Measles outbreak in Andalusia, Spain, January to August 2011.

On 7 January 2011, a six year-old child living in a Roma community near Seville, southern Spain, was hospitalised with measles. Contact tracing identified a probable index case with onset of symptoms on 20 December 2011 and several unreported cases among children under the age of 15 years in the same town. The outbreak initially spread in districts in the city of Seville with a high proportion of Roma residents, and later to other cities and towns in Andalusia. While some towns experienced wide spread of the disease with significant clusters of cases, most of the affected locations saw non-clustered cases or very few secondary cases. The outbreak resulted in 1,759 confirmed or probable cases of which 393 (19%) required hospitalisation. Measles virus of genotype D4 was diagnosed in more than half of the cases. Significant differences (p<0.0001) by age group were found between clustered and non-clustered cases. The highest proportion of clustered cases occurred in the age group of 5-14 yearolds, while the highest proportion of non-clustered cases was seen in those older than 29 years. The last confirmed case related to this outbreak was reported on 20 August 2011.

Community cluster of meningococcal disease by Neisseria meningitidis serogroup C in Andalusia, Spain, March to May 2011.

Between March and May of 2011, a cluster of three fatal cases of meningococcal sepsis occurred in Andalusia, Spain, in a municipality with a population of around 20,000 inhabitants. The cases were in their mid-teens to early thirties and were notified to the epidemiological surveillance system of Andalusia (Sistema de Vigilancia Epidemiológica de Andalucía, SVEA) during a 68-day period from March through May 2011. All three were infected with the same strain of Neisseria meningitidis serogroup C genosubtype VR1:5-1;VR2:10-8. None of the cases had been previously vaccinated against N. meningitidis serogroup C. Antibiotic post-exposure chemoprophylaxis was administered to close contacts of every diagnosed case. Once the cluster was confirmed, the local population was informed through the media about the control measures taken by the health authorities. The vaccination history against N. meningitidis serogroup C of the population under 25 years-old in the municipality was checked. Vaccination was offered to unimmunised individuals younger than 25 years of age and an additional dose of vaccine was offered to those who had been vaccinated between 2000 and 2006 with a vaccination schedule of three doses before the first year of age. No further cases occurred since the beginning of these actions.

Early estimates of the effectiveness of the 2011/12 influenza vaccine in the population targeted for vaccination in Spain, 25 December 2011 to 19 February 2012.

We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.

Rabid puppy-dog imported into the Netherlands from Morocco via Spain, February 2012.

To the editor: We read with interest the article by van Rijckevorsel et al. on a rabid puppy-dog imported into the Netherlands from Morocco via Spain, recently published in Eurosurveillance [1]. We would like to complete the information on this event with actions taken by the Spanish health authorities and lessons learnt.

Sociodemographic factors and clinical conditions associated to hospitalization in influenza A (H1N1) 2009 virus infected patients in Spain, 2009-2010.

The emergence and pandemic spread of a new strain of influenza A (H1N1) virus in 2009 resulted in a serious alarm in clinical and public health services all over the world. One distinguishing feature of this new influenza pandemic was the different profile of hospitalized patients compared to those from traditional seasonal influenza infections. Our goal was to analyze sociodemographic and clinical factors associated to hospitalization following infection by influenza A(H1N1) virus. We report the results of a Spanish nationwide study with laboratory confirmed infection by the new pandemic virus in a case-control design based on hospitalized patients. The main risk factors for hospitalization of influenza A (H1N1) 2009 were determined to be obesity (BMI≥40, with an odds-ratio [OR] 14.27), hematological neoplasia (OR 10.71), chronic heart disease, COPD (OR 5.16) and neurological disease, among the clinical conditions, whereas low education level and some ethnic backgrounds (Gypsies and Amerinds) were the sociodemographic variables found associated to hospitalization. The presence of any clinical condition of moderate risk almost triples the risk of hospitalization (OR 2.88) and high risk conditions raise this value markedly (OR 6.43). The risk of hospitalization increased proportionally when for two (OR 2.08) or for three or more (OR 4.86) risk factors were simultaneously present in the same patient. These findings should be considered when a new influenza virus appears in the human population.

Disseny i càlcul de les façanes i del lluernari del vestíbul d’entrada de la torra Iberdrola

El projecte Torre Iberdrola s’engloba en les actuacions urbanístiques de Bilbao per a regenerar espais industrials no utilitzats situats al Paseo de la Ribera, la Avenida Abandoibarra i la passarel•la Pedro Arrupe. La Torre Iberdrola, situada a la parcel•la 204 del PERI de Abandoibarra (veure plànol nº2), en el districte de Abando (Bilbao), és un gratacels d’oficines de 41 plantes amb una altura total de 165 metres i una superfície construïda total d’aproximadament 62.100 m2 sobre rasant. A més, l’edifici a construir consta de 5 plantes sota rasant amb una superfície total construïda d’aproximadament 32.100 m2. L’objecte del present projecte és presentar la solució acordada conjuntament entre l’arquitecte Pelli Clarke Pelli Architects, les consultories Buro Happold i IDOM, i BELLAPART per a l’execució del revestiment del vestíbul d’entrada de la Torre Iberdrola

Finca-Museo agroindustrial San Julián : proyecto para la difusión y la conservación del patrimonio industrial de Guatemala

Disseny d'un espai multidisciplinar que permeti l'interpretació del Patrimoni Industrial i Cultural de la Finca agroindustrial de San Julián (Guatemala), amb l'objectiu de fomentar la difusió i la conservació del Patrimonio Industrial del país

Projecte bàsic i d'execució de rehabilitació i ampliació d'edifici plurifamiliar entre mitgeres situat al Carrer Roger de Flor, 105 de Granollers (Barcelona)

L’edifici a rehabilitar està situat en una important avinguda de l’eixample oest de Granollers. En l’actualitat l’edifici es troba a ple rendiment, amb l’ús de magatzem i obrador a la planta baixa i planta primera, i com a habitatge a les plantes segona i tercera. En concret es tracta de la formació d’un total de 6 habitatges i 5 trasters, a més de la reforma general del nucli de comunicació vertical on s’incorpora l’ascensor i la construcció de la paret mitgera que delimitarà l’espai de l’edifici en la seva projecció vertical. La rehabilitació també té com a objectiu reforçar els forjats, en els quals s’ha detectat aluminosi, així com l’enderroc d’envans a la segona i tercera planta per construir una millor distribució que permeti augmentar el nombre d’habitatges per planta

Lymphocytic choriomeningitis virus-associated meningitis, southern Spain.

Lymphocytic choriomeningitis virus (LCMV) was detected in 2 patients with acute meningitis in southern Spain within a 3-year period. Although the prevalence of LCMV infection was low (2 [1.3%] of 159 meningitis patients), it represents 2.9% of all pathogens detected. LCMV is a noteworthy agent of neurologic illness in immunocompetent persons.

Disseny del capçal d'un molinet motoritzat per a realitzar extractes de plantes en el sector de la indústria farmacèutica

Una empresa de la indústria farmacèutica vol comercialitzar càpsules elaborades amb plantes medicinals. El procés a seguir per a aconseguir el producte final es realitza mitjançant un molí motoritzat que consta d’unes ganivetes, la funció de les quals és triturar les fulles de les plantes prèviament seleccionades a unes mides realment minúscules, de tal manera que llavors es puguin introduir dins les càpsules. Actualment el procés de trituració es realitza aproximadament a 3.000 rpm i en intentar assolir majors velocitats de treball el capçal de la màquina no les aguanta, cedint un o més dels seus components, patint sobretot l’eix de transmissió i els rodaments, que en ocasions acaben trencant-se. Per a intentar resoldre aquest problema, l’empresa subministradora de maquinària industrial es planteja la viabilitat d’un nou prototipus. La primera mesura que es proposa al client per a solucionar el problema derivat d’aquest augment de la producció és dissenyar un nou capçal del molí motoritzat perquè pugui treballar a velocitats superiors, aproximadament de 18.000 r.p.m, que significaria un canvi total de la transmissió de la màquina

Streptococcus pneumoniae bacteremia: clinical and microbiological epidemiology in a health area of Southern Spain

Streptococcus pneumoniae remains an important cause of bacteremia worldwide. Last years, a decrease of S. pneumoniae penicillin-resistant isolates has been observed. The objective of this study was to describe the episodes of bacteremia due to S. pneumoniae during a period of 11 years. Epidemiological and clinical data, serotypes causing bacteremia, antibiotic susceptibility and prognosis factors were studied. Over a period of 11 years, all the episodes of S. pneumoniae bacteremia were analysed. Their clinical and microbiological features were recorded. Statistical analysis was carried out to determine risk factors for pneumococcal bacteremia and predictors of fatal outcome. Finally, 67 S. pneumoniae bacteremia episodes were included in this study. The majority of cases were produced in white men in the middle age of their life. The main predisposing factors observed were smoking, antimicrobial and/or corticosteroids administration, chronic pulmonary obstructive disease and HIV infection, and the most common source of bacteremia was the low respiratory tract. The main serotypes found were 19A, 1, 14 and 7F. Seventy-seven percent of these isolates were penicillin-susceptible, and the mortality in this serie was really low. Statistical significance was observed between age, sex and race factors and the presence of bacteremia, and there was relationship between the patient’s condition and the outcome. In our study, S. pneumoniae bacteremia is mainly from community-acquired origin mainly caused in men in the median age of the life. 40% of bacteremias were caused by serotypes 19A, 1, 7F and 14. During the period of study the incidence of bacteremia was stable and the mortality rate was very low.

ACME - Mòdul d'usuaris convidats

El projecte ACME va néixer, l’any 1998, amb la finalitat de millorar la docència de les matemàtiques en els estudis d’Enginyeria Industrial i Enginyeries Tècniques de l’Escola Politècnica de la Universitat de Girona, amb la intenció de buscar la manera de que els alumnes s’impliquessin i participessin més activament en aquesta matèria fent ús de la xarxa com a via de comunicació. El projecte ACME, Avaluació Continuada i Millora de l’Ensenyament, és una eina d’e-learning que té com a objectiu fer una avaluació continuada dels alumnes a través d’uns dossiers personalitzats de problemes que el professor proposa. El sistema permet fer el seguiment, per part del professor, del progrés del conjunt de la classe, o d’un alumne individual, en una assignatura concreta. Això fa que l’ACME tingui un gran valor pedagògic. Els objectius d’aquest projecte final de carrera són els següents:• Desenvolupar un sistema de gestió d’usuaris convidats que ens permeti acceptar o denegar l’accés a usuaris que prèviament han fet una petició per poder utilitzar l’ACME.• Crear un sistema que faciliti la tasca d’assignar als usuaris els temes i els problemes més adients pel seu perfil.• Desenvolupar tot un seguit de millores i ampliacions amb la intenció d’integrar el nou mòdul dins les interfícies existents:Ampliar la interfície d’administració en l’apartat d’usuari amb la opció per gestionar els usuaris convidats. Ampliar la interfície d’administració en l’apartat del quadern de problemes amb les opcions adients per tal de gestionar les assignatures dels convidats.

Adherence to interferon β-1b treatment in patients with multiple sclerosis in Spain

BACKGROUND Adherence to interferon β-1b (INFβ-1b) therapy is essential to maximize the beneficial effects of treatment in multiple sclerosis (MS). For that reason, the main objectives of this study are to assess adherence to INFβ-1b in patients suffering from MS in Spain, and to identify the factors responsible for adherence in routine clinical practice. METHODOLOGY/PRINCIPAL FINDINGS This was an observational, retrospective, cross-sectional study including 120 Spanish patients with MS under INFβ-1b treatment. Therapeutic adherence was assessed with Morisky-Green test and with the percentage of doses received. The proportion of adherent patients assessed by Morisky-Green test was 68.3%, being indicative of poor adherence. Nevertheless, the percentage of doses received, which was based on the number of injected medication, was 94.3%. The main reason for missing INFβ-1b injections was forgetting some of the administrations (64%). Therefore, interventions that diminish forgetfulness might have a positive effect in the proportion of adherent patients and in the percentage of doses received. In addition, age and comorbidities had a significant effect in the number of doses injected per month, and should be considered in the management of adherence in MS patients. CONCLUSION/SIGNIFICANCE Among all the available methods for assessing adherence, the overall consumption of the intended dose has to be considered when addressing adherence.

Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

BACKGROUNDS AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. METHODOLOGY/PRINCIPAL FINDINGS An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles. CONCLUSIONS/SIGNIFICANCE The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.