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Background and ObjectivesThe oral calcitonin gene–related peptide receptor antagonist atogepant is indicated for the preventive treatment of episodic migraine. We evaluated changes in patient-reported outcomes with atogepant in adults with migraine.MethodsIn this phase 3, 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group trial (ADVANCE), adults with 4–14 migraine days per month received atogepant (10, 30, or 60 mg) once daily or placebo. Secondary endpoints included changes from baseline in Migraine-Specific Quality-of-Life Questionnaire (MSQ) version 2.1 Role Function–Restrictive (RFR) domain at week 12 and mean monthly Activity Impairment in Migraine–Diary (AIM-D) Performance of Daily Activities (PDA) and Physical Impairment (PI) domains across the 12-week treatment period. Exploratory endpoints included change in MSQ Role Function–Preventive (RFP) and Emotional Function (EF) domains; AIM-D total scores; and change in Headache Impact Test (HIT)–6 scores.ResultsOf 910 participants randomized, 873 comprised the modified intent-to-treat population (atogepant: 10 mg [n = 214]; 30 mg [n = 223]; and 60 mg [n = 222]; placebo [n = 214]). All atogepant groups demonstrated significantly greater improvements vs placebo in MSQ RFR that exceeded minimum clinically meaningful between-group difference (3.2 points) at week 12 (least-square mean difference [LSMD] vs placebo: 10 mg [9.9]; 30 mg [10.1]; 60 mg [10.8]; allp< 0.0001). LSMDs in monthly AIM-D PDA and PI scores across the 12-week treatment period improved significantly for the atogepant 30 (PDA: −2.54;p= 0.0003; PI: −1.99; andp= 0.0011) and 60 mg groups (PDA: −3.32;p< 0.0001; PI: −2.46;p< 0.0001), but not for the 10 mg group (PDA: −1.19;p= 0.086; PI: −1.08;p= 0.074). In exploratory analyses, atogepant 30 and 60 mg were associated with nominal improvements in MSQ RFP and EF domains, other AIM-D outcomes, and HIT-6 scores at the earliest time point (week 4) and throughout the 12-week treatment period. Results varied for atogepant 10 mg.DiscussionAtogepant 30 and 60 mg produced significant improvements in key patient-reported outcomes including MSQ-RFR scores and both AIM-D domains. Nominal improvements also occurred for other MSQ domains and HIT-6, reinforcing the beneficial effects of atogepant as a new treatment for migraine prevention.Trial Registration InformationClinicalTrials.govNCT03777059. Submitted: December 13, 2018; First patient enrolled: December 14, 2018.clinicaltrials.gov/ct2/show/NCT03777059.Classification of EvidenceThis study provides Class II evidence that daily atogepant is associated with improvements in health-related quality-of-life measures in patients with 4–14 migraine days per month.

Cervical length; Microbial diversity; Pessary Longitud cervical; Diversidad microbiana; Pesario Longitud cervical; Diversitat microbiana; Pessari Introduction Our objective was to compare the vaginal microbiome in low-risk and high-risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth. Material and methods A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant women at 18–22 weeks of gestation. Participants were assigned to one of three groups: control (normal cervix), pessary (cervical length ≤25 mm) and cerclage (cervical length ≤25 mm or history of preterm birth). Analysis and comparison of vaginal microbiota as a primary outcome was performed at inclusion and at 30 weeks of gestation, along with a follow-up of pregnancy and perinatal outcomes. We assessed the vaginal microbiome of pregnant women presenting a short cervix with that of pregnant women having a normal cervix, and compared the vaginal microbiome of women with a short cervix before and after placement of a cervical pessary or a cervical cerclage. Results The microbiome of our control cohort was dominated by Lactobacillus crispatus and inners. Five community state types were identified and microbiome diversity did not change significantly over 10 weeks in controls. On the other hand, a short cervix was associated with a lower microbial load and higher microbial richness, and was not correlated with Lactobacillus relative abundance. After intervention, the cerclage group (n = 19) had a significant increase in microbial richness and a shift towards community state types driven by various bacterial species, including Lactobacillus mulieris, unidentified Bifidobacterium or Enterococcus. These changes were not significantly observed in the pessary (n = 26) and control (n = 35) groups. The cerclage group had more threatened preterm labor episodes and poorer outcomes than the control and pessary groups. Conclusions These findings indicate that a short cervix is associated with an altered vaginal microbiome community structure. The use of a cerclage for preterm birth prevention, as compared with a pessary, was associated with a microbial community harboring a relatively low abundance of Lactobacillus, with more threatened preterm labor episodes, and with poorer clinical outcomes. This study was supported by the Instituto de Salud Carlos III/FEDER FIS PI15/02043; Beca Dexeus Mujer 2015. Francisca Yáñez was supported by a grant from ANID, BECAS Chile, N° 72190278. Zixuan Xie received a fellowship from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie Action, Innovative Training Network: FunHoMic; grant number 812969.

Purpose Short-term results have been reported regarding parastomal hernia (PH) prevention with a permanent mesh. Long-term results are scarce. The objective was to assess the long-term PH occurrence after a prophylactic synthetic non-absorbable mesh. Methods Long-term data of three randomized controlled trials (RCTs) were collected. The primary outcome was the detection of PH based exclusively on a radiological diagnosis by computed tomography (CT) performed during the long-term follow-up. The Kaplan–Meier method was used for the comparison of time to diagnosis of PH according to the presence of mesh vs. no-mesh and the technique of mesh insertion: open retromuscular, laparoscopic keyhole, and laparoscopic modified Sugarbaker. Results We studied 121 patients (87 men, median age 70 years), 82 (67.8%) of which developed a PH. The median overall length of follow-up was 48.5 months [interquartile range (IQR) 14.4–104.9], with a median time until PH diagnosis of 17.7 months (IQR 9.3–49.0). The survival analysis did not show significant differences in the time to development of a PH according to the presence or absence of a prophylactic mesh neither in the overall study population (log-rank, P = 0.094) nor in the groups of each technique of mesh insertion, although according to the surgical technique, a higher reduction in the appearance of PH for the open retromuscular technique was found (log-rank, P = 0.001). Conclusion In the long-term follow-up placement of a non-absorbable synthetic prophylactic mesh in the context of an elective end colostomy does not seem effective for preventing PH.

Calor elevada; Mesures de prevenció; Resultats Calor elevada; Medidas de prevención; Resultados High heat; Preventive measures; Results El Pla d'actuació per prevenir els efectes de les onades de calor sobre la salut (POCS) a Catalunya és un pla estacional que s'activa anualment de l'1 de juny fins al 30 de setembre. Està coordinat per l'Agència de Salut Pública de Catalunya (ASPCAT) i el Servei Català de la Salut i compta amb la participació de més d'una quinzena d'entitats. L’informe presenta les actuacions realitzades i dels resultats obtinguts en relació al pla d’actuació per prevenir els efectes de les onades de calor sobre la salut (POCS) durant l'estiu de l'any 2023.

Hospitalization; Influenza; Prevention Hospitalització; Grip; Prevenció Hospitalización; Gripe; Prevención Having a proper understanding of the impact of influenza is a fundamental step towards improved preventive action. This paper reviews findings from the Burden of Acute Respiratory Infections study on the burden of influenza in Iberia, and its potential underestimation, and proposes specific measures to lessen influenza’s impact. The BARI study was funded by Sanofi.

Abdominal wound; Incisional hernia; Surgical site infection Ferida abdominal; Hèrnia incisional; Infecció del lloc quirúrgic Herida abdominal; Hernia incisional; Infección del sitio quirúrgico Aim The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The aim of this study was to investigate current midline closure techniques and practices for prevention of surgical site infection (SSI). Method An online survey was distributed in 2021 among the membership of the European Society of Coloproctology and its partner societies. Surgeons were asked to provide information on how they would close the abdominal wall in three specific clinical scenarios and on SSI prevention practices. Results A total of 561 consultants and trainee surgeons participated in the survey, mainly from Europe (n = 375, 66.8%). Of these, 60.6% identified themselves as colorectal surgeons and 39.4% as general surgeons. The majority used polydioxanone for fascial closure, with small bite techniques predominating in clean-contaminated cases (74.5%, n = 418). No significant differences were found between consultants and trainee surgeons. For SSI prevention, more surgeons preferred the use of mechanical bowel preparation (MBP) alone over MBP and oral antibiotics combined. Most surgeons preferred 2% alcoholic chlorhexidine (68.4%) or aqueous povidone-iodine (61.1%) for skin preparation. The majority did not use triclosan-coated sutures (73.3%) or preoperative warming of the wound site (78.5%), irrespective of level of training or European/non-European practice. Conclusion Abdominal wound closure technique and SSI prevention strategies vary widely between surgeons. There is little evidence of a risk-stratified approach to wound closure materials or techniques, with most surgeons using the same strategy for all patient scenarios. Harmonization of practice and the limitation of outlying techniques might result in better outcomes for patients and provide a stable platform for the introduction and evaluation of further potential improvements.

Prevention; Lymphoma Prevenció; Limfoma Prevención; Linfoma Secondary central nervous system (CNS) lymphoma (SCNSL) is defined by the involvement of the CNS, either at the time of initial diagnosis of systemic lymphoma or in the setting of relapse, and can be either isolated or with synchronous systemic disease. The risk of CNS involvement in patients with diffuse large B-cell lymphoma is approximately 5%; however, certain clinical and biological features have been associated with a risk of up to 15%. There has been growing interest in improving the definition of patients at increased risk of CNS relapse, as well as identifying effective prophylactic strategies to prevent it. SCNSL often occurs within months of the initial diagnosis of lymphoma, suggesting the presence of occult disease at diagnosis in many cases. The differing presentations of SCNSL create the therapeutic challenge of controlling both the systemic disease and the CNS disease, which uniquely requires agents that penetrate the blood-brain barrier. Outcomes are generally poor with a median overall survival of approximately 6 months in retrospective series, particularly in those patients presenting with SCNSL after prior therapy. Prospective studies of intensive chemotherapy regimens containing high-dose methotrexate, followed by hematopoietic stem cell transplantation have shown the most favorable outcomes, especially for patients receiving thiotepa-based conditioning regimens. However, a proportion of patients will not respond to induction therapies or will subsequently relapse, indicating the need for more effective treatment strategies. In this review we focus on the identification of high-risk patients, prophylactic strategies and recent treatment approaches for SCNSL. The incorporation of novel agents in immunochemotherapy deserves further study in prospective trials.

Obesitat infantil; Prevenció; Abordatge Obesidad infantil; Prevención; Abordaje Childhood obesity; Prevention; Approach Aquest document tracta de la prevenció i l'abordatge de la obesitat infantil.

Myeloproliferative disease Enfermedad mieloproliferativa Malaltia mieloproliferativa The study was supported by a research grant by the COVID “3 × 1 project”, BREMBO S.p.A., Bergamo, Italy (T.B.) and by AIRC 5 × 1000 call “Metastatic disease: the key unmet need in oncology” to MYNERVA project, #21267 (MYeloid NEoplasms Research Venture AIRC). A detailed description of the MYNERVA project is available at https://progettomynerva.it (A.M.V., P.G.). The study was also supported by HARMONY PLUS, which is funded through the Innovative Medicines Initiative (IMI), Europe’s largest public–private initiative aiming to speed up the development of better and safer medicines for patients. The HARMONY Alliance has received funding from IMI 2 Joint Undertaking and is listed under grant agreement No. 945406. This Joint Undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA). IMI supports collaborative research projects and builds networks of industrial and academic experts in order to boost pharmaceutical innovation in Europe.

Breast cancer; Evidence-generating care; Risk-adjusted prevention Cáncer de mama; Atención generadora de evidencia; Prevención ajustada al riesgo Càncer de mama; Atenció generadora d'evidències; Prevenció ajustada al risc Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action. Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept. The project was funded by the German Federal Ministry of Health (grant No. 2515FSB401 to Rita Schmutzler and Christiane Woopen) for supporting the international expert meetings, and a grant of the EU Horizon 2020 program, BRIDGES (grant No. 634935, PI Peter Devilee, WP5-PI Rita Schmutzler), for the compilation of the most recent findings of genetic risk prediction.

Introduction In primary ciliary dyskinesia (PCD) impaired mucociliary clearance leads to recurrent airway infections and progressive lung destruction, and concern over chronic airway infection and patient-to-patient transmission is considerable. So far, there has been no defined consensus on how to control infection across centres caring for patients with PCD. Within the BEAT-PCD network, COST Action and ERS CRC together with the ERN-Lung PCD core a first initiative has now been taken towards creating such a consensus statement. Methods A multidisciplinary international PCD expert panel was set up to create a consensus statement for infection prevention and control (IP&C) for PCD, covering diagnostic microbiology, infection prevention for specific pathogens considered indicated for treatment and segregation aspects. Using a modified Delphi process, consensus to a statement demanded at least 80% agreement within the PCD expert panel group. Patient organisation representatives were involved throughout the process. Results We present a consensus statement on 20 IP&C statements for PCD including suggested actions for microbiological identification, indications for treatment of Pseudomonas aeruginosa, Burkholderia cepacia and nontuberculous mycobacteria and suggested segregation aspects aimed to minimise patient-to-patient transmission of infections whether in-hospital, in PCD clinics or wards, or out of hospital at meetings between people with PCD. The statement also includes segregation aspects adapted to the current coronavirus disease 2019 (COVID-19) pandemic. Conclusion The first ever international consensus statement on IP&C intended specifically for PCD is presented and is targeted at clinicians managing paediatric and adult patients with PCD, microbiologists, patient organisations and not least the patients and their families., For the first time ever, an international consensus statement for infection prevention and control in PCD is presented. A total of 20 statements were developed in a collaboration of BEAT-PCD, COST Action, ERS CRC and ERN-LUNG PCD Core Network. https://bit.ly/3yuahKt

Grip; Vacunació; Recomanacions Gripe; Vacunación; Recomendaciones Flu; Vaccination; Recommendations Aquest document conté la informació sobre la Campanya 2022-2023 de vacunació contra la grip amb l'objectiu de protegir les persones més vulnerables a la grip disminuint, tant com sigui possible, la incidència de la grip en aquests grups diana, que en gran part coincideixen amb els de la COVID-19, i contribuir a reduir l’impacte sobre la pressió assistencial.

Riscos laborals; Prevenció; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Riesgos laborales; Prevención; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Occupational risk; Prevention; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Aquesta guia, feta en col·laboració amb l’Associació Catalana de Salut Laboral, pretén aclarir les actuacions (algunes voluntàries, altres no) a desenvolupar pels serveis de prevenció de riscos laborals (SPRL) i respondre a possibles dubtes.

BackgroundChronic lung allograft dysfunction (CLAD) is defined by a progressive loss of FEV1 and is associated with premature mortality. The aim of this study was to investigate the direct association between FEV1 decline and risk of mortality in patients after lung transplantation (LTx).Methods10-year follow up data from lung transplant recipients participating in randomized placebo-controlled clinical trial investigating the role of liposomal Cyclosporine A for inhalation (L-CsA-i) in the prevention of bronchiolitis obliterans syndrome (NCT01334892) was used. The association between the course of FEV1 over time and the risk of mortality was assessed using joint modeling and Cox regression analysis.ResultsA total of 130 patients were included. Predictors of FEV1 decline were a higher absolute FEV1 at baseline and male sex. The joint model analysis indicated a significant association of change of FEV1 and risk of mortality (p < 0.001), with a predicted 3.4% increase in mortality risk for each 1% decline in FEV1. Significant predictors of a progressive phenotype were single LTx and treatment with placebo (as opposed to L-CsA-i). At the end of follow-up, 82 patients (63.1%) were still alive. Cox regression analyses for mortality identified only single LTx as a predictor of higher risk.ConclusionBased on our observation of a close association between FEV1 and mortality over a period of 10 years we suggest FEV1 as a valid predictor of mortality and a suitable surrogate endpoint in the investigation of early interventions.

Xarxa d’Atenció a les Drogodependències; Unitats hospitalàries de desintoxicació; Substàncies addictives Red de Atención a las Drogodependencias; Unidades hospitalarias de desintoxicación; Sustancias adictivas Drug dependency care network; Hospital detoxification units; Addictive substances En aquest informe es descriuen les altes notificades per les UHD de la XAD de Catalunya, el perfil sociodemogràfic de les persones ingressades, les drogues consumides, els motius de l’alta, indicadors relacionats amb els dies d’hospitalització, els reingressos dins el mateix any, i també les taxes d’alta d’UHD ponderades per edat per cada 10.000 habitants, per regió sanitària.

Programa d'intercanvi de xeringues; Consumidors de drogues injectades; Malalties infectocontagioses Programa de intercambio de jeringuillas; Consumidores de drogas inyectadas; Enfermedades infectocontagiosas Syringe exchange program; Injection drug users; Infectious diseases En aquest informe es presenten les dades del Programa d’intercanvi de xeringues (PIX), un programa de llarga trajectòria que té com a objectiu principal prevenir malalties infeccioses associades a les pràctiques de risc relacionades amb el consum de drogues per injecció entre les persones usuàries de drogues, com són les infeccions pel virus de la immunodeficiència humana (VIH), pel virus de l’hepatitis B (VHB) i pel virus de l’hepatitis C (VHC). Es presenten dades de l’evolutiu de distribució general de xeringues dels punts PIX disponibles per tipus de dispositiu i per regió sanitària.

SummaryBackgroundA SARS-CoV-2 protein-based heterodimer vaccine, PHH-1V, has been shown to be safe and welltolerated in healthy young adults in a first-in-human, Phase I/IIa study dose-escalation trial. Here, we report the interim results of the Phase IIb HH-2, where the immunogenicity and safety of a heterologous booster with PHH-1V is assessed versus a homologous booster with BNT162b2 at 14, 28 and 98 days after vaccine administration.MethodsThe HH-2 study is an ongoing multicentre, randomised, active-controlled, double-blind, non-inferiority Phase IIb trial, where participants 18 years or older who had received two doses of BNT162b2 were randomly assigned in a 2:1 ratio to receive a booster dose of vaccine —either heterologous (PHH-1V group) or homologous (BNT162b2 group)— in 10 centres in Spain. Eligible subjects were allocated to treatment stratified by age group (18-64 versus ≥65 years) with approximately 10% of the sample enrolled in the older age group. The primary endpoints were humoral immunogenicity measured by changes in levels of neutralizing antibodies (PBNA) against the ancestral Wuhan-Hu-1 strain after the PHH-1V or the BNT162b2 boost, and the safety and tolerability of PHH-1V as a boost. The secondary endpoints were to compare changes in levels of neutralizing antibodies against different variants of SARS-CoV-2 and the T-cell responses towards the SARS-CoV-2 spike glycoprotein peptides. The exploratory endpoint was to assess the number of subjects with SARS-CoV-2 infections ≥14 days after PHH-1V booster. This study is ongoing and is registered withClinicalTrials.gov,NCT05142553.FindingsFrom 15 November 2021, 782 adults were randomly assigned to PHH-1V (n=522) or BNT162b2 (n=260) boost vaccine groups. The geometric mean titre (GMT) ratio of neutralizing antibodies on days 14, 28 and 98, shown as BNT162b2 active control versus PHH-1V, was, respectively, 1·68 (p+and CD8+T-cells expressing IFN-γ on day 14. There were 458 participants who experienced at least one adverse event (89·3%) in the PHH-1V and 238 (94·4%) in the BNT162b2 group. The most frequent adverse events were injection site pain (79·7% and 89·3%), fatigue (27·5% and 42·1%) and headache (31·2 and 40·1%) for the PHH-1V and the BNT162b2 groups, respectively. A total of 52 COVID-19 cases occurred from day 14 post-vaccination (10·14%) for the PHH-1V group and 30 (11·90%) for the BNT162b2 group (p=0·45), and none of the subjects developed severe COVID-19.InterpretationOur interim results from the Phase IIb HH-2 trial show that PHH-1V as a heterologous booster vaccine, when compared to BNT162b2, although it does not reach a non-inferior neutralizing antibody response against the Wuhan-Hu-1 strain at days 14 and 28 after vaccination, it does so at day 98. PHH-1V as a heterologous booster elicits a superior neutralizing antibody response against the previous circulating Beta and the currently circulating Omicron BA.1 SARS-CoV-2 variants in all time points assessed, and for the Delta variant on day 98 as well. Moreover, the PHH-1V boost also induces a strong and balanced T-cell response. Concerning the safety profile, subjects in the PHH-1V group report significantly fewer adverse events than those in the BNT162b2 group, most of mild intensity, and both vaccine groups present comparable COVID-19 breakthrough cases, none of them severe.FundingHIPRA SCIENTIFIC, S.L.U.

Background Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the “Prevention of Hospital Infections by Intervention and Training” (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect. Methods We included HCWs who contributed at least two observation sessions before and after intervention. Improving, non-changing, and worsening HCWs were defined with a threshold of 20% compliance change. We used multivariable linear regression and spearman’s rank correlation to estimate determinants for the individual response to the intervention and correlation to overall change. Swarm graphs visualized ICU-specific patterns. Results In total 280 HCWs contributed 17,748 HH opportunities during 2677 observation sessions. Overall, pooled HH compliance increased from 43.1 to 58.7%. The proportion of improving HCWs ranged from 33 to 95% among ICUs. The median HH increase per improving HCW ranged from 16 to 34 percentage points. ICU wide improvement correlated significantly with both the proportion of improving HCWs (ρ = 0.82 [95% CI 0.18–0.97], and their median HH increase (ρ = 0.79 [0.08–0.97]). Multilevel regression demonstrated that individual improvement was significantly associated with nurse profession, lower activity index, higher nurse-to-patient ratio, and lower baseline compliance. Conclusions Both the proportion of improving HCWs and their median individual improvement differed substantially among ICUs but correlated with the ICUs’ overall HH improvement. With comparable overall means the range in individual HH varied considerably between some hospitals, implying different transmission risks. Greater insight into improvement dynamics might help to design more effective HH interventions in the future.

Incisional hernia is a frequent complication of abdominal wall incision. Surgical technique is an important risk factor for the development of incisional hernia. The aim of these updated guidelines was to provide recommendations to decrease the incidence of incisional hernia.A systematic literature search of MEDLINE, Embase, and Cochrane CENTRAL was performed on 22 January 2022. The Scottish Intercollegiate Guidelines Network instrument was used to evaluate systematic reviews and meta-analyses, RCTs, and cohort studies. The GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) was used to appraise the certainty of the evidence. The guidelines group consisted of surgical specialists, a biomedical information specialist, certified guideline methodologist, and patient representative.Thirty-nine papers were included covering seven key questions, and weak recommendations were made for all of these. Laparoscopic surgery and non-midline incisions are suggested to be preferred when safe and feasible. In laparoscopic surgery, suturing the fascial defect of trocar sites of 10 mm and larger is advised, especially after single-incision laparoscopic surgery and at the umbilicus. For closure of an elective midline laparotomy, a continuous small-bites suturing technique with a slowly absorbable suture is suggested. Prophylactic mesh augmentation after elective midline laparotomy can be considered to reduce the risk of incisional hernia; a permanent synthetic mesh in either the onlay or retromuscular position is advised.These updated guidelines may help surgeons in selecting the optimal approach and location of abdominal wall incisions.An incisional hernia results from a weakness of the abdominal wall muscles that allows fat from the inside or organs to bulge out. These hernias are quite common after abdominal surgery at the site of a previous incision. There is research that discusses different ways to close an incision and this may relate to the chance of hernia formation. The aim of this study was to review the latest research and to provide a guide for surgeons on how best to close incisions to decrease hernia rates. When possible, surgery through small incisions may decrease the risk of hernia formation. If small incisions are used, it may be better if they are placed away from areas that are already weak (such as the belly button). If the incision is larger than 1 cm, it should be closed with a deep muscle-fascia suture in addition to skin sutures. If there is a large incision in the middle of the abdomen, the muscle should be sutured using small stitches that are close together and a slowly absorbable suture should be used. For patients who are at higher risk of developing hernias, when closing the incision, the muscle layer can be strengthened by using a piece of (synthetic) mesh. There is no good research available on recovery after surgery and no clear guides on activity level or whether a binder will help prevent hernia formation.

Consum de drogues; Alumnes d’educació secundària; Prevenció Drugs consumption; Secondary education students; Prevention Consumo de drogas; Alumnos de educación secundaria; Prevención L’objectiu general d’aquestes enquestes és conèixer la situació i les tendències del consum de drogues i altres addiccions entre les persones entrevistades per tal d’obtenir informació útil per dissenyar i avaluar polítiques dirigides a prevenir el consum de drogues i els problemes que s’hi associen, adreçades sobretot a l’àmbit familiar i/o escolar. Aquesta informació complementa la que s’aconsegueix a través d’altres enquestes i indicadors epidemiològics. En aquest informe es presenten les dades obtingudes a partir de la mostra de centres educatius seleccionats a Catalunya.

Pla d'acció; VIH; Infeccions de transmissió sexual Plan de acción; VIH; Infecciones de transmisión sexual Action plan; HIV; Sexually transmitted infections Article on s'explica la finalitat del Pla d’acció enfront de la infecció pel VIH i les altres ITS 2021-2030. Aquesta és facilitar l’adopció i la implementació de les mesures necessàries per reduir la incidència de la infecció pel VIH i per altres ITS, facilitar l’accés precoç al tractament i millorar la qualitat de vida de les persones infectades, així com reduir l’estigmatització associada a aquestes infeccions mitjançant l’acció comunitària per a la inclusió social.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Mesures de prevenció Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Medidas de prevención Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Prevention measures

Left atrial appendage; Occlusion; Outcomes Apéndice auricular izquierdo; Oclusión; Resultados Apèndix auricular esquerre; Oclusió; Resultats Background The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. Methods Prospective, multicenter, “real-world” registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center’s prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. Results 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. Conclusions The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebracions; Carnestoltes Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebraciones; Carnaval Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebrations; Carnival Document que recull les recomanacions per a la celebració de carnestoltes dels centres educatius per tal d'evitar els contagis de la COVID-19.

Coronavirus SARS-CoV-2; 2019-nCoV; COVID-19; Restauració; Normes d'higiene; Neteja; Desinfecció; Mesures de contenció Coronavirus SARS-CoV-2; 2019-nCoV; COVID-19; Restauración; Normas de higiene; Limpieza; Desinfección; Medidas de contención Coronavirus SARS-CoV-2; 2019-nCoV; COVID-19; Catering; Hygiene measures; Cleaning; Disinfection; Containment measures Document que proporciona recomanacions d'higiene personal i a la cuina, mesures organitzatives i pautes de neteja i desinfecció pels professionals del sector de la restauració per tal d'evitar el contagi del nou coronavirus COVID-19.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Gestió de casos; Centres educatius; TraçaCovid Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Gestión de casos; Centros educativos; TraçaCovid Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Case management; Educational centers; TraçaCovid Document que informa sobre la gestió i les mesures de prevenció i protecció que cal prendre en els centres educatius en relació al coronavirus COVID-19.

Profilaxi PreExposició; VIH; Fàrmacs antiretrovirals Profilaxis PreExposición; VIH; Fármacos antirretrovirales Pre-Exposure Prophylaxis; HIV; Antiretroviral drugs Article on s'expliquen els elements i condicionants per implementar la Profilaxi PreExposició (PrEP) al VIH. Aquesta és una estratègia de salut pública basada en l’ús de fàrmacs antiretrovirals per a prevenir la infecció pel VIH en persones no infectades. És una intervenció biomèdica preventiva amb eficàcia demostrada en la disminució de la transmissió a persones que tenen un risc elevat d’infecció pel VIH.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Portes obertes; Centres educatius Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Puertas abiertas; Centros educativos Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Open days; Schools Document que recull les recomanacions per dur a terme les jornades de portes obertes als centres educatius per tal d'evitar els contagis de la COVID-19.

Androgen antagonists; Denosumab; Diphosphonates Antagonistas de los andrógenos; Denosumab; Difosfonatos Antagonistes dels andrògens; Denosumab; Difosfonats Patients with prostate cancer (PCa) on androgen-deprivation therapy (ADT) are at high risk of osteoporosis and fragility fractures. We aimed to provide some practical insights into the delivery of optimal bone health care for PCa patients, particularly those on ADT. An interdisciplinary group of experts, including urologists and rheumatologists developed recommendations based on their expertise, current evidence and guidelines. The multidisciplinary group's main recommendations are: fragility fracture risk should be assessed in all PCa patient, especially, in those under ADT. FRAX® tool may be incorporated into clinical practice to identify patients at high risk of fracture. Bone mineral density (BMD) should be measured routinely by dual energy X-ray absorptiometry in all patients scheduled for or on ADT. Thoracic and lumbar spine X-ray may be performed at the initial evaluation of patients with the diagnosis of osteoporosis and in case of suspected clinical vertebral fracture. Basic laboratory tests are recommended to exclude secondary osteoporosis. Treatment with bisphosphonates or denosumab should be considered in patients on ADT with fragility fracture, osteoporosis (BMD T-score ≤−2.5), or high risk of fracture according to FRAX®. Referral to a bone metabolism specialist should be contemplated in some cases. The recommendations provided in this document, tailored for clinicians treating PCa patients, may be of help to identify and treat patients at high risk of fracture. Bayer Hispania SL.

MRI; Milvexian; Stroke prevention Resonancia magnética; Milvexian; Prevención de ictus Ressonància magnètica; Milvexian; Prevenció d'ictus Background Individuals with ischemic stroke or transient ischemic attack (TIA) have a high early risk of ischemic stroke despite dual antiplatelet therapy. The risk of ischemic stroke, and associated disability, represents a significant unmet clinical need. Genetic variants resulting in reduced factor XI levels are associated with reduced risk for ischemic stroke but are not associated with increased intracranial bleeding. Milvexian is an oral small-molecule inhibitor of FXIa that binds activated factor XI with high affinity and selectivity and may reduce the risk of stroke when added to antiplatelet drugs without significant bleeding. We aimed to evaluate the dose-response relationship of milvexian in participants treated with dual antiplatelets. Methods We began a phase II, double-blinded, randomized, placebo-controlled trial at 367 sites in 2019. Participants (N = 2366) with ischemic stroke (National Institutes of Health Stroke Scale score ≤7) or high-risk TIA (ABCD2 score ≥6) were randomized to 1 of 5 doses of milvexian or placebo for 90 days. Participants also received clopidogrel 75 mg daily for the first 21 days and aspirin 100 mg for 90 days. The efficacy endpoint was the composite of ischemic stroke or incident infarct on magnetic resonance imaging. Major bleeding, defined as type 3 or 5 bleeding according to the Bleeding Academic Research Consortium, was the safety endpoint. Participant follow-up will end in 2022. Conclusion The AXIOMATIC-SSP trial will evaluate the dose-response of milvexian for ischemic stroke occurrence in participants with ischemic stroke or TIA. This study is sponsored by Bristol Myers Squibb and Janssen Research & Development, LLC.

Suïcidi; Campanya; Prevenció Suicidio; Campaña; Prevención Suicide; Campaign; Prevention Cartell que forma part de la campanya "El suïcidi s’evita parlant-ne" i que té l'objectiu de prevenir el suïcidi i donar suport sanitari.

Profilaxi PreExposició; VIH; Treball sexual Profilaxis PreExposición; VIH; Trabajo sexual Preexposure Prophylaxis; HIV; Sex work Aquest estudi descriu el nivell de coneixement de la profilaxi preexposició (PrEP) ─el nou tractament per a la prevenció del VIH─ i la intenció d’utilitzar-la en homes cisgènere (HTS) i dones transgènere (TTS) que exerceixen el treball sexual a Catalunya (estudi SexCohort). Del total de 116 TTS i 79 HTS participants, el 49,1% i el 58,2% coneixien què era la PrEP, i el 40,3% i el 70,1%, respectivament, tenien intenció d’utilitzar-la. El nivell educatiu i haver tingut relacions sexuals sense preservatiu amb parelles estables estaven associats amb el coneixement de la PrEP. Pel que fa a la intenció d’utilitzar la PrEP, les TTS tenien menys probabilitats que els HTS d’informar de la intenció d’utilitzarla. A més, la intenció d’utilitzar la PrEP es va associar amb el fet de d’haver nascut a l’estranger, amb el consum sexualitzat de drogues i el fet d’haver visitat un servei sanitari en els darrers 12 mesos.

Objectives: to present an interventional radiology standard of practice on the use of inferior vena cava filters (IVCFs) in patients with or at risk to develop venous thromboembolism (VTE) from the Iberoamerican Interventional Society (SIDI) and Spanish Vascular and Interventional Radiology Society (SERVEI). Methods: a group of twenty-two interventional radiologist experts, from the SIDI and SERVEI societies, attended online meetings to develop a current clinical practice guideline on the proper indication for the placement and retrieval of IVCFs. A broad review was undertaken to determine the participation of interventional radiologists in the current guidelines and a consensus on inferior vena cava filters. Twenty-two experts from both societies worked on a common draft and received a questionnaire where they had to assess, for IVCF placement, the absolute, relative, and prophylactic indications. The experts voted on the different indications and reasoned their decision. Results: a total of two-hundred-thirty-three articles were reviewed. Interventional radiologists participated in the development of just two of the eight guidelines. The threshold for inclusion was 100% agreement. Three absolute and four relative indications for the IVCF placement were identified. No indications for the prophylactic filter placement reached the threshold. Conclusion: interventional radiologists are highly involved in the management of IVCFs but have limited participation in the development of multidisciplinary clinical practice guidelines.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Variant òmicron Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Variante ómicron Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Variant omicron Aquest document analitza les principals característiques biològiques i epidemiològiques que condicionen el risc d’una onada per òmicron a Catalunya, utilitza dades pròpies de Catalunya i d’altres països per modelitzar els possibles escenaris de risc i emet recomanacions de mesures per mitigar-ne l’impacte, basades en l'evidència científica disponible a cada moment i el consens d’experts.

Programa d'intercanvi de xeringues; Consumidors de drogues injectades; Malalties infectocontagioses Syringe exchange program; Injected drug users; Infectious-communicable diseases Programa de intercambio de jeringas; Consumidores de drogas inyectadas; Enfermedades infectocontagiosas Document de caràcter anual amb els principals resultats del Programa d’intercanvi de xeringues (PIX), amb l’objectiu d’esdevenir un instrument de consulta per a professionals que col·laboren en el desenvolupament del Programa, persones que treballen en l’àmbit de les drogodependències i altres destinataris que tinguin interès a conèixer l’evolució del Programa a Catalunya.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Rastreig; Contactes; Indicadors Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Rastreo; Contactos; Indicadores Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Tracking; Contacts; Indicators Comunicació sobre les accions realitzades a Catalunya en quant al rastreig i seguiment del SARS-CoV-2.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebracions; Tardor; Centres educatius Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebraciones; Otoño; Centros educativos Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Celebrations; Autumn; Schools Document que recull les recomanacions per a les festes i celebracions de tardor dels centres educatius per tal d'evitar els contagis de la COVID-19.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Pla d'actuació; Activitats extraescolars Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Plan de actuación; Actividades extraescolares Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Action plan; Extracurricular activities Aquest Pla d’actuació és un document operatiu que vol donar resposta a les necessitats d’un àmbit tan essencial i divers com és el de les activitats extraescolars, de lleure, socioeducatives i esportives. Es tracta d’una eina pràctica, consensuada amb els departaments implicats, on es recullen les principals mesures contra de la COVID-19, sens perjudici del que estableixin els plans sectorials específics.

Introduction The majority of women admitted with threatened preterm labour (PTL) do not delivery prematurely. While those with microbial invasion of the amniotic cavity (MIAC) represent the highest risk group, this is a condition that is not routinely ruled out since it requires amniocentesis. Identification of low-risk or high-risk cases might allow individualisation of care, that is, reducing overtreatment with corticosteroids and shorten hospital stay in low-risk women, while allowing early antibiotic therapy in those with MIAC. Benefits versus risks of amniocentesis-based predictor models of spontaneous delivery within 7 days and/or MIAC have not been evaluated. Methods and analysis This will be a Spanish randomised, multicentre clinical trial in singleton pregnancies (23.0-34.6 weeks) with PTL, conducted in 13 tertiary centres. The intervention arm will consist in the use of amniocentesis-based predictor models: if low risk, hospital discharge within 24 hours of results with no further medication will be recommended. If high risk, antibiotics will be added to standard management. The control group will be managed according to standard institutional protocols, without performing amniocentesis for this indication. The primary outcome will be total antenatal doses of corticosteroids, and secondary outcomes will be days of maternal stay and the occurrence of clinical chorioamnionitis. A cost analysis will be undertaken. To observe a reduction from 90% to 70% in corticosteroid doses, a reduction in 1 day of hospital stay (SD of 2) and a reduction from 24% to 12% of clinical chorioamnionitis, a total of 340 eligible patients randomised 1 to 1 to each study arm is required (power of 80%, with type I error alpha=0.05 and two-sided test, considering a dropout rate of 20%). Randomisation will be stratified by gestational age and centre. Ethics and dissemination Prior to receiving approval from the Ethics Committee (HCB/2020/1356) and the Spanish Agency of Medicines and Medical Devices (AEMPS) (identification number: 2020-005-202-26), the trial was registered in the European Union Drug Regulating Authorities Clinical Trials database (2020-005202-26). AEMPS approved the trial as a low-intervention trial. All participants will be required to provide written informed consent. Findings will be disseminated through workshops, peer-reviewed publications and national/international conferences. Protocol version V.4 10 May 2021., This research has received a grant from the Instituto Carlos III (PI21/00972)

Publicidad de alimentos; Niños; Conducta alimentaria Food advertising; Children; Eating behavior Publicitat d'aliments; Nens; Conducta alimentària Introduction Some important factors influencing and maintaining unhealthy habits are food advertising and products accessibility. In order to develop and support recommendations, an analysis of the available evidence on the impact of food advertising on the health of children and adolescents has been carried out. Methods Literature review of systematic reviews and meta-analyses published up to January 2022 for the term “food advertising” that analyzed the impact of food advertising on weight, body mass index (BMI), adiposity, dietary intake, behavior toward the advertised product, its purchase or consumption in children and adolescents. Results Twenty-one systematic reviews fulfilled the inclusion criteria, including a total of 490 primary studies, 5 of which also contained a meta-analysis. The vast majority of the primary studies evaluate intermediate effects, related to the behavior of children and adolescents in relation to advertised products and their consumption. There is great variety in terms of the type of advertising and effects studied. Most of the studies agree that there is an association between food advertising and effect analyzed, being more evident in children under 12 years of age and in obese children. Most recent systematic reviews are focused on online advertising, noticing the negative effects especially in adolescents. Conclusions Children and adolescents are a particularly vulnerable population to food advertising strategies. Despite the difficulty to demonstrate an independent effect, there is evidence of an association between food advertising and childhood and adolescents’ behavior respect to the announced products, and the increase of consumption at short-term. In Spain unhealthy product advertising are still very common in the media and in the children and adolescent's online environment. The Nutrition and Breastfeeding Committee of the Spanish Association of Pediatrics supports the need for regulation and limitation of unhealthy food advertising, covering all media and marketing strategies. Introducción Entre los factores más importantes que influyen en la aparición y el mantenimiento de malos hábitos de alimentación están la accesibilidad y publicidad de los productos alimentarios menos saludables. Con el objetivo de elaborar y fundamentar recomendaciones, se ha realizado un análisis de la evidencia disponible sobre el impacto de la publicidad de alimentos en la salud de niños y adolescentes. Métodos Se ha realizado una revisión bibliográfica de revisiones sistemáticas y metanálisis publicados hasta enero de 2022 con el término “food advertising”, incluyendo aquellas que analizaban el impacto de la publicidad de alimentos sobre el peso, índice de masa corporal (IMC), adiposidad, ingesta dietética, conducta ante el producto anunciado, su compra o su consumo en niños y adolescentes. Resultados Fueron incluidas 21 revisiones sistemáticas que incluyen un total de 490 artículos, 5 de las cuales contienen además un meta-análisis. La gran mayoría de los estudios primarios evalúan efectos intermedios, relacionados con el comportamiento de niños y adolescentes ante los productos anunciados y su consumo. Existe gran variedad en cuanto al tipo de publicidad y efectos estudiados. La mayoría de trabajos muestra una asociación entre el tipo de publicidad y el efecto concreto analizado, siendo más evidente en menores de 12 años y en niños obesos. Las revisiones más recientes se centran en la publicidad online indicando sus efectos nocivos especialmente en adolescentes. Conclusiones Los niños y adolescentes constituyen una población especialmente vulnerable. A pesar de la dificultad para demostrar un efecto independiente, hay evidencia de asociación entre la publicidad y los comportamientos en la infancia y adolescencia respecto a los productos anunciados y el aumento de su consumo a corto plazo. En España, los anuncios de productos no saludables siguen muy presentes en los medios y en el entorno online de los menores. El Comité de Nutrición y Lactancia Materna de la Asociación Española de Pediatría suscribe la necesidad de una regulación y limitación de la publicidad de alimentos no saludables que abarque todos los medios y todas las estrategias de marketing.

Bronchiolitis obliterans; Clinical research; Lung transplantation Bronquiolitis obliterante; Investigación clínica; Trasplante de pulmón Bronquiolitis obliterant; Recerca clínica; Trasplantament de pulmó Long-term survival after lung transplantation is limited by chronic allograft dysfunction. The aim of this study was to investigate the effect of locally augmented immunosuppression with liposomal cyclosporine A for inhalation (L-CsA-i) for the prevention of bronchiolitis obliterans syndrome (BOS). In a randomized, double-blind, placebo-controlled, multi-center Phase 3 study, 180 LT recipients in BOS grade 0 were planned to receive L-CsA-i or placebo in addition to triple-drug immunosuppression. L-CsA-i was administered twice daily via an Investigational eFlow nebulizer to recipients of single (SLT) and bilateral lung transplants (BLT) within 6–32 weeks posttransplant, and continued for 2 years. The primary endpoint was BOS-free survival. 130 patients were enrolled before the study was prematurely terminated for business reasons. Despite a 2-year actuarial difference in BOS-free survival of 14.1% in favor of L-CsA-i in the overall study population, the primary endpoint was not met (p = .243). The pre-defined per protocol analysis of SLT recipients (n = 24) resulted in a treatment difference of 58.2% (p = .053). No difference was observed in the BLT (n = 48) subpopulation (p = .973). L-CsA-i inhalation was well tolerated. Although this study failed to meet its primary endpoint, the results warrant additional investigation of L-CsA-i in lung transplant recipients. The study was funded by PARI Pharma GmbH. Open access funding enabled and organized by ProjektDEAL.

Objectives To develop gestational age-based reference ranges for cervical length in triplet pregnancies. The secondary objective was to assess the performance of cervical length measured between 18 and 20 + 6 days for the prediction of preterm delivery before 28 and 32 weeks, respectively. Methods Observational retrospective study of triplet pregnancies in three Spanish tertiary-care hospitals between 2001 and 2019. Cervical length measurements were consecutively obtained between 15 and 34 weeks of gestation. Pregnancies undergoing multifetal reduction or fetal surgery were excluded. Results Two hundred and six triplet pregnancies were included in the final analysis. There was a quadratic decrease in cervical length with gestational age. The median and fifth centiles for cervical length at 20 weeks were 35 and 13 mm. In the prediction of preterm birth Conclusions In triplet pregnancies, cervical length decreases with gestational age. The performance of cervical length at 18–20 + 6 in screening for preterm birth before 28 and 32 weeks is poor.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Pla d'actuació; Centres educatius; Protecció de la salut Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Plan de actuación; Centros educativos; Protección de la salud Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Action plan; Schools; Health protection Aquest Pla d'actuació estableix les bases perquè el curs 2021-2022 es pugui dur a terme amb les màximes garanties, que busquen l'equilibri entre la protecció de la salut de les persones als centres educatius, la gestió correcta de la pandèmia i el dret de tots els infants i joves a una educació de qualitat.

Làtex; Gestió; A nivell mundial Latex; Management; Wordwide Látex; Gestión; A nivel mundial Despite the efforts made to mitigate the consequences of this disease, natural rubber latex allergy (NRLA) continues to be a global health problem and is still considered one of the main worries in the working environment in many countries throughout the world. Due to thousands of products containing latex, it is not surprising that the current statistics suggest that prevalence remains high among healthcare workers and susceptible patients. In developed countries, reduction in the prevalence of IgE-mediated allergy to latex proteins from gloves may lead to lax attention by health care personnel. On the other hand, this situation is different in developing countries where there is a lack of epidemiological data associated with a deficit in education and awareness of this issue. The aim of this review is to provide an update of the current knowledge and practical recommendations regarding NRLA by allergologists from different parts of the world with experience in this field. The authors have not received any funding to prepare the manuscript.

Microorganismes; Contaminació; Transmissió alimentària Microorganismos; Contaminación; Transmisión alimentaria Microorganisms; Pollution; Food transmission Conèixer quines són les possibles fonts d’infecció de les malalties de caràcter infecciós transmeses pels aliments és bàsic per orientar i prioritzar les accions destinades a reduir aquest risc biològic. Això ha de permetre que es determini la importància relativa de les diferents vies de transmissió: alimentària, entre persones o ambiental. La proximitat entre França i Catalunya, a banda de diverses similituds, afavoreix que les conclusions sobre aquests aspectes a què s’arriben en un territori es puguin tenir en compte pel que fa a l’altre territori. Conocer cuáles son las posibles fuentes de infección de las enfermedades de carácter infeccioso transmitidas por los alimentos es básico para orientar y priorizar las acciones destinadas a reducir este riesgo biológico. Ello permitirá que se determine la importancia relativa de las diferentes vías de transmisión: alimentaria, entre personas o ambiental. La proximidad entre Francia y Cataluña, aparte de varias similitudes, favorece que las conclusiones sobre estos aspectos a que se llegan en un territorio se puedan tener en cuenta con respecto al otro territorio.

Programa d'intercanvi de xeringues; Consumidors de drogues injectades; Malalties infectocontagioses Syringe exchange program; Injected drug users; Infectious-communicable diseases Programa de intercambio de jeringas; Consumidores de drogas inyectadas; Enfermedades infectocontagiosas En aquest informe es presenten les dades del Programa d’intercanvi de xeringues (PIX), un programa de llarga trajectòria que té com a objectiu principal prevenir malalties infeccioses associades a les pràctiques de risc relacionades amb el consum de drogues per injecció entre les persones usuàries de drogues, com són les infeccions pel virus de la immunodeficiència humana (VIH), pel virus de l’hepatitis B (VHB) i pel virus de l’hepatitis C (VHC). Es presenten dades de l’evolutiu de distribució general de xeringues dels punts PIX disponibles per tipus de dispositiu i per regió sanitària

Calor elevada; Mesures de prevenció; Resultats Calor elevada; Medidas de prevención; Resultados High heat; Preventive measures; Results El Pla d'actuació per prevenir els efectes de les onades de calor sobre la salut (POCS) a Catalunya és un pla estacional que s'activa anualment de l'1 de juny fins al 30 de setembre. Està coordinat per l'Agència de Salut Pública de Catalunya (ASPCAT) i el Servei Català de la Salut i compta amb la participació de més d'una quinzena d'entitats. L’informe presenta les actuacions realitzades i dels resultats obtinguts en relació al pla d’actuació per prevenir els efectes de les onades de calor sobre la salut (POCS) durant l'estiu de l'any 2020.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Residències; Mesures de prevenció; Visites Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Residencias; Medidas de prevención; Visitas Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Residences; Prevention measures; Visits Document que conté una sèrie de mesures a prendre per evitar que el SARS-CoV-2 entri a l'àmbit residencial, intensificades respecte a les anteriors per l'augment de la variant Delta, i perquè en el cas que entri es mitiguin les conseqüències.

Equips de protecció individual; EPI; Mesures d'optimització; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Equipos de protección individual; EPI; Medidas de optimización; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV Personal protective equipment; EPI; Optimization measures; Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV El propòsit d’aquest document és recomanar accions per a l’optimització dels equips de protecció individual (EPI), segures per als professionals i els pacients, en el context present de pandèmia per la COVID-19 i per actuar davant de possibles desabastiments d’aquests equipaments.

Suïcidi; Prevenció; Depressió Suicidio; Prevención; Depresión Suicide; Prevention; Depression Al Pla director de salut mental i addiccions (PDSMiA) s’ha prioritzat una sèrie d’accions que inclouen l’elaboració del Pla de prevenció del suïcidi de Catalunya 2021-2025, PLAPRESC, concretament l’acció d’avaluar i consolidar les rutes assistencials de la depressió, posant èmfasi en la detecció, la intervenció precoç i el risc de suïcidi de l’Objectiu estratègic 1.2. Desenvolupar polítiques preventives en salut mental i addiccions en tots els grups d’edat.