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Objectives Employment status and economic recession have been associated with negative effects on self-rated health, and this effect differs by gender. We analysed the effects of the Spanish economic recession in terms of self-rated health, its differential effect among genders and its influence on gender gap. Study design Repeated cross-sectional study using Spanish health surveys (2001-2014). Methods Logistic regression models were conducted to explore the association between self-rated health and employment status and its evolution over time and gender. To test the impact of the economic recession, pooled data regression models were conducted. Results In this study, we considered 104,577 subjects. During the last 15 years, women have entered the labour market, leading to wide changes in the Spanish traditional family roles. Instead of an increasing proportion of women workers, gender employment differences persist. Therefore, in 2014, the prevalence of workers was 55.77% in men, whereas in women, it was 44.01%. Self-rated health trends during the economic recession differ by gender, with women improving slightly their self-rated health from a low self-rated health prevalence of 38.76% in 2001 to 33.78% in 2014. On the contrary, men seem more vulnerable to employment circumstances, which have led to substantial reduction in the gender gap. Conclusions Although a gender gap persists, the change in socio-economic roles seems to increase women's self-rated health, reducing this gap. It is important to promote women's labour market inclusion, even in economic recession periods. [ABSTRACT FROM AUTHOR]

Background: Emerging zoonotic diseases arise from cross-species transmission events between wild or domesticated animals and humans, with bats being one of the major reservoirs of zoonotic viruses. Viral metagenomics has led to the discovery of many viruses, but efforts have mainly been focused on some areas of the world and on certain viral families., Methods: We set out to describe full-length genomes of new picorna-like viruses by collecting feces from hundreds of bats captured in different regions of Spain. Viral sequences were obtained by high-throughput Illumina sequencing and analyzed phylogenetically to classify them in the context of known viruses. Linear discriminant analysis (LDA) was performed to infer likely hosts based on genome composition., Results: We found five complete or nearly complete genomes belonging to the family Picornaviridae, including a new species of the subfamily Ensavirinae. LDA suggested that these were true vertebrate viruses, rather than viruses from the bat diet. Some of these viruses were related to picornaviruses previously found in other bat species from distant geographical regions. We also found a calhevirus genome that most likely belongs to a proposed new family within the order Picornavirales, and for which genome composition analysis suggested a plant host., Conclusions: Our findings describe new picorna-like viral species and variants circulating in the Iberian Peninsula, illustrate the wide geographical distribution and interspecies transmissibility of picornaviruses, and suggest new hosts for calheviruses., (© 2024. The Author(s).)

Bats are natural hosts of multiple viruses, many of which have clear zoonotic potential. The search for emerging viruses has been aided by the implementation of metagenomic tools, which have also enabled the detection of unprecedented viral diversity. Currently, this search is mainly focused on RNA viruses, which are largely over-represented in databases. To compensate for this research bias, we analyzed fecal samples from 189 Spanish bats belonging to 22 different species using viral metagenomics. This allowed us to identify 52 complete or near-complete viral genomes belonging to the families Adenoviridae , Circoviridae , Genomoviridae , Papillomaviridae , Parvoviridae, Polyomaviridae and Smacoviridae . Of these, 30 could constitute new species, doubling the number of viruses currently described in Europe. These findings open the door to a more thorough analysis of bat DNA viruses and their zoonotic potential., Importance: Metagenomics has become a fundamental tool to characterize the global virosphere, allowing us not only to understand the existing viral diversity and its ecological implications but also to identify new and emerging viruses. RNA viruses have a higher zoonotic potential, but this risk is also present for some DNA virus families. In our study, we analyzed the DNA fraction of fecal samples from 22 Spanish bat species, identifying 52 complete or near-complete genomes of different viral families with zoonotic potential. This doubles the number of genomes currently described in Europe. Metagenomic data often produce partial genomes that can be difficult to analyze. Our work, however, has characterized a large number of complete genomes, thus facilitating their taxonomic classification and enabling different analyses to be carried out to evaluate their zoonotic potential. For example, recombination studies are relevant since this phenomenon could play a major role in cross-species transmission., Competing Interests: The authors declare no conflict of interest.

Introduction: There is evidence of a significant upturn of certain unhealthy lifestyle choices such as Alcohol Consumption during the COVID-19 pandemic., Objective: To analyze whether Alcohol Consumption has increased since the onset of pandemic and whether it affects the relationship between Mood and Self-Rated Health among adult Spanish population., Methodology: Study of two cross-sectional cohorts (1-initial period of confinement COVID-19 pandemic, 2-between fifth and sixth waves of pandemic) to examine Alcohol Consumption in the relationship between Mood and Self-Rated Health using a moderation analysis with PROCESS macro for SPSS., Results: 5,949 people (62.1% women) participated in the study. Alcohol Consumption showed a significant increase, with men consuming more Alcohol than women in both periods (58.6% vs. 44.7% and 72.1% vs. 56.7%, respectively, p < 0.001). The moderation analysis revealed that sex and Alcohol Consumption conditioned the relationship between Mood and Self-Rated Health in the first survey, with a greater effect on women, who stated that not consuming Alcohol had a positive effect on the relationship between Mood and Self-Rated Health (B: -0.530; p < 0.001)., Discussion: Currently it is about of implementing strategies to manage the pandemic-some of them aimed at promoting healthy living and stress management as assets that favor healthy lifestyles with fewer risk factors. New studies are needed to address the social thresholds of alcohol consumption, considering different perspectives for understanding variations in the intrapersonal and social perception of drunkenness, as this has been shown to be inconsistent across cultures and time periods., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sánchez-Recio, Parrilla-Huertas, Asensio-Martinez, Valdivieso-Pardos, Zúñiga-Antón and Cerdán-Bernad.)

Objective: There are different socioeconomic variables which determine tuberculosis's epidemiology, diagnosis and treatment. The objective of this paper was to analize these effects in the last years in Spain., Methods: A systematic review was conducted. Screened studies were original articles written in English or Spanish and published between 2007 and 2020. Searching was performed in Pubmed and Web of Science databases. STROBE criteria were followed to analyze studies's quality, and studies included in the review had 15 points or more., Results: 23 articles were selected, and were classified in different topics. Foreigners's proportion with tuberculosis changed in different autonomous communities between 10%-50%. There were diagnostic delay for this group compared to natives. This group had higher incidence of resistance to isoniazid, but without a clear increase in multidrug resistance. There were less adherence to tuberculosis's treatment in case of immigration, drug addiction, HIV coinfection, or lack of family support. Under-reporting of tuberculosis cases varied between 18%-28%, and it was higher in cases of social marginality, HIV coinfection, Spanish nationality or male sex. There were also other social risk groups in which the diagnostic approach to tuberculosis was relevant, such as in schools and health centers. Tuberculosis was one of the most frequent HIV associated diseases, although screening tests were not performed in almost 18%, depending on the concurrence of social risk factors., Conclusions: Tuberculosis's incidence, diagnosis, and treatment are influenced by a lot of social and economic factors, which determine the approach to this disease.

Introduction: A newly identified SARS-CoV-2 variant, VOC202012/01 originating lineage B.1.1.7, recently emerged in the United Kingdom. The rapid spread in the UK of this new variant has caused other countries to be vigilant., Material and Methods: We based our initial screening of B.1.1.7 on the dropout of the S gene signal in the TaqPath assay, caused by the 69/70 deletion. Subsequently, we confirmed the B.1.1.7 candidates by whole genome sequencing., Results: We describe the first three imported cases of this variant from London to Madrid, subsequent post-arrival household transmission to three relatives, and the two first cases without epidemiological links to UK. One case required hospitalization. In all cases, drop-out of gene S was correctly associated to the B.1.1.7 variant, as all the corresponding sequences carried the 17 lineage-marker mutations., Conclusion: The first identifications of the SARS-CoV-2 B.1.1.7 variant in Spain indicate the role of independent introductions from the UK coexisting with post-arrival transmission in the community, since the early steps of this new variant in our country., (Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

In Spain, regional health systems (universal access) depend on each Autonomous Communities (ACs). The management of the 2008 economic crisis has been different in the ACs, which may have led to an increase in inequities in the use of health services. The objective of this study was to analyse the impact of individual and regional characteristics on public hospitalisation inequities in Spain for the period 2003-2017. We developed a repeated cross-sectional study through Spanish National Health Surveys (2003, 2006, 2011 and 2017) and the Spanish European Health Survey (2014; n = 118,499 subjects). Multilevel and Oaxaca decomposition analyses were conducted to analyse the effect of individual and regional factors in hospitalisation inequities. The results showed that the prevalence of hospitalisation was higher for women (2003: 11.2%; 2017: 9.0%) than for men (2003: 10.7%; 2017: 8.8%) and it decreased with time. Multilevel analyses showed that, after adjustment for variables related to healthcare demand, there were inequities in the probability of hospitalisation, mainly in women. The decomposition analyses showed a higher effect of the number of hospital beds available on hospitalisation in men than in women. There is a direct relationship between the number of hospital beds and the probability of hospitalisation in both sexes. In conclusion, a progressive decrease in hospitalisation use was observed in Spain in the context of the economic recession. Individual-level and regional-level factors were associated with hospitalisation inequities. It is necessary to guarantee equitable access to health services according to the need even in recession times., (© 2021 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.)

The clinical significance of molecular detection of respiratory viruses in bronchoalveolar lavage (BAL) samples is poorly defined. We performed an observational retrospective study including all patients who underwent a BAL procedure in our institution, regardless of the reason for bronchoscopy, from January 2015 to December 2018. Respiratory viruses were detected by real-time polymerase chain reaction with a commercial multiplex panel, and a cell culture was performed to detect cytomegalovirus and herpes simplex virus. Positive results were correlated with clinical symptoms and patients' characteristics. Of 540 BAL samples analyzed, 113 (20.9%) were positive for any respiratory virus. Viral detection was significantly associated with respiratory symptoms (83.2% vs. 68.9%, p = .004) and radiological infiltrates (67.3% vs. 52.2%, p = .006). The most frequent viruses detected were rhinovirus (42/113, 37.2%), influenza virus (20/113, 17.7%), and parainfluenza virus (PIV) (16/113, 14.2%). Respiratory pathogens codetections were found in 51/113 (45.1%) BAL samples, including more than one virus (16/51, 31.4%), fungi (8/51, 15.7%), and bacteria (9/51, 17.6%). Viral detection was significantly higher in immunocompromised patients (26.5% vs. 16.9%; p = .022). PIV and human metapneumovirus were mostly observed in lung (50.0%, 8/16) and hemopoietic transplant recipients (25%, 2/8), respectively, with clinical repercussions. Our data underline that molecular diagnosis allows identification of viral agents as the etiology of respiratory infections; however, the high frequency of codetections hinders identification of the agent responsible for the current respiratory symptomatology. Immunocompromised patients are the target population in whom to investigate the presence of respiratory viruses in their BAL samples., (© 2021 Wiley Periodicals LLC.)

It is essential to understand the impact of social inequalities on the risk of COVID-19 infection in order to mitigate the social consequences of the pandemic. With this aim, the objective of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. We conducted a retrospective cohort study and included data from all individuals tested for COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals) in Aragón (Spain). We studied the effect of inequalities on the risk of having a COVID-19 confirmed diagnosis after being tested using multilevel analyses with two levels of aggregation: individuals and basic healthcare area of residence (deprivation level and type of zone). Inequalities in the risk of COVID-19 confirmed infection were observed at both the individual and area level. There was a predominance of low-paid employees living in deprived areas. Workers with low salaries, unemployed and people on minimum integration income or who no longer receive the unemployment allowance, had a higher probability of COVID-19 infection than workers with salaries ≥ €18,000 per year. Inequalities were greater in women and in the second wave. The deprivation level of areas of residence influenced the risk of COVID-19 infection, especially in the second wave. It is necessary to develop individual and area coordinated measures by areas in the control, diagnosis and treatment of the epidemic, in order to avoid an increase in the already existing inequalities.

Objetivo. Identificar la existencia de desigualdades de género en utilización de atención primaria (AP), urgencias y consulta de enfermería. Material y métodos. Estudio transversal, con encuestas nacionales y europeas de salud (2006-2017) de población española de 16 o más años (n=98 929 personas). Se estudió la evolución en el tiempo y la influencia de los determinantes de género mediante regresiones logísticas en la utilización de servicios sanitarios. Resultados. La utilización de los tres servicios asistenciales fue mayor en mujeres. Personas pensionistas, aquellas dedi-cadas a labores del hogar, con estudios bajos y clase social manual, tuvieron mayor riesgo de utilización de AP. Urgencias: a mayor edad menor riesgo de utilización. Enfermería: aque-llas dedicadas a las labores del hogar tenían mayor riesgo de utilización. Conclusiones. Son necesarios estudios que analicen las desigualdades de género en contextos como la utilización de servicios sanitarios, así como nuevas estrategias de gestión para conseguir la equidad asistencial.

Objective: To analyse the effect of the Great Recession (2008) on primary care (PC) and secondary care (SC) inequalities in Spain., Method: Repeated cross-sectional study using Spanish Health Surveys from 2001 to 2017 (n=139,566). Prevalence of PC and SC utilization were calculated standardized by age. Chi square tests for trend were conducted to explore the evolution. We performed logistic regression analyses adjusted by the Andersen's model of demand for care to explore inequalities prior to, during and following the recession. All the analyses were stratified by sex., Results: Healthcare use trends changed from a rapid increase in the pre-recession period to a plateau during the recession and a decrease in the post-recession period. Healthcare use was higher in women (PC: 15.8% to 32.5%; SC: 8.2% to 16.2%) than in men (PC: 11.3% to 24.1%; SC: 5.4% to 11.6%) and the gender gap increased. During the recession the likelihood of PC use was higher in disadvantaged groups, while SC had greater usage amongst more advantaged social groups. Inequalities in SC use increased during the recession and could not be attributed to factors of need., Conclusions: Healthcare use trends changed as a result of the recession. There are socioeconomic inequalities in the use of PC and SC in Spain, which increased in secondary care, during the recession and in the post-recession period. It is necessary to take into account socioeconomic determinants in health planning, in order to achieve equity in healthcare services., (Copyright © 2020 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Mycobacterium bovis is an infrequent cause of central nervous system tuberculosis in Spain, with few cases described in the literature. Since compulsory pasteurization of milk and implementation of eradication programs on infected cattle, human sporadic illness with this organism has dramatically declined in developed countries., Case Report: A 71-year-old immunocompromised male, who presented a calvarial lytic lesion. A craniotomy for the total resection of the lesion was performed and the microbiology results were positive for M. bovis, therefore antituberculous therapy was initiated. Despite of the correct treatment, the patient developed a tuberculous abscess that required an aggressive surgical management followed by a suppurative fistula. Based on the treatment of tuberculous lymphadenitis, we decided to perform a conservative management with antituberculous therapy (isoniazid + rifampicin + ethambutol + moxifloxacin + steroids during 12 months) and avoided new surgical cleanings of the surgical bed obtaining a good response and a good clinical evolution., Conclusions: As far as we know, this is the first case reported of a suppurative fistula after the resection of a cerebral abscess caused by M. bovis, therefore, there is no report in the literature about the treatment of this complication.