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Peer reviewed: True, Acknowledgements: The authors thank the survey participants for their generous contribution of time and effort. We also thank our contact persons for their essential support in making the distribution of the survey possible., BACKGROUND: There is no clear guidance on how to implement opportunistic atrial fibrillation (AF) screening in daily clinical practice. OBJECTIVES: This study evaluated the perception of general practitioners (GPs) about value and practicalities of implementing screening for AF, focusing on opportunistic single-time point screening with a single-lead electrocardiogram (ECG) device. METHODS: A descriptive cross-sectional study was conducted with a survey developed to assess overall perception concerning AF screening, feasibility of opportunistic single-lead ECG screening and implementation requirements and barriers. RESULTS: A total of 659 responses were collected (36.1% Eastern, 33.4% Western, 12.1% Southern, 10.0% Northern Europe, 8.3% United Kingdom & Ireland). The perceived need for standardized AF screening was rated as 82.7 on a scale from 0 to 100. The vast majority (88.0%) indicated no AF screening program is established in their region. Three out of four GPs (72.1%, lowest in Eastern and Southern Europe) were equipped with a 12-lead ECG, while a single-lead ECG was less common (10.8%, highest in United Kingdom & Ireland). Three in five GPs (59.3%) feel confident ruling out AF on a single-lead ECG strip. Assistance through more education (28.7%) and a tele-healthcare service offering advice on ambiguous tracings (25.2%) would be helpful. Preferred strategies to overcome barriers like insufficient (qualified) staff, included integrating AF screening with other healthcare programs (24.9%) and algorithms to identify patients most suitable for AF screening (24.3%). CONCLUSION: GPs perceive a strong need for a standardized AF screening approach. Additional resources may be required to have it widely adopted into clinical practice.

Cribado neonatal; Sepsis neonatal de inicio precoz; Hemocultivo Neonatal screening; Neonatal early-onset sepsis; Blood culture Cribratge neonatal; Sèpsia neonatal d'inici precoç; Hemocultiu Introduction Early-onset neonatal sepsis (EONS) can cause significant morbidity and mortality, especially if it is not detected early. Given the decrease in its incidence in the past few decades, it is important to find a balance between reducing the use of diagnostic tests and continuing to detect affected patients. We compared 3 detection strategies in patients with risk factors (RFs) for infection: laboratory screening (S1), the Neonatal Sepsis Risk Calculator (S2) and clinical observation (S3). Patients and methods Retrospective observational study in neonates born at 34 weeks of gestation or later and with RFs or symptoms compatible with EONS. We analysed outcomes in our unit with the use of laboratory screening (S1) and compared them with the other two strategies (S2 and S3) to contemplate whether to modify our protocol. Results The study included 754 patients, and the most frequent RFs were prolonged rupture of membranes (35.5%) and maternal colonization by Streptococcus agalactiae (38.5%). Strategies S2 and S3 would decrease the performance of laboratory tests (S1, 56.8% of patients; S2, 9.9%; S3, 22.4%; P < 0.01), hospital admissions (S1, 11%; S2, 6.9%; S3, 7.9%; P < 0.01) and the use of antibiotherapy (S1, 8.6%; S2, 6.7%; S3, 6.4%; P < 0.01). Sepsis was diagnosed in 13 patients, and it would have been detected with S2 and S3 except in 1 patient who had asymptomatic bacteriemia by Enterococcus faecalis. No patient with mild and self-limited symptoms in whom antibiotherapy was not started received a diagnosis of sepsis later on. Conclusion Close clinical observation seems to be a safe option and could reduce the use of diagnostic tests, hospital admission and unnecessary antibiotherapy. The watchful waiting approach in patients with mild and self-limiting symptoms in the first hours post birth does not appear to be associated with failure to identify sepsis. Introducción La sepsis neonatal de inicio precoz (SNIP) puede causar morbi-mortalidad importante, sobre todo si se retrasa su identificación. La disminución de su incidencia en las últimas décadas motiva que sea importante encontrar un equilibrio entre reducir las pruebas complementarias y seguir detectando los pacientes afectos. Comparamos 3 estrategias de detección en pacientes con factores de riesgo (FR): E1. Cribado analítico; E2. Calculadora de riesgo de sepsis neonatal; E3. Observación clínica. Pacientes y métodos Estudio observacional retrospectivo, en recién nacidos con edad gestacional ≥34 semanas y con FR o sintomatología compatible con SNIP. Se analizaron los resultados de nuestra unidad con cribado analítico (E1) y se comparó con las otras 2 estrategias (E2 y E3) para valorar modificar nuestro protocolo. Resultados Se incluyeron 754 pacientes cuyos FR más frecuentes fueron la rotura prologada de membranas (35,5%) y la colonización materna por S.agalactiae (38,5%). Las E2 y E3 disminuirían la realización de analíticas (E1 56,8% de los pacientes; E2 9,9%; E3 22,4%; P < 0,01), los ingresos hospitalarios (E1 11%; E2 6,9%; E3 7,9%; P < 0,01) y la administración de antibioterapia (E1 8,6%; E2 6,7%; E3 6,4%; P < 0,01). 13 pacientes se diagnosticaron de sepsis, las cuales se hubieran detectado con E2 y E3, salvo un paciente con bacteriemia asintomática por E. faecalis. Ningún paciente con clínica leve y autolimitada en que no se inició antibioterapia, se diagnosticó posteriormente de sepsis. Conclusiones La observación clínica estrecha parece una opción segura y podría disminuir la realización de pruebas complementarias, la tasa de hospitalización y el uso de antibioterapia innecesaria. Mantener una conducta expectante en pacientes con sintomatología leve y autolimitada en las primeras horas de vida parece no relacionarse con la no identificación de sepsis.

PROPÒSIT: Realitzar una revisió bibliogràfica sistemàtica dels cribratges visuals al servei de pediatria (0-14 anys), analitzant les proves indicades en els protocols de les diferents comunitats autònomes. MÈTODES: Es realitza una cerca bibliogràfica a través de Medline i Pubmed amb la metodologia Prisma. S'hi afegeixen també els 9 documents dels protocols de les diferents comunitats obtinguts a les pàgines autonòmiques. RESULTATS: Aquesta revisió mostra la importància dels valors de sensibilitat i especificitat de les diferents proves. S'hi analitzen els resultats obtinguts en funció del personal executor. Es fa una anàlisi dels protocols a cada etapa d'edat i els seus criteris de remissió. S'analitza el cost que implicaria un cribratge en pediatria realitzat per òptics i optometristes. CONCLUSIÓ: Hi ha diferències significatives entre els protocols analitzats. Des de la selecció de diferents proves, optotips i criteris passa-falla per a la derivació. L'especificitat i la sensibilitat milloren quan les fa personal especialitzat, com un òptic optometrista. La incorporació als cribratges d'atenció primària pot suposar un estalvi econòmic per al sistema, una millor detecció d'anomalies i una reducció de la possible saturació de les consultes d'oftalmologia. PROPÓSITO: Realizar una revisión bibliográfica sistemática de los cribados visuales en el servicio de pediatría (0-14 años), analizando las pruebas indicadas en los protocolos de las diferentes comunidades autónomas. MÉTODOS: Se realiza una búsqueda bibliográfica a través de Medline y Pubmed con la metodología Prisma. Se añaden también los 9 documentos de los protocolos de las diferentes comunidades obtenidos en las páginas autonómicas. RESULTADOS: Esta revisión muestra la importancia de los valores de sensibilidad y especificidad de las diferentes pruebas. Se analizan los resultados obtenidos en función del personal ejecutor. Se hace un análisis de los protocolos en cada etapa de edad y sus criterios de remisión. Se analiza el coste que implicaría un cribado en pediatría realizado por ópticos y optometristas. CONCLUSIÓN: Existen diferencias significativas entre los protocolos analizados. Desde la selección de diferentes pruebas, optotipos y criterios pasa-falla para la derivación. La especificidad y la sensibilidad mejoran cuando las realiza personal especializado, como un óptico optometrista. Su incorporación a los cribados de atención primaria puede suponer un ahorro económico para el sistema, una mejor detección de anomalías y una reducción de la posible saturación de las consultas de oftalmología. PURPOSE: To carry out a systematic bibliographic review of visual screenings in the pediatric service (0-14 years), analyzing the tests indicated in the protocols of the different autonomous communities. METHODS: A bibliographic search was carried out through Medline and Pubmed with the Prisma methodology. The 9 documents of the protocols of the different communities obtained in the autonomous pages are also added. RESULTS: This review shows the importance of the sensitivity and specificity values of the different tests. The results obtained are analyzed according to the executing staff. An analysis of the protocols in each age stage and their remission criteria is made. The cost of a pediatric screening carried out by opticians and optometrists is analyzed. CONCLUSION: There are significant differences between the protocols analyzed. From the selection of different tests, optotypes and pass-fail criteria for referral. Specificity and sensitivity are improved when performed by specialized personnel, such as an optometrist optician. Its incorporation into primary care screening can mean economic savings for the system, better detection of anomalies and a reduction in the possible saturation of ophthalmology consultations.

Diagnosis; Non-endemic; Schistosomiasis Diagnóstico; No endémico; Esquistosomiasis Diagnòstic; No endèmic; Esquistosomiasi A consensus on the recommended screening algorithms for schistosomiasis in asymptomatic high-risk subjects in non-endemic areas is lacking. The objective of this study was to evaluate the real-life performance of direct microscopy and ELISA serology for schistosomiasis screening in a high-risk population in a non-endemic setting. A retrospective cohort study was conducted in two out-patient Tropical Medicine units in Barcelona (Spain) from 2014 to 2017. Asymptomatic adults arriving from the Sub-Saharan region were included. Schistosomiasis screening was conducted according to clinical practice following a different strategy in each setting: (A) feces and urine direct examination plus S. mansoni serology if non-explained eosinophilia was present and (B) S. mansoni serology plus uroparasitological examination as the second step in case of a positive serology. Demographic, clinical and laboratory features were collected. Schistosomiasis cases, clinical management and a 24 month follow-up were recorded for each group. Four-hundred forty individuals were included. The patients were mainly from West African countries. Fifty schistosomiasis cases were detected (11.5% group A vs. 4 % group B, p = 0.733). When both microscopic and serological techniques were performed, discordant results were recorded in 18.4% (16/88). Schistosomiasis cases were younger (p < 0.001) and presented eosinophilia and elevated IgE (p < 0.001) more frequently. Schistosomiasis is a frequent diagnosis among high-risk populations. Serology achieves a similar performance to direct diagnosis for the screening of schistosomiasis in a high-risk population.

Aneurisma d'aorta abdominal; Dolor crònic; Cribratge Aneurisma de aorta abdominal; Dolor crónico; Cribado Abdominal aortic aneurysm; Chronic pain; Screening L’objectiu general d’aquest informe és avaluar l’evidència disponible sobre seguretat, eficàcia clínica i cost-efectivitat de la implantació d’un programa de cribratge de l’AAA mitjançant ecografia abdominal per ultrasons en la població de risc, a més de realitzar una avaluació econòmica, i respondre als criteris del Document marc sobre cribratges poblacionals, amb la condició de valorar la seva inclusió dins de la cartera comuna de serveis del Sistema Nacional de Salut espanyol. El objetivo general de este informe es evaluar la evidencia disponible sobre seguridad, eficacia clínica y coste-efectividad de la implantación de un programa de cribado del AAA mediante ecografía abdominal por ultrasonidos en la población de riesgo, además de realizar una evaluación económica, y responder a los criterios del Documento marco sobre cribados poblacionales, con tal de valorar su inclusión dentro de la cartera común de servicios del Sistema Nacional de Salud español. The general objective of this report is to evaluate the available evidence on safety, clinical efficacy and cost-effectiveness of the implementation of an AAA screening programme, using ultrasound abdominal ultrasound in the population at risk. Other objectives are to carry out an economic evaluation, and to respond to the criteria of the Framework document on population screening, in order to assess its inclusion in the common portfolio of services of the Spanish National Health System.

Population screening; Liver fibrosis; Early diagnosis Cribratge de població; Fibrosi hepàtica; Diagnòstic precoç Cribado de población; Fibrosis hepática; Diagnóstico precoz Cirrhosis, highly prevalent worldwide, develops after years of hepatic inflammation triggering progressive fibrosis. Currently, the main etiologies of cirrhosis are non-alcoholic fatty liver disease and alcohol-related liver disease, although chronic hepatitis B and C infections are still major etiological factors in some areas of the world. Recent studies have shown that liver fibrosis can be assessed with relatively high accuracy noninvasively by serological tests, transient elastography, and radiological methods. These modalities may be utilized for screening for liver fibrosis in at-risk populations. Thus far, a limited number of population-based studies using noninvasive tests in different areas of the world indicate that a significant percentage of subjects without known liver disease (around 5% in general populations and a higher rate −18% to 27%-in populations with risk factors for liver disease) have significant undetected liver fibrosis or established cirrhosis. Larger international studies are required to show the harms and benefits before concluding that screening for liver fibrosis should be applied to populations at risk for chronic liver diseases. Screening for liver fibrosis has the potential for changing the current approach from diagnosing chronic liver diseases late when patients have already developed complications of cirrhosis to diagnosing liver fibrosis in asymptomatic subjects providing the opportunity of preventing disease progression. LiverScreen Consortium and the European Commission under the H20/20 program (847989); AGAUR (2017SGR-01281); Centro de Investigacion Biomedica en Enfermedades Hepaticas y Digestivas; Fundación de Investigación Sanitaria, cofunded by Instituto Carlos III–Subdirección General de Evaluación and the European Regional Development Fund (PI18/01330, PI18/00662, and PI18/00862); and Gilead’s Investigator–sponsored research program (IN-ES-989-5309)

Chagas disease; Community pharmacies; Rapid test Enfermedad de Chagas; Farmacias comunitarias; Test rapido Malaltia de Chagas; Farmàcies comunitàries; Prova ràpida Objectives: This study aimed to report the protocol and results from the pilot phase of an opportunistic CP-based CD screening program in Barcelona, Spain. Methods: Three strategies according to recruitment approach were designed: passive, active and active-community. The study process consisted of signing the informed consent form, recording the patient’s data in a web-based database system, and performing the rapid test and blood collection on dry paper. Results: Nineteen pharmacies participated and 64 patients were included during the pilot phase of the study. The rapid diagnostic test (RDT) was positive in 2/64 (3.13%) cases. Of the 49 DBS samples that arrived at the laboratory, 22 (45%) were collected incorrectly. After quantitative and qualitative assessment of the program, the dry paper sample and passive strategy were ruled out. Conclusion: DBS sampling and the passive strategy are not suitable for CD screening in community pharmacies. There is a need to expand the number of participating pharmacies and individuals to determine whether conducting a RDT in community pharmacies is an effective screening method to increase access to CD diagnosis in a non-endemic area. This work has been supported by the Fundació la Marató TV3 (project number 481/U/2018).

Background and AimsImmunotherapy with immune checkpoint inhibitors (ICIs) is a pillar of many advanced tumors. However, there is scarce data concerning the rate of viral hepatitis screening in this population or the risk of viral reactivation.MethodsRetrospective–prospective study that includes all patients who began ICIs between January/2019 and December/2020 in a University Hospital. Data on viral hepatitis screening prior to the beginning of ICIs were collected. In subjects lacking information, serological tests were requested prospectively. Among HBsAg, anti-HBc, or anti-HCV positive subjects, reactivation was prospectively assessed.ResultsDuring the 2-year period of study, 595 subjects received ICIs (61.2% male, mean age 63 years). The most prevalent cancers found were 35.5% lung cancer, 12.1% melanoma, and 8.2% head and neck; ICIs schemes were mainly anti-PD1 (65.7%), followed by anti-PD-L1 (19.2%), and combined therapy (13.6%). Prior to immunotherapy, anti-HCV screening was performed in 462 (77.6%) subjects, HBsAg in 462 (77.6%), anti-HBc in 335 (56.3%), and the complete screening in 328 (55.1%). The anti-HBc screening was more frequently ordered among patients treated with concomitant systemic therapy (p = 0.003), especially in the case of chemotherapy (p = 0.015), though HCV screening was more commonly performed in concomitant therapies different from chemotherapy (p = 0.001). Serological tests were completed prospectively in those alive, leading to an overall prevalence for anti-HCV of 3.5%, HBsAg at 1.3%, and anti-HBc of 15.2%. HCV-RNA was detected in 2/19 (both patients with hepatocellular carcinoma), HBV-DNA in 4/7 HBsAg positive, and in 1/75 anti-HBc positive subject. Five out of the 7 HBsAg carriers and 1/75 anti-HBc+ subjects (due to concomitant antiretroviral therapy) received antiviral prophylaxis. Neither cases of HBV reactivation nor changes in HCV viral load were observed.DiscussionHBV and HCV screening prior to immunotherapy is suboptimal. Though the rate of viral hepatitis reactivation seems extremely low, efforts should be made to optimize viral hepatitis screening prior to immunotherapy for the selection of candidates for either antiviral prophylaxis or periodical follow-up.

Actualment, a Espanya, les ulleres i lents de contacte no queden cobertes per la sanitat pública espanyola, sinó que la seva adquisició i actualització, depèn de les capacitats econòmiques de cada individu. No obstant això, no hi ha articles científics on s’estudiï la relació entre l’actualització de les ulleres segons l’estatus socioeconòmic. D’aquest fet neix l’objectiu d’aquest estudi, analitzar si la utilització i l’adequació de la correcció òptica dels infants està influenciada pel nivell socioeconòmic familiar i la tipologia de les escoles on estudien. Les dades per realitzar l’estudi s’han obtingut a partir de cribratges visuals realitzats a nens i nenes provinents d’escoles tant classificades com no, d’alta complexitat, i a partir de dades socioeconòmiques proporcionades pels seus progenitors. Els principals resultats de l’estudi són: 1) No existeixen diferències estadísticament significatives sobre una millor adequació òptica en funció del nivell d’estudis dels progenitors; 2) El factor que més influeix en l’adequació de les ulleres és el fet que la mare treballi, assolint majors nivells d’adequació òptica quan la mare és laboralment activa, i 3) Els alumnes d’escoles d’alta complexitat tendeixen a tenir una pitjor correcció òptica en comparació amb els que no, especialment pel que respecta a la correcció de la miopia. Actualmente, en España, las gafas y lentes de contacto no quedan cubiertas por la sanidad pública española, sino que su adquisición y actualización, depende de las capacidades económicas de cada individuo. Sin embargo, no existen artículos científicos donde se estudie la relación entre la actualización de las gafas según el estatus socioeconómico. De este hecho nace el objetivo de este estudio, analizar si la utilización y adecuación de la corrección óptica de los niños está influenciada por el nivel socioeconómico familiar y la tipología de las escuelas en las que estudian. Los datos para realizar el estudio se han obtenido a partir de cribados visuales realizados a niños y niñas provenientes de escuelas tanto clasificadas como no, de alta complejidad, y a partir de datos socioeconómicos proporcionados por sus progenitores. Los principales resultados del estudio son: 1) No existen diferencias estadísticamente significativas sobre una mejor adecuación óptica en función del nivel de estudios de los progenitores; 2) El factor que más influye en la adecuación de las gafas es el hecho de que la madre trabaje, alcanzando mayores niveles de adecuación óptica cuando la madre es laboralmente activa, y 3) Los alumnos de escuelas de alta complejidad tienden a tener una peor corrección óptica en comparación con los que no, especialmente en lo que respecta a la corrección de la miopía. In Spain, glasses and contact lenses are not currently covered by Spanish Public Health, but their acquisition and having their prescription up to date depends on the economic capabilities of each individual, although there are no scientific articles that study the relationship between the updating of glasses according to socioeconomic status. Having said that, the aim of this study is to analyze whether the use and adequacy of children's optical correction is influenced by the family's socioeconomic level and the type of schools where they study. The data for the study was obtained from visual screening of boys and girls from both classified and non-classified schools, and from socioeconomic data provided by their parents. The main results of the study are: 1) There are no statistically significant differences in better optical fit depending on the level of education of the parents; 2) The most influential factor in the fit of glasses is the fact that the mother is employed, achieving higher levels of optical fit when the mother works, and 3) Students in high-complexity schools tend to have a worse optical correction compared to those who do not, especially with regard to the correction of myopia.

Amb l’objectiu de conèixer com és la salut visual dels infants, a Catalunya s’administra periòdicament l’ESCA, enquesta de salut oficial, que, conté un apartat de preguntes de visió infantil que són contestades per les famílies. L’any 2019 Vila va presentar una nova bateria de preguntes de visió i es va proposar al Departament de Salut de la Generalitat de Catalunya, incloure aquestes cinc preguntes de forma provisional a l’ESCA, durant dos anys; des del gener de 2020 fins al desembre de 2022. Per avaluar la fiabilitat de les respostes de les famílies a aquestes preguntes, s’ha realitzat un cribratge visual a un grup d’escolars de la ciutat de Terrassa, els pares dels quals han respost aquestes mateixes preguntes. Un cop teníem les dades, s’ha fet la validació de les noves preguntes de visió, comparant les respostes als qüestionaris amb els resultats clínics, en funció de la tipologia de les escoles i també s’ha comparat l’actualització de les ulleres dels escolars. Podem dir, com a conclusió general, que són cinc preguntes fàcils de comprendre per part de les famílies i que tot i que s’han detectat algunes discrepàncies, aporten informació fiable sobre l’estat visual dels nens. Con el objetivo de conocer cómo es la salud visual de los niños, en Cataluña se administra periódicamente la ESCA, encuesta de salud oficial, que contiene un apartado de preguntas de visión infantil que son contestadas por las familias. El año 2019 Vila presentó una nueva batería de preguntas de visión y se propuso al Departamento de Salud de la Generalitat de Cataluña, incluir estas cinco preguntas de forma provisional a la YESCA, durante dos años; desde enero de 2020 hasta diciembre de 2022. Para evaluar la fiabilidad de las respuestas de las familias a estas preguntas, se ha realizado un cribado visual a un grupo de escolares de la ciudad de Terrassa, los padres de los cuales han respondido estas mismas preguntas. Una vez teníamos los datos, se ha hecho la validación de las nuevas preguntas de visión, comparando las respuestas a los cuestionarios con los resultados clínicos, en función de la tipología de las escuelas y también se ha comparado la actualización de la corrección habitual de los escolares. Podemos decir, como conclusión general, que son cinco preguntas fáciles de comprender por parte de las familias y que a pesar de que se han detectado algunas discrepancias, aportan información fiable sobre el estado visual de los niños. With the aim of finding out what children’s visual health is like, the ESCA, an official health survey, is periodically administered in Catalonia, which contains a section of questions on children’s vision that are answered by families. In 2019, Vila presented a new battery of vision questions, and it was proposed to the Department of Health of the Generalitat de Catalunya to include these five questions provisionally in the ESCA for two years, from January 2020 to December 2022. To evaluate the reliability of the families’ answers to these questions, a visual screening was done in a group of schoolchildren from Terrassa; whose parents answered the same questions. Once we had the data, we validated the new vision questions, comparing the answers to the questionnaires with the clinical results, according to the type of the school, and also compared the updating of the usual correction of schoolchildren. As a general conclusion, we can say that these five questions are easy to understand for families and that, despite some discrepancies, they provide reliable information on the visual status of children.

Cancer screening; Non-small-cell lung cancer Cribado de cáncer; Cáncer de pulmón de células no pequeñas Cribratge de càncer; Càncer de pulmó no de cèl·lules petites Access to a comprehensive molecular alteration screening is patchy in Europe and quality of the molecular analysis varies. SPECTAlung was created in 2015 as a pan-European screening platform for patients with thoracic malignancies. Here we report the results of almost 4 years of prospective molecular screening of patients with thoracic malignancies, in terms of quality of the program and molecular alterations identified. Patients with thoracic malignancies at any stage of disease were recruited in SPECTAlung, from June 2015 to May 2019, in 7 different countries. Molecular tumour boards were organised monthly to discuss patients’ molecular and clinical profile and possible biomarker-driven treatments, including clinical trial options. FFPE material was collected and analysed for 576 patients with diagnosis of pleural, lung, or thymic malignancies. Ultimately, 539 patients were eligible (93.6%) and 528 patients were assessable (91.7%). The turn-around time for report generation and molecular tumour board was 214 days (median). Targetable molecular alterations were observed in almost 20% of cases, but treatment adaptation was low (3% of patients). SPECTAlung showed the feasibility of a pan-European screening platform. One fifth of the patients had a targetable molecular alteration. Some operational issues were discovered and adapted to improve efficiency. This publication was supported by Fonds Baillet Latour from Belgium and Walgreens Boots Alliance.

Clinical course; Infantile nephropathic cystinosis; Newborn screening Curso clínico; Cistinosis nefropática infantil; Cribado de recién nacidos Curs clínic; Cistinosi nefropàtica infantil; Cribratge de nounats Newborn screening (NBS) programmes are considered to be one of the most successful secondary prevention measures in childhood to prevent or reduce morbidity and/or mortality via early disease identification and subsequent initiation of therapy. However, while many rare diseases can now be detected at an early stage using appropriate diagnostics, the introduction of a new target disease requires a detailed analysis of the entire screening process, including a robust scientific background, analytics, information technology, and logistics. In addition, ethics, financing, and the required medical measures need to be considered to allow the benefits of screening to be evaluated at a higher level than its potential harm. Infantile nephropathic cystinosis (INC) is a very rare lysosomal metabolic disorder. With the introduction of cysteamine therapy in the early 1980s and the possibility of renal replacement therapy in infancy, patients with cystinosis can now reach adulthood. Early diagnosis of cystinosis remains important as this enables initiation of cysteamine at the earliest opportunity to support renal and patient survival. Using molecular technologies, the feasibility of screening for cystinosis has been demonstrated in a pilot project. This review aims to provide insight into NBS and discuss its importance for nephropathic cystinosis using molecular technologies.

Cribratge clínic i epidemiològic; Persones migrants; Catalunya Cribado clínico y epidemiológico; Personas migrantes; Cataluña Clinical and epidemiological screening; Migrant people; Catalonia Aquest document ofereix un marc general de recomanacions sobre les actuacions immediates de cribratge i vacunacions que hauran de fer-se operatius en els diferents punts del territori per part de les institucions competents com també conscienciar de la necessitat de la continuïtat dels programes de vacunació i de conèixer les vulnerabilitats enfront de les malalties infeccioses de la població desplaçada.

NCL2 disease; Dried blood spot; Enzymatic activity Enfermedad de NCL2; Mancha de sangre seca; Actividad enzimática Malaltia de NCL2; Taca de sang seca; Activitat enzimàtica Introduction: Neuronal Ceroid Lipofuscinosis (NCL) comprises a clinically and genetically heterogeneous group of 13 neurodegenerative lysosomal storage disorders. Neuronal Ceroid lipofuscinosis type 2 disease (NCL2), caused by the deficient lysosomal enzyme tripeptidyl peptidase 1 (TPP1), is the only one with an approved enzyme replacement treatment (ERT). Early initiation of ERT appears to modify significantly the natural history of the disease. We aimed to shorten the time to diagnosis of NCL2. Methods: In March 2017, we started per first time in Spain a selective screening program, the LINCE project, in pediatric patients with clinical symptoms compatible with NCL2 disease. The program covered the whole country. We distributed kits to pediatricians with the necessary material to assess patients. All samples in this study were received within one week of collection. Enzymatic activity determined on dried blood spots was the main method used to screen for TPP1 and palmitoyl protein thioesterase 1 (PPT1) for the differential diagnosis with neuronal ceroid lipofuscinosis type 1 (NCL1). Results: Over a period of three years, we received 71 samples. The analysis was minimally invasive, relatively cheap and fast-executing. Three cases identified as a direct result of the selective screening strategy were confirmed by genetic study of NCL2 disease with a median age of 4.5 years. Our screening method has a specificity of 100%, and, with the absence to date of false negatives. We did not detect any NCL1-positive cases. Conclusions: LINCE proved to be a simple, useful, and reliable tool for the diagnosis of NCL2, enabling clinicians to diagnose NCL2 faster. The presence of NCL2-positive cases in our population and availability of treatment may facilitate the inclusion of NCL2 in neonatal screening programs for early diagnosis. This study received funding from Grant Biomarin Inc. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

In this study, we examined normative data and diagnostic accuracy of a pictorial screening test to detect memory impairment for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in Spanish-speaking adults with intellectual disability (ID). A total of 94 volunteers with ID (60 controls, 17 MCI, and 17 AD), were evaluated by neuropsychological tests including the PMIS-ID in a cross-sectional validation study. Discriminative validity between the MCI, AD, and control group was analyzed by the area under the ROC curve. A cut-off score of 4.5 on the immediate recall trial had a sensitivity of 69% and a specificity of 80% to detect memory impairment (AUC = 0.685; 95% CI = 0.506–0.863) in the AD group. The PMIS-ID is a useful screening test to rule out a diagnosis of memory decline in people with moderate level of ID and AD, and it shows good psychometric properties.

Magnetic resonance imaging; Predictive model; Prostate cancer Imágenes por resonancia magnética; Modelo predictivo; Cáncer de próstata Imatges per ressonància magnètica; Model predictiu; Càncer de pròstata A predictive model including age, PCa family history, biopsy status (initial vs repeat), DRE (normal vs abnormal), serum prostate-specific antigen (PSA), and DRE prostate volume ca-tegory was developed to stratify initial PCa suspicion in 1486 men with PSA > 3 ng/mL and/or abnormal DRE, in whom mpMRI followed; 2- to 4-core TRUS-guided biopsies where Prostate Imaging Report and Data System (PI-RADS) > 3 lesions and/or 12-core TRUS systematic biopsies were performed in one academic institution between 1 January 2016–31 December 2019. The csPCa detection rate, defined as International Society of Uro-Pathology grade group 2 or higher, was 36.9%. An external validation of designed BCN-RC 1 was carried out on 946 men from two other institutions in the same metropolitan area, using the same criteria of PCa suspicion and diagnostic approach, yielded a csPCa detection rate of 40.8%. The areas under the receiver operating characteristic curves of BCN-RC 1 were 0.823 (95% CI: 0.800–0.846) in the development cohort and 0.837 (95% CI: 0.811–0.863) in the validation cohort (p = 0.447). In both cohorts, BCN-RC 1 exhibited net benefit over performing mpMRI in all men from 8 and 12% risk thresholds, respectively. At 0.95 sensitivity of csPCa, the specificities of BCN-RC 1 were 0.24 (95% CI: 0.22–0.26) in the development cohort and 0.34 (95% CI: 0.31–0.37) in the validation cohort (p < 0.001). The percentages of avoided mpMRI scans were 17.2% in the development cohort and 22.3% in the validation cohort, missing between 1.8% and 2% of csPCa among men at risk of PCa. In summary, BCN-RC 1 can stratify initial PCa suspicion, reducing the demand of mpMRI, with an acceptable loss of csPCa. This research was funded by Instituto de Salut Carlos III (SP) and European Union, grant number PI20/01666.

Digestive cancer; Screening; Europe Cáncer digestivo; Cribado; Europa Càncer digestiu; Cribratge; Europa

Three new therapies for spinal muscular atrophy (SMA) have been approved by the United States Food and Drug Administration and the European Medicines Agency since 2016. Although these new therapies improve the quality of life of patients who are symptomatic at first treatment, administration before the onset of symptoms is significantly more effective. As a consequence, newborn screening programs have been initiated in several countries. In 2018, we launched a 3-year pilot program to screen newborns for SMA in the Belgian region of Liège. This program was rapidly expanding to all of Southern Belgium, a region of approximately 55,000 births annually. During the pilot program, 136,339 neonates were tested for deletion of exon 7 of SMN1, the most common cause of SMA. Nine SMA cases with homozygous deletion were identified through this screen. Another patient was identified after presenting with symptoms and was shown to be heterozygous for the SMN1 exon 7 deletion and a point mutation on the opposite allele. These ten patients were treated. The pilot program has now successfully transitioned into the official neonatal screening program in Southern Belgium. The lessons learned during implementation of this pilot program are reported., SCOPUS: ar.j, info:eu-repo/semantics/published

Newborn screening; Severe combined immunodeficiency Cribatge nounat; Immunodeficiència combinada severa Cribado neonato; Inmunodeficiencia combinada grave Purine nucleoside phosphorylase (PNP) deficiency is a rare inherited disorder, resulting in severe combined immunodeficiency. To date, PNP deficiency has been detected in newborn screening only through the use of liquid chromatography tandem mass spectrometry. We report the first case in which PNP deficiency was detected by TREC analysis. This research was funded by Jeffrey Modell Foundation.

Background: The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. Objective: To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. Methodology: Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. Results: Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. Conclusion: Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.

BELE Study Group leaded by Xavier Castells are listed here in alphabetical order and grouped by institution: (a) IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain: Andrea Burón, Xavier Castells, Merce Comas, Jose Maria Corominas, Javier Louro, Ana Rodríguez-Arana, Marta Román, Maria Sala, Sonia Servitja, Mar Vernet-Tomas; (b) Corporació Sanitària Parc Taulí, Sabadell, Spain: Marisa Baré, Nuria Tora; (c) Catalan Institute of Oncology, Barcelona, Spain: Llucia Benito, Carmen Vidal (d) Hospital Santa Caterina, Girona, Spain: Joana Ferrer; (e) Catalan Institute of Oncology, Girona, Spain: Rafael Marcos-Gragera; (f) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain: Judit Solà-Roca, María Jesús Quintana; (g) General Directorate of Public Health, Government of Cantabria, Spain: Mar Sánchez; (h) Principality of Astúrias Health Service, Spain: Miguel Prieto; (i) Fundació Lliga per a La Investigació i Prevenció Del Cáncer, Tarragona, Spain: Francina Saladié, Jaume Galceran; (j) Hospital Clinic, Barcelona, Spain; Xavier Bargalló, Isabel Torá-Rocamora; (k) Vallés Oriental Breast Cancer Early Detection Program, Spain; Lupe Peñalva; (l) Catalonian Cancer Strategy, Barcelona, Spain: Josep Alfons Espinàs. IRIS Study Group leaded by Marta Román are listed here in alphabetical order and grouped by institution: (a) IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain: Rodrigo Alcantara, Xavier Castells, Laia Domingo, Javier Louro, Margarita Posso, Maria Sala, Ignasi Tusquets, Ivonne Vazquez, Mar Vernet-Tomas; (b) Corporació Sanitària Parc Taulí, Sabadell, Spain: Marisa Baré, Javier del Riego; (c) Catalan Institute of Oncology, Barcelona, Spain: Llucia Benito, Carmen Vidal (d) Hospital Santa Caterina, Girona, Spain: Joana Ferrer; (e) Catalan Institute of Oncology, Girona, Spain: Rafael Marcos-Gragera; (f) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain: Judit Solà-Roca, María Jesús Quintana; (g) General Directorate of Public Health, Government of Cantabria, Spain: Mar Sánchez; (h) Principality of Astúrias Health Service, Spain: Miguel Prieto; (i) Fundació Lliga per a La Investigació i Prevenció Del Cáncer, Tarragona, Spain: Francina Saladié, Jaume Galceran; (j) Hospital Clinic, Barcelona, Spain; Xavier Bargalló, Isabel Torá-Rocamora; (k) Vallés Oriental Breast Cancer Early Detection Program, Spain; Lupe Peñalva; (l) Catalonian Cancer Strategy, Barcelona, Spain: Josep Alfons Espinàs Background Several studies have proposed personalized strategies based on women’s individual breast cancer risk to improve the effectiveness of breast cancer screening. We designed and internally validated an individualized risk prediction model for women eligible for mammography screening. Methods Retrospective cohort study of 121,969 women aged 50 to 69 years, screened at the long-standing population-based screening program in Spain between 1995 and 2015 and followed up until 2017. We used partly conditional Cox proportional hazards regression to estimate the adjusted hazard ratios (aHR) and individual risks for age, family history of breast cancer, previous benign breast disease, and previous mammographic features. We internally validated our model with the expected-to-observed ratio and the area under the receiver operating characteristic curve. Results During a mean follow-up of 7.5 years, 2,058 women were diagnosed with breast cancer. All three risk factors were strongly associated with breast cancer risk, with the highest risk being found among women with family history of breast cancer (aHR: 1.67), a proliferative benign breast disease (aHR: 3.02) and previous calcifications (aHR: 2.52). The model was well calibrated overall (expected-to-observed ratio ranging from 0.99 at 2 years to 1.02 at 20 years) but slightly overestimated the risk in women with proliferative benign breast disease. The area under the receiver operating characteristic curve ranged from 58.7% to 64.7%, depending of the time horizon selected. Conclusions We developed a risk prediction model to estimate the short- and long-term risk of breast cancer in women eligible for mammography screening using information routinely reported at screening participation. The model could help to guiding individualized screening strategies aimed at improving the risk-benefit balance of mammography screening programs

Algoritme; Pneumonia; Atenció primaria; Detecció Neumonía; Atención primaria; Detección; Algoritmo Algorithm; Pneumonia; Primary care; Detection Protocol per al tractament de la pneumònia lleu amb ingrés domiciliari. Protocolo para el tratamiento de la neumonía leve con ingreso domiciliario. Protocol for the treatment of mild pneumonia at home.

Atròfia muscular espinal; Cribratge neonatal; Avaluació; Detecció precoç Atrofia muscular espinal; Cribado neonatal; Evaluación; Detección precoz Spinal muscular atrophy; Neonatal screening; Evaluation; Early detection L'objectiu d'aquest informe és avaluar la inclusió de l’atròfia muscular espinal dins d’un programa de cribratge neonatal en base a l’evidència sobre la seva eficàcia, efectivitat i seguretat, així com els requisits o principis establerts per implementar cribratges genètics i programes de cribratge en general.

Osteoporosi; Cribatge; Atenció primària Osteoporosis; Cribado; Atención primaria Osteoporosis; Screening; Primary care Síntesi dels principals resultats d'un informe elaborat per l'EUnetHTA OTCA19 Assessment Team a partir de la revisió bibliogràfica del cribratge de l'osteoporosi en la població general a l'atenció primària.

Hepatitis C; Diagnóstico descentralizado; Tratamiento antiviral; Población vulnerable Hepatitis C; Decentralised diagnosis; Antiviral treatment; Vulnerable population Hepatitis C; Diagnòstic descentralitzat; Tractament antiviral; Població vulnerable La Asociación Española para el Estudio del Hígado (AEEH) está convencida de que la eliminación de la hepatitis C en España es posible siempre y cuando seamos capaces de emplear los recursos y las herramientas necesarias para la misma. Este documento refleja la posición de la AEEH respecto a la eliminación del virus de la hepatitis C (VHC), estableciendo una amplia serie de recomendaciones que se pueden agrupar en cinco categorías: 1) cribado del VHC en función de la edad, de la existencia de factores de riesgo clásicos de adquisición de la infección, búsqueda activa de pacientes diagnosticados con anterioridad y desarrollo de estrategias de microeliminación en poblaciones vulnerables; 2) simplificación del diagnóstico del VHC (diagnóstico en un solo paso y diagnóstico en el punto de atención del paciente); 3) simplificación del tratamiento de los pacientes y mejora de los circuitos asistenciales; 4) medidas de política sanitaria, y, finalmente, 5) establecimiento de indicadores de eliminación del VHC. The Spanish Association for the Study of the Liver (AEEH) is convinced that the elimination of hepatitis C virus (HCV) in Spain is possible as long as we are able to use the resources and tools necessary for it. This document reflects the position of the AEEH regarding the elimination of HCV, establishing a wide range of recommendations that can be grouped into five categories: 1) Screening of HCV according to age, of the existence of classic acquisition risk factors of infection, active search of previously diagnosed patients and development of microelimination strategies in vulnerable populations; 2) Simplification of HCV diagnosis (onestep diagnosis and diagnosis at the point of patient care); 3) Simplification of patient treatment and improvement of care circuits; 4) Health policy measures, and, finally, 5) Establishment of HCV elimination indicators.

Background We aimed to identify the risk factors associated with early, late and long-term readmissions in women diagnosed with breast cancer participating in screening programs. Methods We performed a multicenter cohort study of 1055 women aged 50–69 years participating in Spanish screening programs, diagnosed with breast cancer between 2000 and 2009, and followed up to 2014. Readmission was defined as a hospital admission related to the disease and/or treatment complications, and was classified as early ( 1 year). We used logistic regression to estimate the adjusted odds ratios (aOR), and 95% confidence intervals (95% CI) to explore the factors associated with early, late and long-term readmissions, adjusting by women’s and tumor characteristics, detection mode, treatments received, and surgical and medical complications. Results Among the women included, early readmission occurred in 76 (7.2%), late readmission in 87 (8.2%), long-term readmission in 71 (6.7%), and no readmission in 821 (77.8%). Surgical complications were associated with an increased risk of early readmissions (aOR = 3.62; 95%CI: 1.27–10.29), and medical complications with late readmissions (aOR = 8.72; 95%CI: 2.83–26.86) and long-term readmissions (aOR = 4.79; 95%CI: 1.41–16.31). Conclusion Our results suggest that the presence of surgical or medical complications increases readmission risk, taking into account the detection mode and treatments received. Identifying early complications related to an increased risk of readmission could be useful to adapt the management of patients and reduce further readmissions. Trial Registration ClinicalTrials.govIdentifier: NCT03165006. Registration date: May 22, 2017 (Retrospectively registered).

Onada migratòria; Cribatge clínic; Vacunacions Ola migratoria; Cribado clínico; Vacunaciones Migratory wave; Clinical screening; Vaccinations Aquest document ofereix un marc general de recomanacions sobre les actuacions immediates de cribratge i vacunacions que hauran de fer-se operatius en els diferents punts del territori per part de les institucions competents com també conscienciar de la necessitat de la continuïtat dels programes de vacunació i de conèixer les vulnerabilitats enfront de les malalties infeccioses de la població desplaçada. Este documento ofrece un marco general de recomendaciones sobre las actuaciones inmediatas de cribado y vacunaciones que tendrán que hacerse operativos en los diferentes puntos del territorio por parte de las instituciones competentes así como concienciar de la necesidad de la continuidad de los programas de vacunación y de conocer las vulnerabilidades frente a las enfermedades infecciosas de la población desplazada.

Newborn screening; Severe combined immunodeficiency; T-cell receptor excision circles Cribratge de nadons; Immunodeficiència combinada greu; Cercles d'excisió de receptors de cèl·lules T Cribado de recién nacidos; Inmunodeficiencia combinada grave; Círculos de escisión de receptores de células T Severe combined immunodeficiency (SCID), the most severe form of T-cell immunodeficiency, can be screened at birth by quantifying T-cell receptor excision circles (TRECs) in dried blood spot (DBS) samples. Early detection of this condition speeds up the establishment of appropriate treatment and increases the patient's life expectancy. Newborn screening for SCID started in January 2017 in Catalonia, the first Spanish and European region to universally include this testing. The results obtained in the first 2 years of experience are evaluated here. All babies born between January 2017 and December 2018 were screened. TREC quantification in DBS (1.5 mm diameter) was performed with the Enlite Neonatal TREC kit from PerkinElmer (Turku, Finland). In 2018, the retest cutoff in the detection algorithm was updated based on the experience gained in the first year, and changed from 34 to 24 copies/μL. This decreased the retest rate from 3.34 to 1.4% (global retest rate, 2.4%), with a requested second sample rate of 0.23% and a positive detection rate of 0.02%. Lymphocyte phenotype (T, B, NK populations), expression of CD45RA/RO isoforms, percentage and intensity of TCR αβ and TCR γδ, presence of HLA-DR+ T lymphocytes, and in vitro lymphocyte proliferation were studied in all patients by flow cytometry. Of 130,903 newborns screened, 30 tested positive, 15 of which were male. During the study period, one patient was diagnosed with SCID: incidence, 1 in 130,903 births in Catalonia. Thirteen patients had clinically significant T-cell lymphopenia (non-SCID) with an incidence of 1 in 10,069 newborns (43% of positive detections). Nine patients were considered false-positive cases because of an initially normal lymphocyte count with normalization of TRECs between 3 and 6 months of life, four infants had transient lymphopenia due to an initially low lymphocyte count with recovery in the following months, and three patients are still under study. The results obtained provide further evidence of the benefits of including this disease in newborn screening programs. Longer follow-up is needed to define the exact incidence of SCID in Catalonia.

CAMISS Study Group (in alphabetical order): IMIM (Hospital del Mar Medical Research Institute), Barcelona: Xavier Castells, Merce` Comas, Laia Domingo, Francesc Macia`, Marta Roman, Anabel Romero, Maria Sala; Canary Islands Health Service: Teresa Barata, Isabel Diez de la Lastra, Mariola de la Vega; Corporacio´ Sanitaria Parc Taul´ı, Sabadell: Marisa Bare´, Nu´ria Tora`; Hospital Santa Caterina, Girona: Joana Ferrer; Epidemiology Unit and Girona Cancer Registry: Maria Carmen Carmona-Garcia; Hospital GaldakaoUsansolo, Vizcaya: Susana Garc´ıa, Maximina Mart´ın, Miren Orive, Maria Amparo Valverde; Canary Islands Foundation for Health Research: Jeanette Pe´rez, Amado Rivero, Cristina Valca´rcel; Hospital Costa del Sol, University of Ma´laga: Mar´ıa del Carmen Padilla, Maximino Redondo, Teresa Te´llez, Irene Zarcos; Hospital Universitario Donostia/Biodonostia: Cristina Churruca, Amaia Perales, Javier Recio, Irune Ruiz, Cristina Sarasqueta, Jose Mar´ıa Urraca; Instituto Oncolo´gico de Guipu´zcoa-Onkologikoa: Maria Jesu´s Michelena; Hospital Universitario Basurto: Julio Moreno; Hospital Universitario Cruces: Gaizka Mallabiabarrena, Patricia Cobos, Borja Otero; Hospital Universitario Txagorritxu: Javier Gorostiaga, Itsaso Troya Background. Our aim was to assess the role of breast density on breast cancer mortality and recurrences, considering patient and tumour characteristics and the treatments received among women attending population-based screening programmes. Methods. We conducted a retrospective cohort study among women aged 50–69 years attending population-based screening programmes, diagnosed with invasive breast cancer between 2000 and 2009, and followed up to 2014. Breast density was categorised as low density (≤25% dense tissue), intermediate density (25–50%), and high density (≥50%). Cox proportional hazards regression models were fitted to estimate the adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) for death and recurrences, adjusting by patient characteristics, mode of detection (screen-detected vs. interval cancer), and tumour features. Results. The percentage of deaths and recurrences was higher among women with intermediate- and high-density breasts than among women with low-density breasts ( for death; for recurrences). Adjusted Cox proportional hazards regression models revealed that women with intermediate- and high-density breasts had a higher risk of death than women with low-density breasts, being statistically significant for intermediate densities (aHR = 2.19 [95% CI: 1.16–4.13], aHR = 1.44 [95% CI: 0.67–3.1], respectively). No association was found between breast density and recurrences. Conclusions. Breast density was associated with a higher risk of death, but not of recurrences, among women participating in breast cancer screening. These findings reinforce the need to improve screening sensitivity among women with dense breasts and to routinely assess breast density, not only for its role as a risk factor for breast cancer but also for its potential influence on cancer prognosis *is study was supported by grants from Instituto de Salud Carlos III FEDER (grant numbers: PS09/01153, PI12/00387, PI11/01296, PI15/ 00098, and PI16/00244) and by the Research Network on Health Services in Chronic Diseases (Instituto de Salud Carlos III) (REDISSEC: RD12/0001/0015, RD12/0001/ 0007, and RD16/0001/0013)

OBJECTIUS L’objectiu d’aquest treball és conèixer fins a quin punt les anomalies de la visió del color poden afectar la vida de les persones que les pateixen i si poden interferir en les diferents activitats escolars o professionals de la persona afectada. Específicament volem conèixer la incidència d’aquestes anomalies segons el sexe i si condicionen el rendiment acadèmic dels escolars. MÈTODE S’ha realitzat un cribratge visual a nens i nenes de tercer de primària, d’edats entre 8 i 9 anys, de les escoles de Terrassa. Les proves realitzades han estat: anamnesi, agudesa visual, cover test en visió llunyana i en visió propera comprovant la comitància, punt pròxim de convergència, punt pròxim d’acomodació, retinoscòpia, Developmental Eye Movement Test (DEM) i visió del color amb el test d’Ishihara. Els resultats obtinguts s’han afegit a la base de dades de la facultat i ha permès que el treball es faci sobre una mostra de 2305 nens i nenes. RESULTATS Els resultats obtinguts mostren una prevalença del 2% de nens i nenes que no passen la prova i presenten alguna alteració. Tot seguit, hem analitzat la incidència d’aquestes anomalies segons el sexe i els resultats obtinguts mostren que el percentatge d’afectació de la mostra masculina és d’un 4,6 % mentre que el de la mostra femenina es troba en un 0,07%. Finalment hem analitzat si els defectes al color influeixen en el rendiment acadèmic dels estudiants i hem pogut veure que no hi ha cap relació entre les dues variables (p = 0,507) i la mitja del rendiment acadèmic per les persones amb la visió del color afectada és molt similar a la mitja d’aquells estudiants que no presenten cap anomalia, per tant, el rendiment acadèmic no es veu afectat per les anomalies de la visió cromàtica. CONCLUSIONS La conclusió que podem extreure és que efectivament les anomalies de la visió del color afecten en una major proporció als homes que a les dones i en l’àmbit escolar podem veure que el rendiment acadèmic no està estadísticament relacionat amb aquestes anomalies. És molt important passar la prova de la visió al color des de la primera visita del nostre pacient per tal de poder informar a temps de la problemàtica i que el pacient sigui conscient i es puguin aportar tècniques més fàcils d’aprenentatge pel problema que presenta i proporcionar una bona orientació professional als estudiants

Càncer de pròstata; Cribratge; Antigen prostàtic específic; PSA Cáncer de próstata; Cribado; Antígeno prostático específico; PSA Prostate cancer; Screening; Prostate specific antigen; PSA Informe que analitza el cribratge que es fa a l'ICS per al diagnòstic del càncer de pròstata a través del PSA; a qui se li practica, com s'usa, si existeix variabilitat entre els professionals i si els metges hiperutilitzadors són més intervencionistes.