An entomological survey was conducted in 52 municipalities in Boyaca known to have had previous infestations of triatomine bugs. Insects were collected through active searches carried out by technical personnel from the Secretary of Health and community members using Triatomine Collection Stations (PITs-acronym in Spanish). For evaluation of natural infection, triatomines were identified morphologically and grouped in pools of one to five individuals of the same species collected in the same household. DNA derived from the feces of each pool of insects was analyzed by PCR for the presence of T. cruzi using primers flanking the satellite DNA of the parasite. SL-IR primers were used to differentiate TCI from the other DTUs and to identify different genotypes. The distribution of the collected triatomines was analyzed to determine any vector hotspots using spatial recreation. RESULTS A total of 670 triatomine bugs was collected, belonging to five species: Triatoma dimidiata (73.2%), Triatoma venosa (16.7%), Panstrongylus geniculatus (5.7%), Rhodnius prolixus (4.4%), and Panstrongylus rufotuberculatus (0.4%), from 29 of the 52 municipalities. In total, 71.6% of the bugs were collected within houses (intradomiciliary) and the rest around the houses (peridomiciliary). Triatoma dimidiata was the most widely distributed species and had the highest natural infection index (37.8%), followed by T. venosa and P. geniculatus. TcI was the only DTU found, with the TcI Dom genotype identified in 80% of positive samples and TcI sylvatic in the other insects. Spatial analysis showed clusters of T. dimidiata and T. venosa in the northeast and southwest regions of Boyaca. CONCLUSIONS After some municipalities were certified free of natural transmission within houses (intradomiciliary transmission) of T. cruzi by R. prolixus, T. dimidiata has become the most prevalent vector present, and represents a significant risk of resurgent CD transmission. However, T. venosa, P. geniculatus, and P. rufotuberculatus also contribute to the increased risk of transmission. The presence of residual R. prolixus may undo the successes achieved through vector elimination programs. The molecular and spatial analysis used here allows us to identify areas with an ongoing threat of parasite transmission and improve entomological surveillance strategies.
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Affiliation(s)
| | - Manuel Medina
- Programa de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Departamental, Tunja, Boyacá, Colombia
| | - Sara Zuluaga
- Grupo BCEI Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - María Isabel Blanco
- Laboratorio Departamental de Salud Pública de Boyacá, Tunja, Boyacá, Colombia
| | - Rodrigo Caro
- Programa de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Departamental, Tunja, Boyacá, Colombia
| | - Jeiczon Jaimes-Dueñez
- Grupo de Investigación en Ciencias Animales (GRICA), Universidad Cooperativa de Colombia UCC, Bucaramanga, Colombia
| | - Virgilio Beltrán
- Programa de Control de Enfermedades Transmitidas por Vectores, Secretaría de Salud Departamental, Tunja, Boyacá, Colombia
| | - Samanta CC Xavier
- Laboratorio Biología de Tripanosomatídeos (Labtrip), Fundación Oswaldo Cruz, Rio de Janeiro, Brasil
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Coma E, Guiriguet C, Mora N, Marzo-Castillejo M, Benítez M, Méndez-Boo L, Fina F, Fàbregas M, Mercadé A, Medina M. Impact of the COVID-19 pandemic and related control measures on cancer diagnosis in Catalonia: a time-series analysis of primary care electronic health records covering about five million people. BMJ Open 2021; 11:e047567. [PMID: 34006554 PMCID: PMC8130761 DOI: 10.1136/bmjopen-2020-047567] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/06/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Cancer care has been disrupted by the response of health systems to the COVID-19 pandemic, especially during lockdowns. The objective of our study is to evaluate the impact of the pandemic on the incidence of cancer diagnoses in primary care. DESIGN Time-series study of malignant neoplasms and diagnostic procedures, using data from the primary care electronic health records from January 2014 to September 2020. SETTING Primary care, Catalonia, Spain. PARTICIPANTS People older than 14 years and assigned in one of the primary care practices of the Catalan Institute of Health with a new diagnosis of malignant neoplasm. MAIN OUTCOME MEASURES We obtained the monthly expected incidence of malignant neoplasms using a temporary regression, where the response variable was the incidence of cancer from 2014 to 2018 and the adjustment variables were the trend and seasonality of the time series. Excess or lack of malignant neoplasms was defined as the number of observed minus expected cases, globally and stratified by sex, age, type of cancer and socioeconomic status. RESULTS Between March and September 2020 we observed 8766 (95% CI 4135 to 13 397) fewer malignant neoplasm diagnoses, representing a reduction of 34% (95% CI 19.5% to 44.1%) compared with the expected. This underdiagnosis was greater in individuals aged older than 64 years, men and in some types of cancers (skin, colorectal, prostate). Although the reduction was predominantly focused during the lockdown, expected figures have not yet been reached (40.5% reduction during the lockdown and 24.3% reduction after that). CONCLUSIONS Reduction in cancer incidence has been observed during and after the lockdown. Urgent policy interventions are necessary to mitigate the indirect effects of the COVID-19 pandemic and related control measures on other diseases and some strategies must be designed in order to reduce the underdiagnosis of cancer.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
| | - Carolina Guiriguet
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
- Equip d'Atenció Primària Gòtic, Institut Catala De La Salut, Barcelona, Spain
| | - Nuria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Mercè Marzo-Castillejo
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Sud, Direcció d'Atenció Primària Costa de Ponent, ICS, Barcelona, Spain
| | - Mencia Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
- Equip d'Atenció Primària Gòtic, Institut Catala De La Salut, Barcelona, Spain
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
| | - Albert Mercadé
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Catala De La Salut, Barcelona, Spain
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Silva-Lima AW, Froes AM, Garcia GD, Tonon LAC, Swings J, Cosenza CAN, Medina M, Penn K, Thompson JR, Thompson CC, Thompson FL. Mussismilia braziliensis White Plague Disease Is Characterized by an Affected Coral Immune System and Dysbiosis. Microb Ecol 2021; 81:795-806. [PMID: 33000311 DOI: 10.1007/s00248-020-01588-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/14/2020] [Indexed: 06/11/2023]
Abstract
Infectious diseases are one of the major drivers of coral reef decline worldwide. White plague-like disease (WPL) is a widespread disease with a complex etiology that infects several coral species, including the Brazilian endemic species Mussismilia braziliensis. Gene expression profiles of healthy and WPL-affected M. braziliensis were analyzed in winter and summer seasons. The de novo assembly of the M. braziliensis transcriptome from healthy and white plague samples produced a reference transcriptome containing 119,088 transcripts. WPL-diseased samples were characterized by repression of immune system and cellular defense processes. Autophagy and cellular adhesion transcripts were also repressed in WPL samples, suggesting exhaustion of the coral host defenses. Seasonal variation leads to plasticity in transcription with upregulation of intracellular signal transduction, apoptosis regulation, and oocyte development in the summer. Analysis of the active bacterial rRNA indicated that Pantoea bacteria were more abundant in WPL corals, while Tistlia, Fulvivirga, and Gammaproteobacteria Ga0077536 were more abundant in healthy samples. Cyanobacteria proliferation was also observed in WPL, mostly in the winter. These results indicate a scenario of dysbiosis in WPL-affected M. braziliensis, with the loss of potentially symbiotic bacteria and proliferation of opportunistic microbes after the start of the infection process.
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Affiliation(s)
- A W Silva-Lima
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
| | - A M Froes
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
| | - G D Garcia
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil
| | - L A C Tonon
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil
| | - J Swings
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil
| | - C A N Cosenza
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil
| | - M Medina
- Pennsylvania State University, 324 Mueller Lab, University Park, PA, 16802, USA
| | - K Penn
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - J R Thompson
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - C C Thompson
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil
| | - F L Thompson
- Laboratório de Microbiologia, Instituto de Biologia, Universidade Federal do Rio de Janeiro (UFRJ), Av. Carlos Chagas Fo. S/N-CCS-IB-Lab de Microbiologia-BLOCO A (Anexo) A3-sl 102, Cidade Universitária, Rio de Janeiro, RJ, 21941-599, Brazil.
- Sage/Coppe, Centro de Gestão Tecnológica-CT2, Rua Moniz de Aragão, no. 360-Bloco 2, Ilha do Fundão-Cidade Universitária, Rio de Janeiro, 21941-972, Brazil.
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Coma E, Mora N, Peremiquel-Trillas P, Benítez M, Méndez L, Mercadé A, Fina F, Fàbregas M, Medina M. Influence of organization and demographic characteristics of primary care practices on continuity of care: analysis of a retrospective cohort from 287 primary care practices covering about 6 million people in Catalonia. BMC Fam Pract 2021; 22:56. [PMID: 33761874 PMCID: PMC7992318 DOI: 10.1186/s12875-021-01414-y] [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] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 03/11/2021] [Indexed: 11/10/2022]
Abstract
Background There is evidence that an ongoing patient-physician relationship is associated with improved health outcomes and more efficient health systems. The main objective of this study is to describe the continuity of care in primary healthcare in Catalonia (Spain) and to analyze whether the organization of primary care practices (PCP) or their patients’ sociodemographic characteristics play a role in its continuity of care. Methods Four indices were used to measure continuity of care: Usual Provider Index (UPC), Modified Modified Continuity Index (MMCI), Continuity of Care Index (COC), and Sequential Continuity Index (SECON). The study was conducted on 287 PCP of the Catalan Institute of Health (Institut Català de la Salut—ICS). Each continuity of care index was calculated at the patient level (3.2 million patients and 35.5 million visits) and then aggregated at the PCP level. We adjusted linear regression models for each continuity index studied, considering the result of the index as an independent variable and demographic and organizational characteristics of the PCP as explanatory variables. Pearson correlation tests were used to compare the four continuity of care indices. Results Indices’ results were: UPC: 70,5%; MMCI: 73%; COC: 53,7%; SECON: 60,5%. The continuity of care indices had the highest bivariate correlation with the percentage of appointments booked with an assigned health provider (VISUBA variable: the lower the value, the higher the visits without an assigned health provider, and thus an organization favoring immediate consultation). Its R2 ranged between 56 and 63%, depending on the index. The multivariate model which explained better the variability of continuity of care indices (from 49 to 56%) included the variables VISUBA and rurality with a direct relationship; while the variables primary care physician leave days and training practices showed an inverse relationship. Conclusion Study results suggest that an organization of primary care favoring immediate consultation is related to a lower continuity of patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01414-y.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Preventive Medicine and Epidemiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Unit of Molecular Epidemiology and Genetics in Infections and Cancer, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mència Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain.,Equip d'Atenció Primària Gòtic, Institut Català de La Salut (ICS), Barcelona, Spain
| | - Leonardo Méndez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Albert Mercadé
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de Les Corts Catalanes, 587, 08007, Barcelona, Spain
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Coma E, Méndez-Boo L, Mora N, Guiriguet C, Benítez M, Fina F, Fàbregas M, Balló E, Ramos F, Medina M, Argimon JM. Divergences on expected pneumonia cases during the COVID-19 epidemic in Catalonia: a time-series analysis of primary care electronic health records covering about 6 million people. BMC Infect Dis 2021; 21:283. [PMID: 33740907 PMCID: PMC7979451 DOI: 10.1186/s12879-021-05985-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/08/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Pneumonia is one of the complications of COVID-19. Primary care electronic health records (EHR) have shown the utility as a surveillance system. We therefore analyse the trends of pneumonia during two waves of COVID-19 pandemic in order to use it as a clinical surveillance system and an early indicator of severity. METHODS Time series analysis of pneumonia cases, from January 2014 to December 2020. We collected pneumonia diagnoses from primary care EHR, a software system covering > 6 million people in Catalonia (Spain). We compared the trend of pneumonia in the season 2019-2020 with that in the previous years. We estimated the expected pneumonia cases with data from 2014 to 2018 using a time series regression adjusted by seasonality and influenza epidemics. RESULTS Between 4 March and 5 May 2020, 11,704 excess pneumonia cases (95% CI: 9909 to 13,498) were identified. Previously, we identified an excess from January to March 2020 in the population older than 15 years of 20%. We observed another excess pneumonia period from 22 october to 15 november of 1377 excess cases (95% CI: 665 to 2089). In contrast, we observed two great periods with reductions of pneumonia cases in children, accounting for 131 days and 3534 less pneumonia cases (95% CI, 1005 to 6064) from March to July; and 54 days and 1960 less pneumonia cases (95% CI 917 to 3002) from October to December. CONCLUSIONS Diagnoses of pneumonia from the EHR could be used as an early and low cost surveillance system to monitor the spread of COVID-19.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
| | - Leonardo Méndez-Boo
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Carolina Guiriguet
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Mència Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Elisabet Balló
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Salt, Institut Català de la Salut, Girona, Spain
| | - Francisa Ramos
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
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Engels V, Medina M, Antolín E, Ros C, Amaro A, De-Guirior C, Manzour N, Sotillo L, De la Cuesta R, Rodríguez R, San-Frutos L, Peralta S, Martin-Martínez A, Alcázar JL. Feasibility, tolerability, and safety of hysterosalpingo-foam sonography (hyfosy). multicenter, prospective Spanish study. J Gynecol Obstet Hum Reprod 2020; 50:102004. [PMID: 33242678 DOI: 10.1016/j.jogoh.2020.102004] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/14/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the feasibility,tolerability, and safety of the ultrasound assessment of tubal patency using foam as contrast. METHODS This was a prospective multicenter study of 915 infertile nulliparous women scheduled for sonohysterosalpingography with foam instillation (HYFOSY) for tubal patency testing as a part of the fertility workup. Clinical and sonographic data were recorded into a web-shared database. Tubal patency, cervical catheterization, pain during the procedure and post-procedural complications were collected. Patients reported discomfort or pain experienced during the procedure with a visual analogue scale (VAS) score. RESULTS Nine hundred fifteen women were included in the final analysis. Median age was 34 (range, 21-45) years and median body mass index was 23 (range, 16-41) kg/m2. Of 839 women, only 8(0.95 %) cases were abandoned due to impossibility of introducing the intracervical catheter. Most of the cervical os were easily cannulated with either paediatric nasogastric probes or special catheter for intrauterine insemination / sonohysterosalpingography 688/914(75.3 %). With a median instillation of 4 mL (range 1-16) of foam, both tubes were identified in 649/875 (70.9 %) patients, while unilateral patency was observed in 190/875 (20.8 %). Only 36/875 (3.9 %) of the women had bilateral tubal obstruction. The median VAS score for perception of pain during HyFoSy examination was 2 (range 0-10), and only 17 (1.9 %) of women reported severe pain (VAS ≥ 7). Pain was unrelated to tubal patency or tubal blockage. Unexpectedly, difficult cervical catheterizations that needed tenaculum, were more likely associated with mild pain during procedure [nasogastric probe group 176/289 (70.9 %) vs. insemination catheter group 166/399 (41.6 %) vs. tenaculum group 190/218(87.2 %) p < 0.001]. Finally, among 915 patients, we only noticed 3 (0.32 %) complications of the technique: two vasovagal episodes and a mild urinary infection. CONCLUSION HYFOSY is a feasible, well-tolerated and safe technique for the evaluation of tubal patency in infertile women.
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Affiliation(s)
- V Engels
- Hospital Universitario Puerta de Hierro Majadahonda, Spain.
| | - M Medina
- Hospital Materno Infantil Las Palmas de Gran Canaria, Spain
| | - E Antolín
- Hospital Materno Infantil La Paz, Spain
| | - C Ros
- Hospital Clinic Barcelona, Spain
| | - A Amaro
- Hospital Materno Infantil Las Palmas de Gran Canaria, Spain
| | - C De-Guirior
- Hospital Materno Infantil La Paz, Spain; Hospital Clinic Barcelona, Spain
| | - N Manzour
- Clínica Universitaria De Navarra, Spain
| | - L Sotillo
- Hospital Materno Infantil La Paz, Spain
| | - R De la Cuesta
- Hospital Universitario Puerta de Hierro Majadahonda, Spain
| | | | - L San-Frutos
- Hospital Universitario Puerta de Hierro Majadahonda, Spain
| | - S Peralta
- Hospital Materno Infantil Las Palmas de Gran Canaria, Spain
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Coma E, Mora N, Méndez L, Benítez M, Hermosilla E, Fàbregas M, Fina F, Mercadé A, Flayeh S, Guiriguet C, Balló E, Martinez Leon N, Mas A, Cordomí S, Lejardi Y, Medina M. Primary care in the time of COVID-19: monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia. BMC Fam Pract 2020; 21:208. [PMID: 33038926 PMCID: PMC7547821 DOI: 10.1186/s12875-020-01278-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [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: 07/02/2020] [Accepted: 09/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND To analyse the impact of the COVID-19 epidemic and the lockdown measures on the follow-up and control of chronic diseases in primary care. METHODS Retrospective study in 288 primary care practices (PCP) of the Catalan Institute of Health. We analysed the results of 34 indicators of the Healthcare quality standard (EQA), comprising different types: treatment (4), follow-up (5), control (10), screening (7), vaccinations (4) and quaternary prevention (4). For each PCP, we calculated each indicator's percentage of change in February, March and April 2020 respective to the results of the previous month; and used the T-Student test for paired data to compare them with the percentage of change in the same month of the previous year. We defined indicators with a negative effect those with a greater negative change or a lesser positive change in 2020 in comparison to 2019; and indicators with a positive effect those with a greater positive change or a lesser negative change. RESULTS We observed a negative effect on 85% of the EQA indicators in March and 68% in April. 90% of the control indicators had a negative effect, highlighting the control of LDL cholesterol with a reduction of - 2.69% (95%CI - 3.17% to - 2.23%) in March and - 3.41% (95%CI - 3.82% to - 3.01%) in April; and the control of blood pressure with a reduction of - 2.13% (95%CI - 2.34% to - 1.9%) and - 2.59% (95%CI - 2.8% to - 2.37%). The indicators with the greatest negative effect were those of screening, such as the indicator of diabetic foot screening with a negative effect of - 2.86% (95%CI - 3.33% to - 2.39%) and - 4.13% (95%CI - 4.55% to - 3.71%) in March and April, respectively. Only one vaccination indicator, adult Measles-Mumps-Rubella vaccine, had a negative effect in both months. Finally, among the indicators of quaternary prevention, we observed negative effects in March and April although in that case a lower inadequacy that means better clinical outcome. CONCLUSIONS The COVID-19 epidemic and the lockdown measures have significantly reduced the results of the follow-up, control, screening and vaccination indicators for patients in primary care. On the other hand, the indicators for quaternary prevention have been strengthened and their results have improved.
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Affiliation(s)
- Ermengol Coma
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.
| | - Núria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Leonardo Méndez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Mència Benítez
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Eduardo Hermosilla
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Mireia Fàbregas
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Francesc Fina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Albert Mercadé
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
| | - Souhel Flayeh
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària Gran Sol, Institut Català de la Salut, Badalona, Spain
| | - Carolina Guiriguet
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària Gòtic, Institut Català de la Salut, Barcelona, Spain
| | - Elisabet Balló
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
- Equip d'Atenció Primària de Salt, Institut Català de la Salut, Girona, Spain
| | - Nuria Martinez Leon
- Direcció Assistencial Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Ariadna Mas
- Direcció Assistencial Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Sílvia Cordomí
- Direcció Assistencial Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Yolanda Lejardi
- Direcció Assistencial Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut (ICS), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain
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Cantillo-Barraza O, Medina M, Zuluaga S, Valverde C, Motta C, Ladino A, Osorio MI, Jaimes-Dueñez J, Triana-Chávez O. Eco-epidemiological study reveals the importance of Triatoma dimidiata in the Trypanosoma cruzi transmission, in a municipality certified without transmission by Rhodnius prolixus in Colombia. Acta Trop 2020; 209:105550. [PMID: 32473116 DOI: 10.1016/j.actatropica.2020.105550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/08/2023]
Abstract
Boyaca department is an endemic area for Chagas disease in Colombia, where 24 of its municipalities have been certified by the PAHO with interruption of Trypanosoma cruzi transmission by R. prolixus. However, the presence of secondary vectors, represent a risk of parasite transmission for citizens and a challenge for the health care institutions. The aim of this work was to investigate eco-epidemiological features of Chagas disease in the municipality of Socota (Boyaca), in order to improve control and surveillance strategies. To understand the transmission dynamics of T. cruzi in this area, we designed a comprehensive, multi-faceted study including: (i) entomological survey in five villages (La Vega, Comaita, Chusvita, Guaquira and Pueblo Nuevo), (ii) blood meal source determination, (iii) T. cruzi infection rate in collected triatomines, (iv) identification of circulating T. cruzi genotypes, (v) serological determination of T. cruzi infection in domestic dogs; and (vi) evaluation of infection in synanthropic mammals. A total of 90 T. dimidiata were collected, of which 73.3% (66/90) and 24.4% (22/90) were collected inside dwellings and peridomestic areas, respectively, while the rest (2/90) in Chusvita Elementary School. T. cruzi infection was evidenced in 40% (36/90) of triatomine bugs using PCR analyses, in which only DTU I was found, and TcI Dom was the most distributed. Blood-meal analysis showed that T. dimidiata only fed of humans. Seroprevalence in domestic dogs was 4.6% (3/66), while that two Didelphis marsupialis captured showed no infection. In conclusion, the high dispersion and colonization of T. dimidiata shown in this municipality, along the high rate of T. cruzi (TcI) infection and its anthropophilic behavior constitute a risk situation for Chagas disease transmission in this municipality certified without R. prolixus. The epidemiological implications of these findings are herein discussed.
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Langa S, Peirotén A, Gaya P, Garde S, Arqués J, Nuñez M, Medina M, Rodríguez-Mínguez E. Human Bifidobacterium strains as adjunct cultures in Spanish sheep milk cheese. J Dairy Sci 2020; 103:7695-7706. [DOI: 10.3168/jds.2020-18203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/26/2020] [Indexed: 02/02/2023]
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Cantillo-Barraza O, Medina M, Granada Y, Muñoz C, Valverde C, Cely F, Gonzalez P, Mendoza Y, Zuluaga S, Triana-Chávez O. Susceptibility to Insecticides and Natural Infection in Aedes aegypti: An Initiative to Improve the Mosquito Control Actions in Boyacá, Colombia. Ann Glob Health 2020; 86:94. [PMID: 32864349 PMCID: PMC7427689 DOI: 10.5334/aogh.2805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 01/27/2023] Open
Abstract
Background Integrated management strategies for dengue prevention and control have been the main way to decrease the transmission of arboviruses transmitted by A. aegypti in Colombia. However, the increase of chikungunya (CHIKV), Zika, and dengue (DENV) fever cases suggests deficiencies in vector control strategies in some regions from this country. Objective This work aimed to establish a baseline susceptibility profile of A. aegypti to insecticides, determine the presence of kdr mutations associated with resistance to pyrethroids, and detect natural arbovirus infection in this vector from Moniquirá - Boyacá, one of the most endemic cities in Colombia. Methods Mosquitos were collected in six neighborhoods, and colonies established in the laboratory. Susceptibility to malathion and lambda-cyhalothrin insecticides was evaluated, and we examined the point mutations present in portions of domains I, II, III, and IV of the sodium channel gene using a simple allele-specific PCR-based assay (AS-PCR). Findings A. aegypti from Moniquirá showed decreased susceptibility to pyrethroid insecticides, and kdr mutations 419L, 1016I, and 1558C with allelic frequencies of 0.39, 0.40 and 0.95, respectively, were observed. The minimal infection rate (MIR) to DENV-1 was 44.1, while to CHIKV was 14.7. Conclusions We establish a baseline insecticide resistance, kdr mutations, and arbovirus circulation, which contain the elements necessary for the consolidation of a local surveillance strategy with an early warning system and rational selection and rotation of insecticides.
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Affiliation(s)
- Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, CO
| | - Manuel Medina
- Programa de control de enfermedades transmitidas por vectores, Secretaria de Salud Departamental, Tunja, Boyacá, CO
| | - Yurany Granada
- Grupo Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, CO
| | - Camilo Muñoz
- Programa de control de enfermedades transmitidas por vectores, Secretaria de Salud Departamental, Tunja, Boyacá, CO
| | - Cesar Valverde
- Grupo Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, CO
| | - Fernando Cely
- Programa de control de enfermedades transmitidas por vectores, Secretaria de Salud Departamental, Tunja, Boyacá, CO
| | - Paola Gonzalez
- Programa de control de enfermedades transmitidas por vectores, Secretaria de Salud Departamental, Tunja, Boyacá, CO
| | - Yovanny Mendoza
- Programa de control de enfermedades transmitidas por vectores, Secretaria de Salud Departamental, Tunja, Boyacá, CO
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, CO
| | - Omar Triana-Chávez
- Grupo Biología y Control de Enfermedades Infecciosas, BCEI, Universidad de Antioquia, Medellín, CO
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Coma Redon E, Mora N, Prats-Uribe A, Fina Avilés F, Prieto-Alhambra D, Medina M. Excess cases of influenza and the coronavirus epidemic in Catalonia: a time-series analysis of primary-care electronic medical records covering over 6 million people. BMJ Open 2020; 10:e039369. [PMID: 32727740 PMCID: PMC7431772 DOI: 10.1136/bmjopen-2020-039369] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES There is uncertainty about when the first cases of COVID-19 appeared in Spain. We aimed to determine whether influenza diagnoses masked early COVID-19 cases and estimate numbers of undetected COVID-19 cases. DESIGN Time-series study of influenza and COVID-19 cases, 2010-2020. SETTING Primary care, Catalonia, Spain. PARTICIPANTS People registered in primary-care practices, covering >6 million people and >85% of the population. MAIN OUTCOME MEASURES Weekly new cases of influenza and COVID-19 clinically diagnosed in primary care. ANALYSES Daily counts of both cases were computed using the total cases recorded over the previous 7 days to avoid weekly effects. Epidemic curves were characterised for the 2010-2011 to 2019-2020 influenza seasons. Influenza seasons with a similar epidemic curve and peak case number as the 2019-2020 season were used to model expected case numbers with Auto Regressive Integrated Moving Average models, overall and stratified by age. Daily excess influenza cases were defined as the number of observed minus expected cases. RESULTS Four influenza season curves (2011-2012, 2012-2013, 2013-2014 and 2016-2017) were used to estimate the number of expected cases of influenza in 2019-2020. Between 4 February 2020 and 20 March 2020, 8017 (95% CI: 1841 to 14 718) excess influenza cases were identified. This excess was highest in the 15-64 age group. CONCLUSIONS COVID-19 cases may have been present in the Catalan population when the first imported case was reported on 25 February 2020. COVID-19 carriers may have been misclassified as influenza diagnoses in primary care, boosting community transmission before public health measures were taken. The use of clinical codes could misrepresent the true occurrence of the disease. Serological or PCR testing should be used to confirm these findings. In future, this surveillance of excess influenza could help detect new outbreaks of COVID-19 or other influenza-like pathogens, to initiate early public health responses.
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Affiliation(s)
- Ermengol Coma Redon
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), ICS, Barcelona, Catalunya, Spain
- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Nuria Mora
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), ICS, Barcelona, Catalunya, Spain
- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Albert Prats-Uribe
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, Oxfordshire, UK
| | - Francesc Fina Avilés
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), ICS, Barcelona, Catalunya, Spain
- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Daniel Prieto-Alhambra
- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, Oxfordshire, UK
| | - Manuel Medina
- Sistemes d'Informació dels Serveis d'Atenció Primària (SISAP), ICS, Barcelona, Catalunya, Spain
- IDIAP Jordi Gol, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Sciabarrasi A, Marengo R, Cornejo A, Torrents J, Imoberdorf P, Banega D, Alvez G, Barrios L, Torretta R, Medina M, Detarsio S, Pelosi MC, Schachner L, Garello D, Eichman L, Sosa MF. Gastrointestinal parasites found in Psittacids of the genera Amazona sp, Ara sp, Aratinga so Forpus sp and macaw hybrids of the La Esmeralda Biological Station, Santa Fe, Argentina. Compend cienc vet 2020. [DOI: 10.18004/compend.cienc.vet.2020.10.01.26] [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: 10/23/2022] Open
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Affiliation(s)
- M Medina
- Universidade Federal de São Paulo, São Paulo, Brazil
| | - S Tufik
- Universidade Federal de São Paulo, São Paulo, Brazil
| | - M L Andersen
- Universidade Federal de São Paulo, São Paulo, Brazil
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García-Mejido JA, Martín-Martínez A, González-Diaz E, Fernández-Fernández C, Ortega I, Medina M, Fernández-Corona A, Fernández-Palacín A, Sainz JA. Malmström vacuum or Kielland forceps: which causes more damage to pelvic floor? Ultrasound Obstet Gynecol 2020; 55:257-263. [PMID: 31332857 DOI: 10.1002/uog.20404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine whether differences exist in the rate of levator ani muscle (LAM) avulsion between women who had undergone either Malmström vacuum delivery (MVD) or Kielland forceps delivery (KFD), allowing for potential confounding factors. METHODS This was a prospective observational study of nulliparous women undergoing instrumental delivery using Malmström vacuum extractor or Kielland forceps, at two hospital centers in Spain. Fetal head position (anterior, posterior or transverse) and fetal head station (low or mid) were assessed by ultrasound and digital examination, respectively. Avulsion was defined on tomographic ultrasound imaging as an abnormal insertion of the LAM in the three central slices from the plane of minimal hiatal dimensions. RESULTS In total, 414 patients were included in the study (212 MVD and 202 KFD). We observed a higher rate of LAM avulsion in the KFD group (KFD 49.5% vs MVD 32.5%; P = 0.001). When the results were evaluated according to fetal head position and station, we observed no differences in LAM avulsion. The crude odds ratio (OR) for the difference in avulsion between women in the KFD and MVD groups was 2.03 (95% CI, 1.36-3.03). However, when adjusted for duration of second stage of labor, fetal head circumference and fetal head station, the OR was no longer statistically significant (OR, 2.14 (95% CI, 0.95-4.85); P = 0.068). CONCLUSION When potential confounding factors are taken into account, the rate of LAM avulsion does not differ between women according to whether they have undergone KFD or MVD. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J A García-Mejido
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | - A Martín-Martínez
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Gran Canarias, Gran Canarias, Spain
| | - E González-Diaz
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Leon (CAULE), Leon, Spain
| | - C Fernández-Fernández
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Leon (CAULE), Leon, Spain
| | - I Ortega
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Gran Canarias, Gran Canarias, Spain
| | - M Medina
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Gran Canarias, Gran Canarias, Spain
| | - A Fernández-Corona
- Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de Leon (CAULE), Leon, Spain
| | - A Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - J A Sainz
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
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Coma E, Medina M, Méndez L, Hermosilla E, Iglesias M, Olmos C, Calero S. Effectiveness of electronic point-of-care reminders versus monthly feedback to improve adherence to 10 clinical recommendations in primary care: a cluster randomized clinical trial. BMC Med Inform Decis Mak 2019; 19:245. [PMID: 31783854 PMCID: PMC6884876 DOI: 10.1186/s12911-019-0976-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 10/05/2018] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous studies have analyzed the effectiveness of electronic reminder interventions to improve different clinical conditions, and most have reported a small to moderate effect. Few studies, however, have analyzed reminder systems targeting multiple conditions, and fewer still have compared electronic point-of-care reminders systems with other forms of feedback designed to improve delivery of care. METHODS We performed an unblinded cluster randomized clinical trial to compare the effectiveness of an electronic point-of-care reminder system with that of a well-established system providing monthly feedback on adherence to clinical recommendations. The control group received monthly feedback only while the intervention group received monthly feedback in addition to on-screen point-of-care reminders for 10 clinical conditions. The study targeted all physicians and nurses at the 283 primary care centers managed by the Institut Català de la Salut (approximately 6600 professionals). RESULTS Following exclusions and randomization, 132 primary care centers (328,728 patients with reminders) were assigned to the intervention group while 137 centers (317,117 patients with reminders) were randomized to the control group. A 20.6% improvement (OR 1.29, 95% CI: 1.25-1.34) in reminder resolution rates was observed in the intervention group. Results varied according to the clinical condition. The most effective reminder was screening for diabetic retinopathy (OR 1.51, 95% CI:1.46-1.57) while the least effective reminders were measurement of glycated hemoglobin (OR: 1.10, 95% CI: 1.07-1.13) and smoking cessation encouragement (OR 1.12, 95% CI: 1.09-1.16). CONCLUSIONS Electronic point-of-care reminders were more effective than the existing monthly feedback system at resolving the 10 clinical situations. However, more studies are needed to investigate the variations of the effect observed. TRIAL REGISTRATION Current Controlled Trials ISRCTN42391639, 08/10/2012. Retrospectively registered.
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Affiliation(s)
- Ermengol Coma
- Sistema d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
| | - Manuel Medina
- Sistema d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Leonardo Méndez
- Sistema d'Informació dels Serveis d'Atenció Primària (SISAP), Institut Català de la Salut. Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Eduardo Hermosilla
- Sistema de Informació pel Desenvolupament d'Investigació en Atenció Primària (SIDIAP), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Manuel Iglesias
- Oficina Projecte ECAP, Centre de competència funcional, Institut Català de la Salut, Barcelona, Spain
| | - Carmen Olmos
- Oficina Projecte ECAP, Centre de competència funcional, Institut Català de la Salut, Barcelona, Spain
| | - Sebastian Calero
- UGEAP Hospitalet Nord. DAP Delta. Institut Català de la Salut, Barcelona, Spain
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Morsley K, Miller A, Luqmani R, Fina-Aviles F, Javaid MK, Edwards CJ, Pinedo-Villanueva R, Medina M, Calero S, Cooper C, Arden N, Prieto-Alhambra D. Rheumatoid factor testing in Spanish primary care: A population-based cohort study including 4.8 million subjects and almost half a million measurements. ACTA ACUST UNITED AC 2019; 15:350-354. [DOI: 10.1016/j.reuma.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 11/28/2022]
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Medina M, Sander L, Moncada S. Endothelial dysfunction on cerebral small vessel disease. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.198] [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: 10/25/2022]
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Reátegui-Sokolova C, Rodríguez-Bellido Z, Gamboa-Cárdenas RV, Medina M, Zevallos F, Pimentel-Quiroz VR, Elera-Fitzcarrald C, Cucho-Venegas M, Pastor-Asurza CA, Perich-Campos R, Alarcón GS, Ugarte-Gil MF. Remission and low disease activity state prevent hospitalizations in systemic lupus erythematosus patients. Lupus 2019. [PMID: 31551028 DOI: 10.1177/0961203319876998.pmid:31551028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether remission and low disease activity state protect systemic lupus erythematosus patients from being hospitalized. MATERIALS AND METHODS Patients from the Almenara Lupus Cohort were included. Visits were performed every 6 months. Variables were measured at each visit. Hospitalizations were evaluated in the interval between two visits. Remission was defined as: a SLEDAI-2 K of 0, prednisone ≤5 mg/day and immunosuppressants on maintenance dose; low disease activity state as: a SLEDAI-2 K of ≤4, prednisone ≤7.5 mg/day and immunosuppressants on maintenance dose. Univariable and multivariable interval-censored survival regression models were used. In multivariable analysis, possible confounders were gender, age at diagnosis, socioeconomic status, educational level, disease duration, antimalarial use, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI) and Charlson comorbidity index. Confounders were determined in the same visit as disease activity state. RESULTS Of the 308 patients, 92.5% of them (n = 285) were women, had a mean age at diagnosis of 34.8 (13.4) years and a disease duration of 7.7 (6.5) years. At baseline the mean SDI was 1.13 (1.34). A total of 163 of the patients were hospitalized. In the multivariable analysis remission (hazard ratio 0.445 (0.274-0.725), P = 0.001) and low disease activity state (relative risk 0.504 (0.336-0.757), P = 0.001) at baseline were found to decrease the risk of hospitalization in systemic lupus erythematosus patients. A total of 158 hospitalizations presented a discernible cause. Disease activity was the most common cause of hospitalization, with 84 admissions (53.16%), the majority, 38, was due to active kidney disease (45.23%). CONCLUSION Remission and low disease activity state decreased the risk of hospitalizations in these systemic lupus erythematosus patients. Disease activity, particularly renal, was the most frequent cause of hospitalization.
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Affiliation(s)
- C Reátegui-Sokolova
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Z Rodríguez-Bellido
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,School of Medicine, Universidad Nacional Mayor de San Marcos, Peru
| | - R V Gamboa-Cárdenas
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - M Medina
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - F Zevallos
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - V R Pimentel-Quiroz
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - C Elera-Fitzcarrald
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,School of Medicine, Universidad Cientifica del Sur, Lima, Peru
| | - M Cucho-Venegas
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - C A Pastor-Asurza
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,School of Medicine, Universidad Nacional Mayor de San Marcos, Peru
| | - R Perich-Campos
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,School of Medicine, Universidad Nacional Mayor de San Marcos, Peru
| | - G S Alarcón
- School of Medicine, University of Alabama at Birmingham, USA
| | - M F Ugarte-Gil
- Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru.,School of Medicine, Universidad Cientifica del Sur, Lima, Peru
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Medina M, Medina-Moontoya M. Neurologic consequences of arbovirus infections: New challenges. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.055] [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: 10/25/2022]
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50
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Kolenda C, Josse J, Medina M, Fevre C, Lustig S, Ferry T, Laurent F. Évaluation de l’efficacité d’un assemblage de trois bactériophages anti Staphyloccocus aureus contre les bactéries au sein du biofilm ou internalisées dans les ostéoblastes. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.223] [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: 11/16/2022]
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