Scientia, Dipòsit d’Informació Digital del Departament de Salut
Not a member yet
12576 research outputs found
Sort by
Self-Inflicted Burns: A Comparative Study in a Spanish Sample
Get PDFSelf-inflicted burns; SuicideQuemaduras autoinfligidas; SuicidioCremades autoinfligides; SuïcidiBackground: In 1994, the first Spanish study on patients with self-inflicted burns (SIB) was published, showing a prototypical profile of a patient with SIB: adult male, unmarried and, in 75% of the cases, with a psychiatric background. In addition, SIB accounted for 1.98% of the total admissions in a Burns Unit between 1983 and 1991, a lower percentage than other European studies. The present study aims to replicate this work, updating this profile and comparing it with the current profile. Methods: We compared the clinical and socio-demographic characteristics of 67 patients admitted during 1983–1991 (Study I) with those of 36 patients admitted during 2010–2015 (Study II). Results: It was observed that the percentage of patients with SIB admitted to the Burns Unit was lower in Study II than in Study I (1.45% vs. 1.98%). Significant age differences were identified (t(101) = −2.074, p = 0.041, 95% CI [−11.739, −0.261]). Similarly, there were statistically significant differences in several clinical characteristics, such as psychiatric history (X2 = 11.591, p = 0.001), the occurrence of previous autolytic attempts (X2 = 7.714, p = 0.007), the place where the incident occurred (X2 = 11.647, p = 0.020), the etiology of the burn (X2 = 13.142, p = 0.004), and triggers (X2 = 6.420, p = 0.036). Conclusions: Several differences have arisen between the two studies, mainly related to the specific characteristics of SIB (e.g., etiology, triggering cause, and place of the incident), possibly attributable to the social changes that have occurred in the last 20 years. These results will add to our knowledge and will stress various precipitating factors that may lead to SIB, with the final goal of designing preventive strategies
Full informatiu del Sistema d’Informació per a la Vigilància d’Infeccions a Catalunya – 2025/04
Get PDFVigilància d'infeccions; Epidemiologia; Assistència sanitàriaInfection surveillance; Epidemiology; Health careVigilancia de infecciones; Epidemiología; Asistencia sanitariaL’objectiu de l’informe de la xarxa Sistema d’Informació per a la Vigilància d’Infeccions a Catalunya (SIVIC) és tenir un sistema de vigilància creat per seguir no només els casos més greus sinó també els casos comunitaris de diverses infeccions respiratòries, com són Covid-19, grip, virus sincitial respiratori i enterovirus, entre d’altres
The effect between metabolic syndrome and life expectancy after cancer diagnosis: Catalan cohort study
Get PDFCancer; Metabolic syndrome; Remaining life expectancy; SurvivalCàncer; Síndrome metabòlica; Esperança de vida restantCáncer; Síndrome metabólico; Esperanza de vida restanteThis study examines remaining life expectancy (RLE) after a cancer diagnosis, focusing on age, sex, cancer type, and metabolic syndrome (MS) components, using data from the SIDIAP database in Catalonia (2006-2017). RLE was analyzed for 13 cancer types, stratified by sex and MS components. The cohort study includes 183,364 individuals followed from diagnosis until death, transfer, or study end (December 2017). RLE at age 68 (median diagnosis age) was calculated based on MS components (0, 1, 2, and ≥ 3). Men aged 68 with 0 MS components had an RLE of 13.2 years, compared to 8.9 years for those with ≥ 3 MS. Women had an RLE of 15.9 years with 0 MS components versus 11.4 years with ≥ 3 MS. RLE varied by cancer type, with the highest RLE in men seen in prostate cancer and in women in non-Hodgkin lymphoma. The lowest RLE for both sexes was in pancreatic cancer. The largest differences between 0 and ≥ 3 MS components were observed in non-Hodgkin lymphoma and the smallest in pancreatic cancer. Increased MS components were associated with reduced RLE in at least 8 cancer types for men and 9 for women. Prevention strategies targeting MS components could increase RLE in cancer patients.The project was funded from the Carlos III Institute of Health, (Spain) (reference PI17/00914)
Estadística de la interrupció voluntària de l'embaràs a Catalunya, 2024
Get PDFAvortament legal; CatalunyaLegal abortion; CataloniaAborto legal; CataluñaL’Estadística d’Interrupció Voluntària de l’Embaràs (IVE) de Catalunya conté informació sociodemogràfica i de les característiques de la intervenció de les IVE realitzades en tots els centres sanitaris públics i privats autoritzats.
Tots els centres autoritzats han de proporcionar les dades sobre les IVE realitzades, d’acord amb l’Ordre de 10 de desembre de 1986 del Departament de Salut, per la qual es disposa el procediment de recollida de dades relatives a les interrupcions voluntàries d’embaràs dutes a terme de conformitat amb la Llei orgànica 9/1985, de 5 de juliol.The Statistics on Voluntary Interruption of Pregnancy in Catalonia contains sociodemographic information and the characteristics of the intervention carried out in all public and private health centers authorized.
All authorized centers must provide the data on the interventions carried out, in accordance with the Order of December 10, 1986 of the Department of Health, which provides for the procedure for collecting data related to voluntary interruptions of pregnancy carried out in accordance with Organic Law 9/1985 of 5 July.La Estadística de Interrupción Voluntaria del Embarazo (IVE) de Cataluña contiene información sociodemográfica y de las características de la intervención de las IVE realizadas en todos los centros sanitarios públicos y privados autorizados.
Todos los centros autorizados deben proporcionar los datos sobre las IVE realizadas, de acuerdo con la Orden de 10 de diciembre de 1986 del Departamento de Salud, por la que se dispone el procedimiento de recogida de datos relativos a las interrupciones voluntarias de embarazo llevadas a cabo de conformidad con la Ley orgánica 9/1985, de 5 de julio
Long-term comparative outcomes after ileocecal resection for inflammatory versus complicated Crohn’s disease. A multicenter, retrospective study (Crohn's-Urg)
Get PDFCrohn’s disease; Ileocecal resection; Inflammatory bowel diseaseEnfermedad de Crohn; Resección ileocecal; Enfermedad inflamatoria intestinalMalaltia de Crohn; Resecció ileocecal; Malaltia inflamatòria intestinalBackground: Surgical intervention in Crohn's disease (CD) is often reserved for complications or failure of medical therapy. However, the benefits of early ileocecal resection for inflammatory phenotype (ICR) in patients with uncomplicated disease remain debated, particularly regarding long-term outcomes compared with complicated cases.
Methods: This international, multicenter, retrospective cohort study evaluated long-term outcomes of ICR in patients with inflammatory (uncomplicated) and complicated CD phenotypes. Data from 2013 patients (291 with uncomplicated CD) who underwent surgery between 2012 and 2022 were analyzed. The primary endpoint was endoscopic disease recurrence, with secondary outcomes including clinical and surgical recurrence, fecal calprotectin levels, and risk factors for recurrence. Statistical analyses included Kaplan-Meier survival estimates, Cox regression, and multivariable modeling.
Results: Complicated CD patients had higher rates of preoperative anemia, emergent surgery, and open procedures. Despite these differences, long-term endoscopic (HR: 1.03; p = 0.748), clinical (HR: 1.35; p = 0.073), and surgical recurrence rates (HR: 0.77; p = 0.419) were comparable between groups. Protective factors for recurrence included laparoscopic surgery (HR: 0.74; p = 0.009) and postoperative prophylaxis (HR: 0.63; p < 0.0001), while preoperative anemia (HR: 1.52; p < 0.0001) and positive margins (HR: 1.36; p = 0.001) increased recurrence risk.
Conclusion: Long-term outcomes of ICR are similar in inflammatory and complicated CD when appropriate surgical and medical management is applied. Optimizing perioperative care and mitigating modifiable risk factors may improve outcomes, supporting the role of surgery even in less complicated CD cases
Insights into the clinical, platelet and genetic landscape of inherited thrombocytopenia with malignancy risk
Get PDFInherited thrombocytopenia; Malignancy predispositionTrombocitopenia hereditaria; Predisposición a malignidadTrombocitopènia hereditària; Predisposició a malignitatInherited thrombocytopenia (IT) with germline variants in RUNX1, ETV6 or ANKRD26 carries a high risk (10%–45%) of developing haematological malignancy (IT-HM). We evaluated the clinical, platelet and molecular characteristics in 37 patients with RUNX1-related thrombocytopenia (RT), 9 with ETV6-RT and 20 with ANRKD26-RT. Genetic diagnosis was delayed by about 20 years from the identification of thrombocytopenia. Bleeding tendency was present in 25%–30% of RUNX1-RT and ANKRD26-RT patients. Platelet aggregation was impaired in 90% of all patients, while reduced activation and granule secretion were heterogeneous. Most RUNX1-RT patients had low glycoprotein Ia (GPIa) levels, which may be a useful disease biomarker. Sixteen distinct genetic variants in RUNX1, four in ETV6 and four in ANKRD26 were identified in patients. The clinical profile showed immune, skin, gastrointestinal and other comorbidities in many patients. One third of the cases developed a malignancy: This included eight RUNX1-RT patients with myelodysplastic syndrome (MDS), five with acute myeloid leukaemia (AML), and one with chronic myeloid leukaemia (CML) Ph+. One patient with ETV6-RT subsequently developed B-cell acute lymphoblastic leukaemia (B-ALL) during childhood. Three cases with ANKRD26-RT demonstrated a multifaceted clinical presentation, including B-ALL Ph+, MDS and breast cancer. The high incidence of HM development highlights the importance of early diagnosis in life.This work was supported by grants from: Instituto de Salud Carlos III (ISCIII) & European Union (PI23/00624, PI24/01458); ISCIII & European Union- NextGeneration EU and for PRTR (PMP21/00052); CIBERER-ISCIII (CB15/00055); Fundación Séneca- Agencia de Ciencia y Tecnología de la Región de Murcia (21 920/PI/22); Gerencia Regional de Salud (GRS2551/A/22, GRS2907/A1/2023, GRS2727/A1/23); Sociedad Española de Trombosis y Hemostasia (SETH, Premio López Borrasca, Ayuda a Grupos de Trabajo & Beca Dr. Francisco España, 2024); and Real Fundación Victoria Eugenia (Premio Investigación 2023). AM-Q is funded by ‘Ayuda postdoctoral from Sociedad Española de Hematología y Hemoterapia (SEHH)’ and Ministerio de Ciencia, Innovación y Universidades-Programa Juan de la Cierva (JDC2023-052518-I). AS-F and AZ-C hold training grants from ISCIII (Rio Hortega CM23/00028, FI21/00157). LD-A holds a fellowship from Junta de Castilla y León (JCYL-EDU/1868/2022). The authors' research on Inherited Platelet Disorders is conducted in accordance with the objectives of the project ‘Functional and Molecular Characterization of Patients with Inherited Platelet Disorders’ of the Grupo Español de Alteraciones Plaquetarias Congénitas (GEAPC), supported by SETH
Integrating CEN ISO/TS 82304-2 in the Catalan Health App Assessment Framework: Comparative Case Study
Get PDFCEN ISO/TS 82304-2; Comparative analysis; Health apps assessmentCEN ISO/TS 82304-2; Análisis comparativo; Evaluación de aplicaciones de saludCEN ISO/TS 82304-2; Anàlisi comparativa; Avaluació d'aplicacions de salutHealth apps are increasingly being used to promote health, manage diseases, and deliver health care services. Still, there is scarce objective information regarding their quality beyond the required Conformité Européenne mark for medical apps, leading to potential risks for users. To address these challenges, several authorities have developed health app assessment frameworks. In 2017, the TIC Salut Social Foundation (FTSS) in Catalonia developed its own health app assessment framework, which has been in use since that year. The publication of CEN ISO/TS 82304-2 (abbreviated as 82304-2)-a Technical Specification for assessing health apps-and the cocreation of the Label2Enable 82304-2 handbook for certified assessment organizations provide a unique opportunity to harmonize app assessments across the European Union.
This study aimed to perform a comparative analysis of the FTSS assessment framework with 82304-2 to explore the integration of 82304-2 in Catalonia. Our broader aim was to provide this methodology for health authorities elsewhere to consider integrating 82304-2 or other evaluation frameworks.
For the comparative analysis, a mixed methods approach was used, combining a qualitative case study with a quantitative analysis of the 2 frameworks. The qualitative evaluation covered rationale for assessment, framework characteristics, governance, workflows, quality aspects, and quality requirements. For the quantitative analysis, all FTSS and 82304-2 requirements were translated into concepts and subconcepts. A scoring system identified matches of the frameworks with these subconcepts, with scores ranging from 0 (no match) to 0.5 (partial match) and 1 (full match). Integration was evaluated considering several scenarios, including adopting the Label2Enable 82304-2 handbook, adopting the 82304-2 requirements, adapting the 82304-2 requirements to local needs, and maintaining the current FTSS framework.
The main difference between the frameworks was the app usage-based assessment (FTSS) versus evidence- and app usage-based assessment (82304-2). All 120 FTSS requirements and 74 quality aspect-related 82304-2 requirements were translated into 78 concepts and 97 subconcepts. Overall, 48% (47/97) of the subconcepts were found in both frameworks, 39% (37.5/97) were specific to 82304-2, and 13% (12.5/97) were specific to FTSS. All 82304-2-specific subconcepts and thus all 82304-2 requirements were found to be relevant to FTSS. FTSS decided to integrate (adopt and adapt) all 74 82304-2 requirements. In total, 5 FTSS-specific requirements were included in the Label2Enable 82304-2 handbook, while another 4 rigor-enhancing requirements, 1 scope-expanding requirement, and 1 context-specific requirement would be assessed on top.
The comprehensive comparative analysis of the FTSS framework and 82304-2 enabled FTSS decision-making to integrate all 82304-2 quality requirements and adopt the Label2Enable 82304-2 handbook in the future. The many new and all relevant 82304-2 concepts, the rigor of the handbook, and the few remaining FTSS-specific requirements are expected to be indicative of 82304-2's potential to make harmonized, robust health app assessments common in Catalonia and elsewhere. FTSS encourages other authorities to perform a similar evaluation.This study was initiated and led by the TIC Salut Social Foundation (FTSS), within the Ministry of Health of Catalonia, and later integrated and conducted as part of the Label2Enable project and funded by the European Union (Project: 101057522 —Label2Enable—HORIZON-HLTH-2021-IND-07)
Training to Act (Formar para Actuar): Peer-to-Peer Education to Promote Health Among Vulnerable Immigrant Women in Barcelona (Spain)
Get PDFCommunity participation; Health promotion; ImmigrantsParticipación comunitaria; Promoción de la salud; InmigrantesParticipació comunitària; Promoció de la salut; Immigrants“Formar para actuar” (FxA; “Training to act”) is an innovative peer-to-peer educational program that employs a training-action model with a gender and intercultural perspective. The program aims to enhance knowledge and empower immigrant women to advocate for health promotion within their communities. This study assesses FxA program’s impact on knowledge acquisition and participant satisfaction. Conducted across four FxA editions (2018, 2020, 2021, 2022), this before-and-after intervention study evaluates a structured two-module approach implemented consecutively in each edition. In Module 1 (Training), migrant women with leadership and community ties attended 12 h of training led by healthcare professionals, covering sexual and reproductive health and communication strategies. Those identifying a peer group advanced to Module 2 (Action), acting as peer educators and leading workshops. Self-reported questionnaires covering sociodemographics, knowledge and satisfaction, were collected from both peer educators and participants. Knowledge impact comparisons before and after the intervention were performed using paired t-tests. Module 1 of the FxA program trained 29 migrant women as peer educators; 20 continued in Module 2, delivering workshops to 166 participants who faced higher vulnerability levels, including language barriers, fewer years in Europe, and lower educational levels. The study revealed significant knowledge improvements, particularly among women participants. Overall satisfaction was high. This study highlights the program’s effectiveness in transmitting health promotion messages within vulnerable environments by training immigrant women as peer educators. The findings provide valuable insights to implement the program in other regions and further reinforce its application in public health programs
Programa de diagnòstic ràpid de càncer del Sistema sanitari integral d’utilització pública de Catalunya (07/2025)
Get PDFPrograma de diagnòstic ràpid de càncer; DRC; Sistema Sanitari Públic de CatalunyaPrograma de diagnóstico rápido de cáncer; DRC; Sistema Sanitario Público de CataluñaRapid Cancer Diagnosis Program; DRC; Public Health System of CataloniaAquesta Instrucció té per objecte actualitzar la implantació del Programa de diagnòstic ràpid de càncer (DRC) del Sistema sanitari integral d’utilització pública de Catalunya (SISCAT). Concretament, pretén: − Ampliar el Programa de DRC a onze localitzacions tumorals diferents que són càncers amb signes i símptomes d’alt risc. − Establir els criteris clínics d’inclusió en el Programa de DRC i introduir-los en el sistema d’història clínica electrònica a partir d’un formulari de derivació únic al SISCAT. − Determinar un model estandarditzat de circuit de DRC al SISCAT, així com consensuar les possibles vies d’entrada.
− Especificar la sectorització territorial que ordeni els fluxos de persones ateses, de tal manera que en funció de l’equip d’atenció primària assignat siguin referenciades als centres hospitalaris corresponents. Les previsions d‘aquesta Instrucció no tenen caràcter clínic sinó exclusivament organitzatiu i d’ordenació del Programa en el sistema sanitari públic de Catalunya
Nutritional and Physical Rehabilitation in Post-Critical Coronavirus Disease 2019 (COVID-19) Ambulatory Patients: The NutriEcoMuscle Study
Get PDFCOVID-19; Intensive care units; MalnutritionCOVID-19; Unidades de cuidados intensivos; DesnutriciónCOVID-19; Unitats de cures intensives; DesnutricióBackground: The prevalence of malnutrition is high in post-intensive care unit (ICU) coronavirus disease 2019 (COVID-19) patients during hospitalization and after hospital discharge. This paper presents prospective results from the NutriEcoMuscle study, a multicenter observational study. The study aimed to evaluate changes in nutritional and functional status in post-ICU COVID-19 patients following nutritional and physical rehabilitation interventions. Secondary aims included assessing adherence to and tolerance of the oral nutritional supplement (ONS) used in the nutritional intervention. Methods: The study enrolled adults who had been admitted to the ICU due to severe COVID-19. At hospital discharge, the patients underwent a nutritional intervention based on oral nutritional supplements (ONSs) with 100% serum lactoprotein enriched with leucine and vitamin D and a physical rehabilitation program. They were followed up during three months. Performed assessments included Subjective Global Assessment (SGA), Global Leadership Initiative on Malnutrition (GLIM) criteria, Barthel index (BI), handgrip strength and Timed Up and Go test, bioelectrical impedance analysis (BIA), nutritional ultrasound (US), and tolerance and adherence to ONS. Sample size was calculated based on handgrip strength, and parametric and non-parametric tests were used to assess differences between the baseline and three-month outcomes. Results: The study included 96 patients (71.9% male, mean age 58.8 years, mean body mass index (BMI) of 28.8 kg/m2, 36.5% obese). A total of 85 patients (62 men and 23 women) completed the 90-day follow-up. The mean weight gain after the intervention was 6.8 (SD 5.2) kg (similar in men and women; p = 0.263). The proportion of patients with malnutrition according to the SGA or GLIM criteria decreased from 100% to 11.8% and 36.4%, respectively (p < 0.00001 in both cases). The proportion of patients with functional limitations by BI decreased from 66.7% to 27.0% (p < 0.0001). Handgrip strength increased more than 40% in both men and women (p < 0.00001). The time to perform the Timed Up and Go (TUG) test decreased more than 40% in both men and women (p < 0.00001). According to BIA, the mean fat mass did not increase significantly in either men or women. The mean fat-free mass index (FFMI) increased significantly in both men and women. There were also significant increases in body cell mass, skeletal muscle mass index, and appendicular skeletal muscle mass index. The phase angle (PhA) increased significantly in both men (26.5%) and women (17.4%). In a multivariate analysis, age and baseline PhA were related to the PhA increase (adjusted R2 = 0.5573). The US study showed a significant increase in the mean measurements of muscle area, muscle circumference, X-axis, and Y-axis in the rectus femoris. Regarding abdominal fat, there were no significant increases in total, superficial, or preperitoneal adipose tissue by US. Participants engaged in a median interquartile range (IQR) of 70 (0-120) min/week of strength exercise and 60 (0-120) min/week of moderate physical exercise. The supplement was well tolerated, and poor adherence (less than 50%) was low (4% of the participants). Conclusions: A three-month intervention, including ONS and physical rehabilitation, is associated with a significant improvement in nutritional and functional status. Patients gained weight primarily by increasing their muscle mass. There was no significant increase in fat mass, as measured by BIA or US. The intervention was well tolerated and had good adherence.This research was funded by Danone-Nutricia S.R.L. Calle Torrelaguna, 77. 28043 Madrid. CIF:B-78073913