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Background: The aim of this study was to determine incidence of COVID-19 in relationship to geographical distribution among Spain., Method: Cluster analysis taking into consideration the incidence of COVID-19 in the provinces and autonomous cities of Spain in each of the first six waves of the pandemic., Results: All the provinces of the Canary Islands, Catalonia and Andalusia form independent clusters. In Comunidad Valenciana, Galicia, País Vasco and Aragón two out of three provinces (three out of four in Galicia) were in the same cluster, with no other provinces., Discussion: The incidence of COVID-19 in Spain in the first six waves forms clusters that reproduce the territorial division of Spain into autonomous communities. Although this could be explained by greater mobility within a community, it cannot be ruled out that this distribution is due to differences in screening, diagnosis, registration or reporting of COVID-19 cases., (Copyright © 2023 FECA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Aims: To assess patient preferences their satisfaction level and their participation in decision making with nurses., Methods: Cross-sectional and mixed quantitative-qualitative study carried out in people attending the nursing services of 9 Health Centres in Andalusia. Patients were interviewed immediately after receiving nursing treatment using two different questionnaires for assessing their opinions, satisfaction and perception of involvement in the decisional process. A descriptive analysis using the χ(2) test (P<.05) was performed to assess the differences among close-ended and open-ended questions. Qualitative analysis: Open-ended questions were grouped into categories by a process involving three researchers independently., Results: A total of 235 patients took part, of whom 59% (138) preferred a collaborative role with the nurse when making decisions. In the closed questions, 96.2% (228) of the surveyed patients declared to be satisfied or very satisfied with the decision making process; nevertheless 17.4% (41) made specific suggestions for improving this process. For them the main improvement areas were related to: general communication skills or a more specific one such as: strategies for helping them make decisions, reaching common ground or giving advice., Conclusions: Nurses should be aware that most patients wish to be involved in decision making and in clinical practice this participation can be improved by obtaining specific communicational skills. Surveys that include open-ended questions are more useful to assess the quality of care., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Introduction and Objective: There is a significant lack of scientific evidence on the role of SAHS in the elderly despite the increasing ageing of the population. The objective of the present study is to analyse the current healthcare situation in Spain on the diagnosis and treatment of sleep apnea in the population ≥65 years and its progress over the last few years., Material and Method: Cross-sectional study. Healthcare information was collected on the diagnosis and treatment of patients of both sexes and ≥65 years suspected with having SAHS and referred to sleep units (SU) between 2002 and 2008., Results: There were 51,229 sleep studies performed in 16 SU. Of these, 24.3% were performed on subjects ≥ 65 years (64.9% males), of which 71.5% had an AHI (apnoea-hypopnoea index) >10 (68.6% treated with CPAP). There were no differences over time as regards mean age, mean AHI or percentage of studies done. A significant decrease was observed in the number of CPAP prescribed to males ≥65 years from 2002 to 2005 (p=0.01) which subsequently increased up to 2008 (p=0.01). This phenomenon was not observed in women ≥65 years., Conclusion: Despite the lack of evidence on the subject, healthcare activity due to suspected SAHS in the elderly population is intense, therefore it should be a priority to start clinical studies that may be able to answer key questions on the diagnosis and treatment of SAHS in this age group., (Copyright © 2009 SEPAR. Published by Elsevier Espana. All rights reserved.)

We report the case of an asthmatic man in whom a solitary pulmonary nodule was discovered after an episode of self-limited hemoptysis. Infection was suspected after initial response to empirical antibiotic therapy, and the pathogen was later identified to be a rare mycobacterium. The pulmonary nodule resolved without surgery after oral quinolone therapy. Mycobacterium fortuitum should be added to the list of possible causes of solitary pulmonary nodule in Spain.

To check the possible existence of long-term pulmonary functional sequelae in patients with pneumonia due to Mycoplasma pneumoniae, 17 patients who showed evident spirometric disorders during the recovery from the acute phase of a pneumonia due to Mycoplasma pneumoniae were studied. In the acute phase of the disease, 7 patients showed a ventilatory restriction, 6 of them had an obstructive pattern while in four patients a mixed pattern was observed. After a latency period, which mean length was 39 months, it was seen that there was a return to normal values of the spirometric conventional parameters initially altered in all cases. However 5 patients (33%) who did not smoke, showed a significant decrease on the maximum flows at low volume. These results suggest that in a high percentage of adult patients, as has been previously described in children, pneumonia due to M. pneumoniae could leave as a sequelae the persistent affectation of small airway.

With the aim of testing the cost-effectiveness of diagnostic fiberbronchoscopy in pleural effusions, the results obtained in a study of 46 patients in whom pleural effusion was the only indication for this diagnostic technique was analyzed. Patients were divided into two groups based on whether they presented pleural effusion of unkown ethiology (group A) or non-localized primary metastatic effusion (group B). Two out of 28 patients in group A, and 5 out of 18 in group B were diagnosed by means of fiberbronchoscopy. It is concluded that given the good tolerance and low morbidity of this exam, the diagnostic cost-effectiveness justifies its performance in such situations. Possible modifications in the indications that could influence its utility are discussed.

149 patients suffering from hemoptysis of unknown origin who presented a normal chest X-ray were followed up, in order to evaluate their prognosis, during a mean period of 12.6 months after the initial study which included fiberoptic bronchoscopy. During this time, 24 patients (16.1%) presented new episodes of hemoptysis without radiological modifications; a second fiberoptic bronchoscopy carried out in 13 of these patients did not contribute with any new diagnostic data. One patient was diagnosed of pulmonary thromboembolism after persistent hemoptysis and two others of bronchial carcinoma 4 and 30 months after the initial fiberoptic bronchoscopy when the chest X-ray had already suffered significant changes. These data confirm that short term prognosis of cryptogenetic hemoptysis is generally favourable when the fiberoptic bronchoscopy is negative. The fact that a high percentage of these patients (37%, 55/149) had previously suffered pulmonary tuberculosis and/or inflammatory-scar type localized endobronchiolar lesions suggests that sequelae of these diseases, not observed in the X-ray, could play an etiological role in the bleeding.