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Regió Sanitària Barcelona Metropolitana Sud: memòria 2024
No full textSistema sanitari públic; Activitat assistencial; MemòriaSistema sanitario público; Actividad asistencial; MemoriaPublic health system; Healthcare activity; ReportLa Memòria anual 2024 de la Regió Sanitària Barcelona Metropolitana Sud recull l’activitat duta a terme i els principals projectes desenvolupats.
Aquest any hem avançat en iniciatives clau per a la transformació del sistema sanitari, amb el compromís de millorar la qualitat assistencial i adaptar-nos
a les necessitats canviants de la població. En primer lloc, vull destacar el desplegament de l’atenció integrada social i sanitària a les residències de gent gran, que impulsa la coordinació entre la primària i els centres residencials per oferir una assistència més propera i de qualitat. A més, hem actualitzat la Ruta de la Complexitat per millorar l’atenció a les persones amb malalties cròniques avançades. En l’àmbit assistencial també hem implantat circuits de derivació inversa des de les urgències hospitalàries cap als CUAP, la qual cosa optimitza recursos i millora els temps d’atenció. I a la primària, continuem liderant el desplegament a Catalunya del nou programa de prevenció del càncer de cèrvix.
Alhora, participem en la reordenació de la llarga estada psiquiàtrica, un model pioner que aposta per l’atenció comunitària, evita la institucionalització i
facilita la recuperació de les persones amb trastorns severs. Una vegada més, som capdavanters i coordinem tres dels cinc centres de Catalunya inclosos
en el programa. Pel que fa a les infraestructures, hem celebrat l’obertura del nou Hospital de Viladecans i del CAP Florida Sud, dos equipaments molt esperats, a més d’altres inversions arreu del territori. Aquestes iniciatives reflecteixen l’esforç dels professionals sanitaris i la col·laboració amb altres institucions i actors del territori. Són projectes amb molta capacitat d’impacte que requereixen un treball en xarxa i una visió compartida: posar les persones al centre, vetllar per l’accessibilitat i l’equitat i ser més eficients i resolutius
Real-world impact of nirsevimab immunisation against respiratory disease on emergency department attendances and admissions among infants: a multinational retrospective analysis
Full text linkBronchiolitis; Children; Lower respiratory tract infectionsBronquiolitis; Niños; Infecciones del tracto respiratorio inferiorBronquiolitis; Infants; Infeccions del tracte respiratori inferiorBackground
Nirsevimab, a novel monoclonal antibody with a long half-life, has received European Union approval to prevent lower respiratory tract infections (LRTIs) caused by respiratory syncytial virus (RSV) during the first season of exposure. It was implemented in Catalonia (Spain) in the 2023–2024 season. Our main objective was to analyse the impact of the nirsevimab on LRTIs presenting to the Emergency Department (ED) in Catalonia (Spain) by comparing presentations to those at five sites in the United Kingdom (UK) and Rome (Italy).
Methods
In this multi-national retrospective analysis of emergency department attendances and admissions, we retrospectively collected information for all diagnoses, respiratory diagnoses excluding bronchiolitis, and bronchiolitis, for different age groups from 68 hospitals in Catalonia (Spain), one hospital in Rome (Italy), and four hospitals in the UK (Bristol, Leicester, Glasgow, and Edinburgh), from May 1st, 2018, to April 30th 2024. Applying a generalised linear model (GLM) in Poisson regression, we obtained the risk ratio (RR) and 95% confidence intervals (CI) of bronchiolitis in 2023–2024 season compared to the mean of all previous seasons. We analysed data in annual bins, from May 1st to April 30th, excluding 2020–21 as a COVID year, for a total of 5 years of data.
Findings
Data was available for 1,574,392 ED attendances (96,028 for bronchiolitis) and 255,689 hospital admissions (27,691 for bronchiolitis). In the 2023–2024 season, in Catalonia there was a reduction in the RR for bronchiolitis hospital admissions in the youngest infants aged <6 months (0.52, 95% CI: 0.48–0.55). There was also a reduction in Catalonia in the RR for hospital attendances for bronchiolitis in nirsevimab eligible age groups (0–11 months), with a RR of 0.56 (95% CI: 0.54–0.58) for infants <6 m and 0.93 (95% CI: 0.89–0.97) for infants 6–11 m. None of the other sites or age groups showed a significant reduction in the RR for attendances or admissions for the 2023–2024 season compared to previous years.
Interpretation
Nirsevimab had a clear impact in reducing attendances and admissions for infants with bronchiolitis aged <6 months in Catalonia. However, the impact on older infants was less clear
A procedure using low-cost reagents to prepare allogeneic platelet gel from standard platelet units
Full text linkBatroxobin; Platelet gel; Tranexamic acidGel de plaquetes; Batroxobina; Àcid tranexàmicBatroxobina; Gel de plaquetas; Ácido tranexámicoBackground and Objectives
Highly effective procedures for the preparation of allogeneic platelet gel (PG) use Ca-gluconate and batroxobin, an expensive commercial reagent. In this preliminary study, we explored the use of the plasmin-inhibitor, low-cost drug tranexamic acid (TXA) in place of batroxobin, based on the literature supporting TXA ability to prevent fibrinolysis and stabilize the gel formed by fibrin polymerization prompted by Ca-gluconate.
Materials and Methods
Eight blood centres determined PG weight and volume of non-gelled, liquid portion in 116 PG prepared in 20-mL commercial BioNest D bags. Ten-millilitre platelet aliquots from platelets in 100% plasma or in 35% plasma/65% platelet additive solution (PAS) were aseptically transferred into the D bag, followed by the injection of 3.3 mL of 10% Ca-gluconate and 0.4 mL of TXA. After 30-min incubation, PG weight and non-gelled liquid volume were determined.
Results
PG weight and liquid volume at 30 min were 6.5 ± 3.4 g and 7.4 ± 3.5 mL with platelets in 100% plasma, and 3.7 ± 3.0 g and 10.2 ± 3.3 mL with PAS platelets, respectively.
Conclusion
This study provides preliminary evidence supporting the use of TXA as a low-cost reagent for PG manufacturing from platelets in 100% plasma.This work was partially funded by the Italian Ministry of Health—Ricerca Corrente IRCCS, and by White Nest Pharma, S.r.l. through the provision of BioNest 12D systems
Informe sobre els microorganismes causants de malalties infeccioses declarats durant l’any 2024: sistema de notificació microbiològica de Catalunya (SNMC)
Full text linkDeclaracions microbiològiques; Notificació; Indicadors de salutMicrobiological statement; Notification; Health status indicatorsDeclaraciones microbiológicas; Notificación; Indicadores de saludMicrobiological Notification System of Catalonia (SNMC) belongs to the epidemiological surveillance network and collects information of microorganisms that cause infectious diseases which are notified when detected in the involved laboratories.
These documents present the annual statements of microbiological laboratories that participated in the Microbiological Notification System of Catalonia (SNMC).El sistema de notificación microbiológica de Cataluña (SNMC) pertenece a la red de vigilancia epidemiológica y recoge información de los microorganismos causantes de enfermedades infecciosas que son objeto de declaración y que se detectan en los laboratorios que participan. En estos documentos se presentan las declaraciones microbiológicas anuales de los laboratorios que han participado en el sistema de notificación microbiológica de Cataluña (SNMC).El sistema de notificació microbiològica de Catalunya (SNMC) pertany a la xarxa de vigilància epidemiològica i recull informació dels microorganismes causants de malalties infeccioses que són objecte de declaració i que es detecten als laboratoris que hi participen. En aquests documents es presenten les declaracions microbiològiques anuals dels laboratoris que han participat en el sistema de notificació microbiològica de Catalunya (SNMC)
Effect of sitagliptin on diabetes-induced hyperpermeability of blood-retinal barrier components
Full text linkSitagliptin; Diabetes; Blood-retinal barrierSitagliptina; Diabetes; Barrera hematorretinianaSitagliptina; Diabetis; Barrera hematoretinianaHR was recipient of a grant from Ministerio de Ciencia, Innovación y Universidades (BES-2017-081690) and the research was funded by Instituto de Salud Carlos III and co-funded by the European Union (ICI20/00129). The study funder was not involved in the design of the study
Challenge of long-term benzodiazepine use in primary care: insights from a real-world cohort study in Catalonia
Full text linkEpidemiology; Mental Health; Pharmacology; Primary Health Care; Public HealthEpidemiologia; Salut Mental; Farmacologia; Atenció Primària; Salut PúblicaEpidemiología; Salud Mental; Farmacología; Atención Primaria de Salud; Salud PúblicaLong-term use of benzodiazepines (BZD) triggers health problems. Although Spain leads European use of BZD, the number of long-term users (LTUs) remains unknown.
The aim of the study is to estimate the proportion of primary care (PC) patients who initiate a BDZ prescription that subsequently become LTU and to identify its associated factors.
Retrospective real-world data cohort.
It included the population over 15 years with a new prescription of BZD in PC in Catalonia. Users were considered LTU if they had been dispensed at least three prescriptions within 3 months. Sociodemographic characteristics of patients and prescribers, pathologies, previous BZD use, number and type of visits, and prescription quality standard were considered. We estimated the proportion of LTU among patients with a new prescription, stratified by age and sex, and estimated risk factors by multivariate generalised linear models.
100 638 users with a new BZD prescription were included. 27.1% were LTU at 3 months and 14.5% at 6 months. LTU increases with age and is higher in women. Predictors of LTU are Spanish nationality, living in rural areas, having a mental illness, having used BZD, having virtual visits or not meeting pharmacy-therapeutic quality standards.
The number of patients who develop LTU is high, especially in the elderly. Exploring the causes of this phenomenon could contribute to the development of future interventions.This study was supported by the CIBERESP Network Biomedical Research Center for Epidemiology and Public Health (ESP22PI08) Intramural Call for Research Projects 2022. The funding entity was not involved in the design or development of the study. IA-L has a Miguel Servet contract (CP22/00029) funded by the Carlos III Health Institute
Registro Español de Hidradenitis Supurativa (REHS) de la Academia Española de Dermatología y Venereología: descripción y datos del primer año de funcionamiento
Full text linkHidradenitis suppurativa; Patient reported outcome measures; RegistriesHidradenitis supurativa; Medidas de resultados informadas por el paciente; RegistrosHidradenitis supurativa; Mesures de resultats informades pels pacients; RegistresIntroduction: Hidradenitis suppurativa (HS) is a skin disease that significantly impacts patients' quality of life. There are still uncertainties surrounding its epidemiology, natural history, and the safety and effectiveness of existing treatments. The Spanish Academy of Dermatology and Venereology has promoted the creation of a Spanish Registry of patients with HS (REHS). The aim of this article is to present the REHS and provide the initial results obtained.
Methods: The REHS is a prospective, multicenter, observational study that collects the clinical and epidemiological characteristics of patients with HS, as well as the safety and effectiveness of the medical and surgical treatments received.
Results: Between June 2023 and June 2024, 359 patients were recruited from 23 Spanish centers. The average age of the patients is 37 years, and 53% of them are women. Over 70% of the patients are smokers or former smokers. One third have a family history of HS. The most frequent sites of disease onset are the axillae and groin. Median baseline IHS4 at recruitment was 4 (p25-p75=1-9), HiSQOL was 20 (p25-p75=8-36), and BMI was 27.3 (p25-p75=24-33.2). At least 82% of patients have received antibiotic therapy for their disease, and almost 20% a biologic drug.
Conclusions: We present data from the first patients enrolled in the REHS, which will allow for the generation of evidence on the natural course of the disease, as well as the effectiveness and safety of treatments in HS
European Consensus on Malabsorption—UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN
Full text linkBreath test; Coeliac disease; DiarrhoeaProva d'alè; Malaltia celíaca; DiarreaPrueba del aliento; Enfermedad celíaca; DiarreaMalabsorption is a complex and multifaceted condition characterised by the defective passage of nutrients into the blood and lymphatic streams. Several congenital or acquired disorders may cause either selective or global malabsorption in both children and adults, such as cystic fibrosis, exocrine pancreatic insufficiency (EPI), coeliac disease (CD) and other enteropathies, lactase deficiency, small intestinal bacterial overgrowth (SIBO), autoimmune atrophic gastritis, Crohn's disease, and gastric or small bowel resections. Early recognition of malabsorption is key for tailoring a proper diagnostic work-up for identifying the cause of malabsorption. Patient's medical and pharmacological history are essential for identifying risk factors. Several examinations like endoscopy with small intestinal biopsies, non-invasive functional tests, and radiologic imaging are useful in diagnosing malabsorption. Due to its high prevalence, CD should always be looked for in case of malabsorption with no other obvious explanations and in high-risk individuals. Nutritional support is key in management of patients with malabsorption; different options are available, including oral supplements, enteral or parenteral nutrition. In patients with short bowel syndrome, teduglutide proved effective in reducing the need for parenteral nutrition, thus improving the quality of life of these patients. Primary care physicians have a central role in early detection of malabsorption and should be involved into multidisciplinary teams for improving the overall management of these patients. In this European consensus, involving 10 scientific societies and several experts, we have dissected all the issues around malabsorption, including the definitions and diagnostic testing (Part 1), high-risk categories and special populations, nutritional assessment and management, and primary care perspective (Part 2).We thank United European Gastroenterology (UEG) for supporting this project and University of Pavia for covering the APC cost
Serveis de reducció de danys: informe d’activitat assistencial - 2023
No full textServeis de reducció de danys; Drogodependències; Atenció sociosanitàriaDamage reduction services; Drug addictions; Socio-health careServicios de reducción de daños; Drogodependencias; Atención sociosanitariaEn aquest informe es presenten les dades d’activitat dels serveis de reducció de danys en aquests diferents programes quant a persones ateses, perfil sociodemogràfic, dades sanitàries bàsiques i de consum, programa d’intercanvi de xeringues, atenció sanitària i social i d’activat de les sales de consum supervisat
A contributory citizen science project reveals the impact of dietary keys to microbiome health in Spain
Full text linkContributory citizen science; Dietary keys; MicrobiomeCiencia ciudadana contributiva; Claves dietéticas; MicrobiomaCiència ciutadana contributiva; Claus dietètiques; MicrobiomaLow consumption of whole grains, fruits, and vegetables has been identified as dietary risks for non-communicable diseases such as inflammatory bowel diseases (IBDs). We explore how individual and lifestyle factors influence these risks by shaping gut microbiome composition. 1001 healthy participants from all Spanish regions provided personal and dietary data at baseline, six, and twelve months, yielding 2475 responses. Gut microbiome data were analyzed for 500 healthy participants and 321 IBD patients. Our findings reveal that adherence to national dietary guidelines—characterized by diets rich in nuts, seeds, fruits, and vegetables—was associated with greater microbial diversity and reduced IBD-related dysbiosis. Finally, we observed variations in dietary patterns and microbiome diversity and composition across age groups, genders, regions, seasons, and transit time. This study is among the first to uncover dietary intake associated with IBD-related dysbiosis and to propose an interactive website for participants (https://manichanh.vhir.org/POP/en).This work was financially supported by the Instituto de Salud Carlos III and co-funded by the European Union (ERDF/ESF, “A way to make Europe”/“Investing in your future” (PI20/00130; FI21/00262) and by the AGAUR (2021 SGR 00459). Francisca Yáñez was supported by a fellowship from ANID, BECAS Chile, No. 72190278. None of the funders were private companies