Background: To determine risk factors of death in diagnosed patients with COVID-19 who were aged ... more Background: To determine risk factors of death in diagnosed patients with COVID-19 who were aged ≥60 years and could not benefit from intubation and mechanical ventilation. Methods: Retrospective multicentre study including all patients with COVID-19 admitted to four medium-stay centres in Catalonia (March-June 2020). At the multivariate level, we calculated hazard ratios (HR) with 95% confidence intervals (CI) to determine risk factors associated with mortality. Results: 683 patients were included, of whom 227 died (case fatality rate of 33%, reaching 42% in patients of more than 90 years). Mean survival was 21.92 (20.98–22.86) days. Factors associated with death were fever (HR:1.5 (1.06–2.13)), malaise (HR:1.4 (1.04–1.99)), dyspnoea (HR:1.98 (1.41–2.79)) and atrial fibrillation (HR:1.45 (1.03–2.05)), while coughing (HR: 0.66 (0.46–0.94)), diarrhoea (HR:0.46 (0.23–0.92)), dyslipidaemia (HR:0.47 (0.28–0.82)), and receiving antithrombotic treatment (HR:0.56 (0.40–0.78)) had a protect...
The objective of this study was to analyze and compare the effect of high temperatures on daily m... more The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid. Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2020. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00-R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic "context variables" were included: population >64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tumbral) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables. The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population >64 years of age and living in the metropolitan area were found to be risk factors. Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.
Environmental Science and Pollution Research, 2022
This study aims to identify the combined role of environmental pollutants and atmospheric variabl... more This study aims to identify the combined role of environmental pollutants and atmospheric variables at short term on the rate of incidence (TIC) and on the hospital admission rate (TIHC) due to COVID-19 disease in Spain. This study used information from 41 of the 52 provinces of Spain (from Feb. 1, 2021 to May 31, 2021). Using TIC and TIHC as dependent variables, and average daily concentrations of PM 10 and NO 2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). Generalized linear models (GLM) with Poisson link were carried out for each provinces The GLM model controlled for trend, seasonalities, and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 μg/m 3 in PM 10 and NO 2 and by 1 °C in the case of Tmax and 1 g/m 3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Statistically significant associations were found between PM 10 , NO 2 , and the rate of COVID-19 incidence. NO 2 was the variable that showed greater association, both for TIC as well as for TIHC in the majority of provinces. Temperature and HA do not seem to have played an important role. The geographic distribution of RR in the studied provinces was very much heterogeneous. Some of the health determinants considered, including income per capita, presence of airports, average number of diesel cars per inhabitant, average number of nursing personnel, and homes under 30 m 2 could explain the differential geographic behavior. As findings indicates, environmental factors only could modulate the incidence and severity of COVID-19. Moreover, the social determinants and public health measures could explain some patterns of geographically distribution founded.
Background An area of current study concerns analysis of the possible adaptation of the populatio... more Background An area of current study concerns analysis of the possible adaptation of the population to heat, based on the temporal evolution of the minimum mortality temperature (MMT). It is important to know how is the evolution of the threshold temperatures (Tthreshold) due to these temperatures provide the basis for the activation of public health prevention plans against high temperatures. The objective of this study was to analyze the temporal evolution of threshold temperatures (Tthreshold) produced in different Spanish regions during the 1983–2018 period and to compare this evolution with the evolution of MMT. The dependent variable used was the raw rate of daily mortality due to natural causes ICD X: (A00-R99) for the considered period. The independent variable was maximum daily temperature (Tmax) during the summer months registered in the reference observatory of each region. Threshold values were determined using dispersion diagrams (annual) of the prewhitened series of mor...
A battery pack system is provided that can be replaced easily without modifying the side of an ap... more A battery pack system is provided that can be replaced easily without modifying the side of an appliance using this battery pack system, on which charging is controlled by a voltage control, and includes a secondary battery with high performance that undergoes charging by a current control. A battery pack system is provided with a battery including at least one unit cell serving as a secondary battery with a positive electrode containing a nickel oxide as an active material, a detecting portion for detecting a battery state including a charging state in the battery, and a current adjusting portion, that is connected in series with the battery, for adjusting a charging current value according to the charging state detected by the detecting portion.
Background: In recent years, abundant scientific evidence has been generated based on clinical tr... more Background: In recent years, abundant scientific evidence has been generated based on clinical trials (CT) in the field of oncology. The general objective of this paper is to find out the extent to which decision making is based on knowledge of the most recent CT. Its specific objectives are to pinpoint difficulties with decision making based on the CT performed and find out the motivations patients and clinicians have when taking part in a CT. Methodology: Combined, prospective study, based on the Delphi method. A lack of correspondence between the people who take part in CT and patients who come for consultation has been identified. A need for training in analysing and interpreting CT has also been identified and a lack of trust in the results of CT financed by the pharmaceutical industry itself has been perceived. Conclusions: There is a difficulty in selecting oncological treatment due to the lack of correspondence between the patients included in the CT and patients seen in con...
Scientific evidence suggests that Saharan dust intrusions in Southern Europe contribute to the wo... more Scientific evidence suggests that Saharan dust intrusions in Southern Europe contribute to the worsening of multiple pathologies and increase the concentrations of particulate matter (PM) and other pollutants. However, few studies have examined whether Saharan dust intrusions influence the incidence and severity of COVID-19 cases. To address this question, in this study we carried out generalized linear models with Poisson link between incidence rates and daily hospital admissions and average daily concentrations of PM10 and NO2 in nine Spanish regions for the period from February 1, 2020 to May 31, 2020. The models were adjusted by maximum daily temperature and average daily absolute humidity. Furthermore, we controlled for trend, seasonality and the autoregressive nature of the series. The variable relating to Saharan dust intrusions was introduced using a dichotomous variable, NAF, averaged across daily lags in ranges of 0–7 days, 8–14 days, 14–21 days and 22–28 days. The results...
Background While many studies analyze the effect of extreme thermal events on health, little has ... more Background While many studies analyze the effect of extreme thermal events on health, little has been written about the effects of extreme cold on mortality. This scarcity of papers is particularly relevant when we search studies about extreme cold on the health of rural population. Therefore, we tried to analyze the effect of cold waves on urban areas and rural areas from Madrid and to test whether differentiated effects exist between both population classes. For this purpose, we analyzed data from the municipalities with over 10,000 inhabitants for the period from January 1, 2000 through December 31, 2013. Municipalities were classified as urban or rural (Eurostat), and they were grouped into similar climatological zones: Urban Metropolitan Centre (UMC), Rural Northern Mountains (RNM), Rural Centre (RC) and Southern Rural (SR). The dependent variable was the daily mortality rate due to natural causes per million inhabitants (CIE-X: A00-R99) that occurred between the months of Nove...
Research that analyzes the effect of different environmental factors on the impact of COVID-19 fo... more Research that analyzes the effect of different environmental factors on the impact of COVID-19 focus primarily on meteorological variables such as humidity and temperature or on air pollution variables. However, noise pollution is also a relevant environmental factor that contributes to the worsening of chronic cardiovascular diseases and even diabetes. This study analyzes the role of short-term noise pollution levels on the incidence and severity of cases of COVID-19 in Madrid from February 1 to May 31, 2020. The following variables were used in the study: daily noise levels averaged over 14 days; daily incidence rates, average cumulative incidence over 14 days; hospital admissions, Intensive Care Unit (ICU) admissions and mortality due to COVID-19. We controlled for the effect of the pollutants PM10 and NO2 as well as for variables related to seasonality and autoregressive nature. GLM models with Poisson regressions were carried out using significant variable selection (p<0.05) to calculate attributable RR. The results of the modeling using a single variable show that the levels of noise (leq24h) were related to the incidence rate, the rate of hospital admissions, the ICU admissions and the rate of average cumulative incidence over 14 days. These associations presented lags, and the first association was with incidence (lag 7 and lag 10), then with hospital admissions (lag 17) and finally ICU admissions (lag 22). There was no association with deaths due to COVID-19. In the results of the models that included PM10, NO2, Leq24h and the control variables simultaneously, we observed that only Leq24h went on to become a part of the models using COVID-19 variables, including the 14-day average cumulative incidence. These results show that noise pollution is an important environmental variable that is relevant in relation to the incidence and severity of COVID-19 in the Province of Madrid.
Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infe... more Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infection of Human Immunodeficiency Virus (HIV). Methods BCN Checkpoint promotes sexual health among men who have sex with men (MSM), with a focus on diagnosing HIV early, initiating combined antiretroviral treatment (cART) promptly, and recommending regular repeat testing for those who have tested negative. This cross-sectional study included all test results obtained at the centre between 25 March 2016 and 24 March 2019. The Alere™ HIV Combo (now rebranded to Determine™ HIV Ultra, from Abbott) was used to detect p24 antigen (p24 Ag) and/or immunoglobulin M (IgM) and G (IgG) antibodies to HIV-1/HIV-2 (HIV Ab). Rapid polymerase chain reaction (PCR) confirmatory testing and Western blot (WB) were performed for clients with a positive rapid test result. Confirmed HIV cases were promptly referred to the HIV unit for care and cART prescription. Results A total of 12,961 clients attended BCN Chec...
Background There are studies that analyze the role of meteorological variables on the incidence a... more Background There are studies that analyze the role of meteorological variables on the incidence and severity of COVID-19, and others that explore the role played by air pollutants, but currently there are very few studies that analyze the impact of both effects together. This is the aim of the current study. We analyzed data corresponding to the period from February 1 to May 31, 2020 for the City of Madrid. As meteorological variables, maximum daily temperature (Tmax) in ºC and mean daily absolute humidity (AH) in g/m3 were used corresponding to the mean values recorded by all Spanish Meteorological Agency (AEMET) observatories in the Madrid region. Atmospheric pollutant data for PM10 and NO2 in µg/m3 for the Madrid region were provided by the Spanish Environmental Ministry (MITECO). Daily incidence, daily hospital admissions per 100.000 inhabitants, daily ICU admissions and daily death rates per million inhabitants were used as dependent variables. These data were provided by the I...
After the heat wave of 2003, many European countries have implemented plans for monitoring and co... more After the heat wave of 2003, many European countries have implemented plans for monitoring and controlling the effects of heat waves (PMSEHW) to mitigate the effects of heat on health and few countries have assessed their impact. The aim of study was to evaluate the PMSEHW impact in the mortality attributed to heat. To evaluate the mortality attributed to heat during the period 1990-2009, we conducted a time series analysis using ARIMA models with exogenous variables (temperature). We examined the impact of high temperatures on mortality before and after the year 2004, year of the implementation of PVCEOC. The impact attributable to the heat wave in 2003 was 22.39% increase in mortality per degree ºC, with an intensity of 8.2 ºC. Some heat waves prior to 2003 were higher in intensity, so in the years 1991, 1992 and 1995 the intensity of heat waves was 25.9 ºC, 8.3 ºC and 12.5 ºC respectively. Heat waves subsequent to 2003 had lower intensity, and the 2005, with a heat wave intensity of 4.5 ºC greater impact was observed, which was 45.71% increase in mortality per degree ºC. Finally, we can not say, that, in the city of Madrid, the implementation of PVEOC results in a decrease of the mortality attributable to high temperatures.
To identify factors that predict noncompliance with tuberculosis treatment in the province of Ica... more To identify factors that predict noncompliance with tuberculosis treatment in the province of Ica, Peru. Methods. Between 1998 and 2000 a case-control study (1:1 ratio) was conducted in the province of Ica, with 55 cases (persons who dropped out of treatment) being identified. The factors evaluated were chosen from Lalonde's model of the field of health. The respective odds ratios were calculated by means of univariate analysis and multivariate analysis. Results. The following factors were identified as being predictive of noncompliance with tuberculosis treatment: thinking that the information that health workers provided on treatment was insufficient (odds ratio (OR) = 4.20; 95% confidence interval (95% CI), 1.77-10.02), thinking that the office hours for receiving treatment were inadequate (OR = 9.95; 95% CI, 1.97-50.21), and consuming illegal drugs (OR = 7.15; 95% CI, 1.69-30.23). Conclusions. To improve compliance with tuberculosis treatment, it is necessary to provide patients with personalized information on the disease and its treatment, and to offer them flexible, appropriate times to receive treatment. Drug consumption is the most serious risk factor for noncompliance, and identifying and following up with drug users is crucial.
Objetivos: Describir la situación de la tuberculosis en distritos aimaras del Perú, en términos d... more Objetivos: Describir la situación de la tuberculosis en distritos aimaras del Perú, en términos de incidencia y mortalidad, y la relación con la altura y otros indicadores sociales. Material y métodos: Se realizó un estudio ecológico tomando como unidad de análisis a todos los distritos aimaras del país, comparándolos con los no aimaras, en altura, población con alta dependencia económica, población con al menos una necesidad básica insatisfecha (NBI), y hacinamiento. Se realizó un análisis de regresión lineal, que fue complementado con investigación cualitativa. Para el análisis cuantitativo se utilizó el programa estadístico SPSS versión 12.0, y Excel. Resultados: En los distritos aimaras estudiados, se identificó una incidencia promedio de tuberculosis pulmonar frotis positivo (TBP FP) de 33.35 por 100 000 habitantes, con un máximo de 399.39 por 100 000 habitantes, se encontró que las variables estudiadas (población con alta carga o dependencia económica, población con al menos una NBI, hacinamiento y altitud) explicaban parcialmente el modelo (R 2 = 0.468), mostrando un R = 0.68. Se identificaron los condicionantes culturales como externo, referido a la migración estacional por trabajo a zonas productivas, y como cultural interactuante, referido a la relación entre la cultura que migra y la que acoge, modificando sus estilos de vida como alimentación y en consecuencia la salud. Conclusiones: Se ha observado que la altura no es el único factor que explica el modelo y que los otros factores sociales estudiados, así como el factor cultural, intervienen para explicar la incidencia de tuberculosis en aimaras.
Enfermedades Infecciosas Y Microbiologia Clinica, Mar 26, 2014
The National Hospital Discharge Registry is a clinical-administrative database on hospital discha... more The National Hospital Discharge Registry is a clinical-administrative database on hospital discharges, which is very useful at a regional level as a complementary source for surveillance. There are few national studies on tuberculosis (TB) using the National Hospital Discharge Registry, thus it was considered of interest to study the characteristics and trends of hospital discharges for TB in Spain. A descriptive study was performed using the main variables in the National Hospital Discharge Registry (sex, age, main diagnosis, type of discharge, length of stay), and trend analysis of hospitalization rates per 100,000 population, as well as primary diagnosis, by sex, age group, and type of TB (pulmonary [TBP]/extrapulmonary [TBEP]), for the period 1999-2009 in Spain. A total of 65,609 hospital discharges were included in the study (66% male, 66% TBP, and 52% between 15-44 years). The overall rate of TB for the entire hospitalization period was 13.93 per 100,000 inhabitants, being 18.83 in males and 9.18 in females. The hospitalization rates for TBP and TBEP decreased in the period 1999-2009 in both sexes (TBP in males, from 18 to 13, and in females, from 8 to 6; TBEP in males from 4 to 3, and from 3 to 2 in female hospitalizations/100,000 habitants). In TBP, children are those with a smallest decline, and in TBEP there is an increase in males in all age groups from 2005. The results are consistent with those from surveillance. The slow decline in rates in children and the increase in extrapulmonary forms in males may be related to immigration, so it is necessary to improve TB monitoring in these groups.
We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's popul... more We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's population, considered of initial contact. This population consists of human groups that for a long time decided to live in isolation, but lately have begun living a more sedentary lifestyle and in contact with Western populations. There are two fully identified initial contact groups in Peru: the Nahua and the Nanti. The health statistics of the Nahua are scarce. This study offers an interpretation of demographic and epidemiological indicators of the Nahua people, trying to identify if a certain degree of health vulnerability exists. We performed a cross sectional study, and after analyzing their health indicators, as well as the supplemental qualitative analysis of the population, brought us to conclude that in 2006, the Nahua, remained in a state of health vulnerability.
Background: To determine risk factors of death in diagnosed patients with COVID-19 who were aged ... more Background: To determine risk factors of death in diagnosed patients with COVID-19 who were aged ≥60 years and could not benefit from intubation and mechanical ventilation. Methods: Retrospective multicentre study including all patients with COVID-19 admitted to four medium-stay centres in Catalonia (March-June 2020). At the multivariate level, we calculated hazard ratios (HR) with 95% confidence intervals (CI) to determine risk factors associated with mortality. Results: 683 patients were included, of whom 227 died (case fatality rate of 33%, reaching 42% in patients of more than 90 years). Mean survival was 21.92 (20.98–22.86) days. Factors associated with death were fever (HR:1.5 (1.06–2.13)), malaise (HR:1.4 (1.04–1.99)), dyspnoea (HR:1.98 (1.41–2.79)) and atrial fibrillation (HR:1.45 (1.03–2.05)), while coughing (HR: 0.66 (0.46–0.94)), diarrhoea (HR:0.46 (0.23–0.92)), dyslipidaemia (HR:0.47 (0.28–0.82)), and receiving antithrombotic treatment (HR:0.56 (0.40–0.78)) had a protect...
The objective of this study was to analyze and compare the effect of high temperatures on daily m... more The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid. Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2020. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00-R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic "context variables" were included: population >64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tumbral) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables. The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population >64 years of age and living in the metropolitan area were found to be risk factors. Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.
Environmental Science and Pollution Research, 2022
This study aims to identify the combined role of environmental pollutants and atmospheric variabl... more This study aims to identify the combined role of environmental pollutants and atmospheric variables at short term on the rate of incidence (TIC) and on the hospital admission rate (TIHC) due to COVID-19 disease in Spain. This study used information from 41 of the 52 provinces of Spain (from Feb. 1, 2021 to May 31, 2021). Using TIC and TIHC as dependent variables, and average daily concentrations of PM 10 and NO 2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). Generalized linear models (GLM) with Poisson link were carried out for each provinces The GLM model controlled for trend, seasonalities, and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 μg/m 3 in PM 10 and NO 2 and by 1 °C in the case of Tmax and 1 g/m 3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Statistically significant associations were found between PM 10 , NO 2 , and the rate of COVID-19 incidence. NO 2 was the variable that showed greater association, both for TIC as well as for TIHC in the majority of provinces. Temperature and HA do not seem to have played an important role. The geographic distribution of RR in the studied provinces was very much heterogeneous. Some of the health determinants considered, including income per capita, presence of airports, average number of diesel cars per inhabitant, average number of nursing personnel, and homes under 30 m 2 could explain the differential geographic behavior. As findings indicates, environmental factors only could modulate the incidence and severity of COVID-19. Moreover, the social determinants and public health measures could explain some patterns of geographically distribution founded.
Background An area of current study concerns analysis of the possible adaptation of the populatio... more Background An area of current study concerns analysis of the possible adaptation of the population to heat, based on the temporal evolution of the minimum mortality temperature (MMT). It is important to know how is the evolution of the threshold temperatures (Tthreshold) due to these temperatures provide the basis for the activation of public health prevention plans against high temperatures. The objective of this study was to analyze the temporal evolution of threshold temperatures (Tthreshold) produced in different Spanish regions during the 1983–2018 period and to compare this evolution with the evolution of MMT. The dependent variable used was the raw rate of daily mortality due to natural causes ICD X: (A00-R99) for the considered period. The independent variable was maximum daily temperature (Tmax) during the summer months registered in the reference observatory of each region. Threshold values were determined using dispersion diagrams (annual) of the prewhitened series of mor...
A battery pack system is provided that can be replaced easily without modifying the side of an ap... more A battery pack system is provided that can be replaced easily without modifying the side of an appliance using this battery pack system, on which charging is controlled by a voltage control, and includes a secondary battery with high performance that undergoes charging by a current control. A battery pack system is provided with a battery including at least one unit cell serving as a secondary battery with a positive electrode containing a nickel oxide as an active material, a detecting portion for detecting a battery state including a charging state in the battery, and a current adjusting portion, that is connected in series with the battery, for adjusting a charging current value according to the charging state detected by the detecting portion.
Background: In recent years, abundant scientific evidence has been generated based on clinical tr... more Background: In recent years, abundant scientific evidence has been generated based on clinical trials (CT) in the field of oncology. The general objective of this paper is to find out the extent to which decision making is based on knowledge of the most recent CT. Its specific objectives are to pinpoint difficulties with decision making based on the CT performed and find out the motivations patients and clinicians have when taking part in a CT. Methodology: Combined, prospective study, based on the Delphi method. A lack of correspondence between the people who take part in CT and patients who come for consultation has been identified. A need for training in analysing and interpreting CT has also been identified and a lack of trust in the results of CT financed by the pharmaceutical industry itself has been perceived. Conclusions: There is a difficulty in selecting oncological treatment due to the lack of correspondence between the patients included in the CT and patients seen in con...
Scientific evidence suggests that Saharan dust intrusions in Southern Europe contribute to the wo... more Scientific evidence suggests that Saharan dust intrusions in Southern Europe contribute to the worsening of multiple pathologies and increase the concentrations of particulate matter (PM) and other pollutants. However, few studies have examined whether Saharan dust intrusions influence the incidence and severity of COVID-19 cases. To address this question, in this study we carried out generalized linear models with Poisson link between incidence rates and daily hospital admissions and average daily concentrations of PM10 and NO2 in nine Spanish regions for the period from February 1, 2020 to May 31, 2020. The models were adjusted by maximum daily temperature and average daily absolute humidity. Furthermore, we controlled for trend, seasonality and the autoregressive nature of the series. The variable relating to Saharan dust intrusions was introduced using a dichotomous variable, NAF, averaged across daily lags in ranges of 0–7 days, 8–14 days, 14–21 days and 22–28 days. The results...
Background While many studies analyze the effect of extreme thermal events on health, little has ... more Background While many studies analyze the effect of extreme thermal events on health, little has been written about the effects of extreme cold on mortality. This scarcity of papers is particularly relevant when we search studies about extreme cold on the health of rural population. Therefore, we tried to analyze the effect of cold waves on urban areas and rural areas from Madrid and to test whether differentiated effects exist between both population classes. For this purpose, we analyzed data from the municipalities with over 10,000 inhabitants for the period from January 1, 2000 through December 31, 2013. Municipalities were classified as urban or rural (Eurostat), and they were grouped into similar climatological zones: Urban Metropolitan Centre (UMC), Rural Northern Mountains (RNM), Rural Centre (RC) and Southern Rural (SR). The dependent variable was the daily mortality rate due to natural causes per million inhabitants (CIE-X: A00-R99) that occurred between the months of Nove...
Research that analyzes the effect of different environmental factors on the impact of COVID-19 fo... more Research that analyzes the effect of different environmental factors on the impact of COVID-19 focus primarily on meteorological variables such as humidity and temperature or on air pollution variables. However, noise pollution is also a relevant environmental factor that contributes to the worsening of chronic cardiovascular diseases and even diabetes. This study analyzes the role of short-term noise pollution levels on the incidence and severity of cases of COVID-19 in Madrid from February 1 to May 31, 2020. The following variables were used in the study: daily noise levels averaged over 14 days; daily incidence rates, average cumulative incidence over 14 days; hospital admissions, Intensive Care Unit (ICU) admissions and mortality due to COVID-19. We controlled for the effect of the pollutants PM10 and NO2 as well as for variables related to seasonality and autoregressive nature. GLM models with Poisson regressions were carried out using significant variable selection (p<0.05) to calculate attributable RR. The results of the modeling using a single variable show that the levels of noise (leq24h) were related to the incidence rate, the rate of hospital admissions, the ICU admissions and the rate of average cumulative incidence over 14 days. These associations presented lags, and the first association was with incidence (lag 7 and lag 10), then with hospital admissions (lag 17) and finally ICU admissions (lag 22). There was no association with deaths due to COVID-19. In the results of the models that included PM10, NO2, Leq24h and the control variables simultaneously, we observed that only Leq24h went on to become a part of the models using COVID-19 variables, including the 14-day average cumulative incidence. These results show that noise pollution is an important environmental variable that is relevant in relation to the incidence and severity of COVID-19 in the Province of Madrid.
Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infe... more Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infection of Human Immunodeficiency Virus (HIV). Methods BCN Checkpoint promotes sexual health among men who have sex with men (MSM), with a focus on diagnosing HIV early, initiating combined antiretroviral treatment (cART) promptly, and recommending regular repeat testing for those who have tested negative. This cross-sectional study included all test results obtained at the centre between 25 March 2016 and 24 March 2019. The Alere™ HIV Combo (now rebranded to Determine™ HIV Ultra, from Abbott) was used to detect p24 antigen (p24 Ag) and/or immunoglobulin M (IgM) and G (IgG) antibodies to HIV-1/HIV-2 (HIV Ab). Rapid polymerase chain reaction (PCR) confirmatory testing and Western blot (WB) were performed for clients with a positive rapid test result. Confirmed HIV cases were promptly referred to the HIV unit for care and cART prescription. Results A total of 12,961 clients attended BCN Chec...
Background There are studies that analyze the role of meteorological variables on the incidence a... more Background There are studies that analyze the role of meteorological variables on the incidence and severity of COVID-19, and others that explore the role played by air pollutants, but currently there are very few studies that analyze the impact of both effects together. This is the aim of the current study. We analyzed data corresponding to the period from February 1 to May 31, 2020 for the City of Madrid. As meteorological variables, maximum daily temperature (Tmax) in ºC and mean daily absolute humidity (AH) in g/m3 were used corresponding to the mean values recorded by all Spanish Meteorological Agency (AEMET) observatories in the Madrid region. Atmospheric pollutant data for PM10 and NO2 in µg/m3 for the Madrid region were provided by the Spanish Environmental Ministry (MITECO). Daily incidence, daily hospital admissions per 100.000 inhabitants, daily ICU admissions and daily death rates per million inhabitants were used as dependent variables. These data were provided by the I...
After the heat wave of 2003, many European countries have implemented plans for monitoring and co... more After the heat wave of 2003, many European countries have implemented plans for monitoring and controlling the effects of heat waves (PMSEHW) to mitigate the effects of heat on health and few countries have assessed their impact. The aim of study was to evaluate the PMSEHW impact in the mortality attributed to heat. To evaluate the mortality attributed to heat during the period 1990-2009, we conducted a time series analysis using ARIMA models with exogenous variables (temperature). We examined the impact of high temperatures on mortality before and after the year 2004, year of the implementation of PVCEOC. The impact attributable to the heat wave in 2003 was 22.39% increase in mortality per degree ºC, with an intensity of 8.2 ºC. Some heat waves prior to 2003 were higher in intensity, so in the years 1991, 1992 and 1995 the intensity of heat waves was 25.9 ºC, 8.3 ºC and 12.5 ºC respectively. Heat waves subsequent to 2003 had lower intensity, and the 2005, with a heat wave intensity of 4.5 ºC greater impact was observed, which was 45.71% increase in mortality per degree ºC. Finally, we can not say, that, in the city of Madrid, the implementation of PVEOC results in a decrease of the mortality attributable to high temperatures.
To identify factors that predict noncompliance with tuberculosis treatment in the province of Ica... more To identify factors that predict noncompliance with tuberculosis treatment in the province of Ica, Peru. Methods. Between 1998 and 2000 a case-control study (1:1 ratio) was conducted in the province of Ica, with 55 cases (persons who dropped out of treatment) being identified. The factors evaluated were chosen from Lalonde's model of the field of health. The respective odds ratios were calculated by means of univariate analysis and multivariate analysis. Results. The following factors were identified as being predictive of noncompliance with tuberculosis treatment: thinking that the information that health workers provided on treatment was insufficient (odds ratio (OR) = 4.20; 95% confidence interval (95% CI), 1.77-10.02), thinking that the office hours for receiving treatment were inadequate (OR = 9.95; 95% CI, 1.97-50.21), and consuming illegal drugs (OR = 7.15; 95% CI, 1.69-30.23). Conclusions. To improve compliance with tuberculosis treatment, it is necessary to provide patients with personalized information on the disease and its treatment, and to offer them flexible, appropriate times to receive treatment. Drug consumption is the most serious risk factor for noncompliance, and identifying and following up with drug users is crucial.
Objetivos: Describir la situación de la tuberculosis en distritos aimaras del Perú, en términos d... more Objetivos: Describir la situación de la tuberculosis en distritos aimaras del Perú, en términos de incidencia y mortalidad, y la relación con la altura y otros indicadores sociales. Material y métodos: Se realizó un estudio ecológico tomando como unidad de análisis a todos los distritos aimaras del país, comparándolos con los no aimaras, en altura, población con alta dependencia económica, población con al menos una necesidad básica insatisfecha (NBI), y hacinamiento. Se realizó un análisis de regresión lineal, que fue complementado con investigación cualitativa. Para el análisis cuantitativo se utilizó el programa estadístico SPSS versión 12.0, y Excel. Resultados: En los distritos aimaras estudiados, se identificó una incidencia promedio de tuberculosis pulmonar frotis positivo (TBP FP) de 33.35 por 100 000 habitantes, con un máximo de 399.39 por 100 000 habitantes, se encontró que las variables estudiadas (población con alta carga o dependencia económica, población con al menos una NBI, hacinamiento y altitud) explicaban parcialmente el modelo (R 2 = 0.468), mostrando un R = 0.68. Se identificaron los condicionantes culturales como externo, referido a la migración estacional por trabajo a zonas productivas, y como cultural interactuante, referido a la relación entre la cultura que migra y la que acoge, modificando sus estilos de vida como alimentación y en consecuencia la salud. Conclusiones: Se ha observado que la altura no es el único factor que explica el modelo y que los otros factores sociales estudiados, así como el factor cultural, intervienen para explicar la incidencia de tuberculosis en aimaras.
Enfermedades Infecciosas Y Microbiologia Clinica, Mar 26, 2014
The National Hospital Discharge Registry is a clinical-administrative database on hospital discha... more The National Hospital Discharge Registry is a clinical-administrative database on hospital discharges, which is very useful at a regional level as a complementary source for surveillance. There are few national studies on tuberculosis (TB) using the National Hospital Discharge Registry, thus it was considered of interest to study the characteristics and trends of hospital discharges for TB in Spain. A descriptive study was performed using the main variables in the National Hospital Discharge Registry (sex, age, main diagnosis, type of discharge, length of stay), and trend analysis of hospitalization rates per 100,000 population, as well as primary diagnosis, by sex, age group, and type of TB (pulmonary [TBP]/extrapulmonary [TBEP]), for the period 1999-2009 in Spain. A total of 65,609 hospital discharges were included in the study (66% male, 66% TBP, and 52% between 15-44 years). The overall rate of TB for the entire hospitalization period was 13.93 per 100,000 inhabitants, being 18.83 in males and 9.18 in females. The hospitalization rates for TBP and TBEP decreased in the period 1999-2009 in both sexes (TBP in males, from 18 to 13, and in females, from 8 to 6; TBEP in males from 4 to 3, and from 3 to 2 in female hospitalizations/100,000 habitants). In TBP, children are those with a smallest decline, and in TBEP there is an increase in males in all age groups from 2005. The results are consistent with those from surveillance. The slow decline in rates in children and the increase in extrapulmonary forms in males may be related to immigration, so it is necessary to improve TB monitoring in these groups.
We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's popul... more We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's population, considered of initial contact. This population consists of human groups that for a long time decided to live in isolation, but lately have begun living a more sedentary lifestyle and in contact with Western populations. There are two fully identified initial contact groups in Peru: the Nahua and the Nanti. The health statistics of the Nahua are scarce. This study offers an interpretation of demographic and epidemiological indicators of the Nahua people, trying to identify if a certain degree of health vulnerability exists. We performed a cross sectional study, and after analyzing their health indicators, as well as the supplemental qualitative analysis of the population, brought us to conclude that in 2006, the Nahua, remained in a state of health vulnerability.
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