No abstract available.
Humans ; Spain* ; Students, Medical*

BACKGROUND AND PURPOSE: This work was undertaken to review the current cost-effectiveness analysis data on thrombolysis by intravenous (IV) therapy with recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke. METHODS: PubMed was searched for articles published between 1995 and 2008. The cost-effectiveness analysis data from eight eligible studies were reviewed, paying particular attention to their modeling assumptions and the quality of the source data. RESULTS: The reviewed studies were from six countries: USA (n=2), UK (n=2), Canada (n=1), Australia (n=1), Spain (n=1), and Denmark (n=1); most were performed from the healthcare-system and/or societal perspectives. IV rtPA was associated with an acceptable increase in short-term cost [range: US$ 36-236/patient; US$ 29,148-55,591/quality-adjusted life-years (QALYs)], and a net long-term cost saving that was higher from a societal perspective (range: -US$ 12,043 to -US$ 630/patient; -US$ 207,253 to -US$ 21,938/QALYs) than from a healthcare-system perspective (range: -US$ 5,811 to -US$ 5,415/patient; -US$ 41,137 to -US$ 4,662/QALYs). CONCLUSIONS: IV rtPA seems to be a cost-effective strategy for the management of acute ischemic stroke, and might reduce the associated healthcare costs as well as patients' disabilities. Further cost-effectiveness research and the development of a public health strategy are warranted to optimize the use of rtPA in Korea.
Australia ; Canada ; Cost Savings ; Denmark ; Health Care Costs ; Korea ; Public Health ; Spain ; Stroke ; Tissue Plasminogen Activator

Since the first deceased donor kidney transplantation in 1979, continuous efforts have been made to increase deceased organ donation in Korea. However, a critical shortage of human organs for transplant is still a serious problem and is partly caused by the absence of a system to actively identify and properly manage deceased donors in Korea. Considering this, Korea needs to create a new national system for deceased donor identification, management, and organ procurement. There are three kinds of organ procurement systems in the world: The "Spanish model", the "United States model", and the "other European model". We reviewed each system and suggested the optimal organ procurement system for Korea. We also proposed requirements for operating an organ procurement organization and increasing deceased organ donation. Further improvements in the organ procurement system will contribute to improve the current organ shortage.
Brain Death ; Humans ; Kidney Transplantation ; Korea ; Spain ; Tissue and Organ Procurement ; Tissue Donors ; Transplants ; United States

Dust ; analysis ; Humans ; Mining ; Occupational Exposure ; prevention & control ; Quartz ; analysis ; Spain

BACKGROUND: Changes in lung cancer has been characterized by the increase of cases among women and the increase in adenocarcinomas among other histological subtypes. METHODS: Descriptive analysis of cases diagnosed with lung cancer in Hospital Virgen de las Nieves (Spain) from 1990 to 2010, based on five variables (age, sex, smoking, histology and pathological anatomy). The study establishes associations between these variables and compares the results with the literature. RESULTS: 2,026 patients were diagnosed with lung cancer in this period; 1,838 were males (90.7%) and 188 women (9.3%); 1,892 patients (93.4%) were smokers or ex-smokers and 134 (6.6%) had never smoked; the most frequent non-small cell histology types were squamous cell carcinoma and adenocarcinoma and it was the most frequent neoplasia in women and were associated with a lower tobacco consumption. CONCLUSIONS The large majority of lung cancer cases is associated with a history of smoking tobacco and there are histopathological differences according to gender and cumulative tobacco smoke load.
Female ; Humans ; Lung Neoplasms ; epidemiology ; Male ; Middle Aged ; Smoking ; epidemiology ; Spain ; epidemiology

INTRODUCTION: A new third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) has been developed in response to trends in working life, theoretical concepts, and international experience. A key component of the COPSOQ III is a defined set of mandatory core items to be included in national short, middle, and long versions of the questionnaire. The aim of the present article is to present and test the reliability of the new international middle version of the COPSOQ III.METHODS: The questionnaire was tested among 23,361 employees during 2016–2017 in Canada, Spain, France, Germany, Sweden, and Turkey. A total of 26 dimensions (measured through scales or single items) of the middle version and two from the long version were tested. Psychometric properties of the dimensions were assessed regarding reliability (Cronbach α), ceiling and floor effects (fractions with extreme answers), and distinctiveness (correlations with other dimensions).RESULTS: Most international middle dimensions had satisfactory reliability in most countries, though some ceiling and floor effects were present. Dimensions with missing values were rare. Most dimensions had low to medium intercorrelations.CONCLUSIONS: The COPSOQ III offers reliable and distinct measures of a wide range of psychosocial dimensions of modern working life in different countries; although a few measures could be improved. Future testing should focus on validation of the COPSOQ items and dimensions using both qualitative and quantitative approaches. Such investigations would enhance the basis for recommendations using the COPSOQ III.
Canada ; France ; Germany ; Psychometrics ; Risk Assessment ; Spain ; Sweden ; Turkey ; Weights and Measures

OBJECTIVE: Complementary and alternative medicine use and type of use may be influenced by sociodemographic and economic determinants through which we could identify characteristics of patients with greater trend to use it. This paper aims to describe the changes in the consumption of homeopathic and natural remedies in Spain for three time points in order to discern changes in rate of consumption, associated factors and whether their use has been affected by a period of economic recession. METHODS: This study utilized 2006, 2011 and 2017 cross-sectional data from the Spanish National Health Survey, a nationally representative survey of the population aged more than 15 years old and resident in Spain. Independent bivariate and multivariate descriptive analyses for each of the 3 years studied were performed. RESULTS: The rate of consumption of both homeopathic and natural remedies has decreased over the periods studied. In spite of this decrease, the consumer profile appears to remain stable over the three periods. The sociodemographic factors associated with their consumption were being female, being 30-64 years old, being separated/divorced, having higher education qualifications, being employed and belonging to a higher social class. Psychiatric morbidity, chronic health problems such as pain, mental health problems or malignant tumors, and absence of major cardiovascular events were the clinical factors associated. CONCLUSION It can be concluded that beyond the economic situation, the use of homeopathic and natural remedies obeys to the needs of the patients related to their state of health and the response they receive from the health system. It may be that women have different needs and expectations of the healthcare system and, given this breach of expectations, seek remedy to alleviate their needs outside the system and conventional medicine.
Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Homeopathy ; Humans ; Middle Aged ; Sociodemographic Factors ; Socioeconomic Factors ; Spain

BACKGROUND: Although incidence of leprosy in Korea has declined steadily over the years, the increase in immigration since the turn of the century-much of it from countries where leprosy is still prevalent-has been linked to an uptick in registered cases. OBJECTIVE: To describe the epidemiologic trends of incident leprosy cases detected in Spain among Korea-and foreign-born population groups METHODS: Observational, retrospective study of suspected leprosy cases in Korea, as reviewed leprosy records from the Korea Centers for Disease Control & Prevention from 2001 to 2015, with results disaggregated by country of birth. Author collected statistical data on leprosy burden for other countries from WHO(World Health Organization) to estimate the expected number of imported cases. RESULTS: Of the 198 leprosy cases registered during the study period, 172(86.9%) were in Korea patients, while 26(13.1%) were detected in resident immigrants. Author identified a significantly higher number of imported leprosy cases during the 2004~2006, 2007~2009, 2010~2012 and 2013~2015 trienniums compared to the reference triennium 2001~2003 (OR 2.66, 95% CI 0.607–11.65; OR 8.33, 95% CI 2.05–33.94; OR 10.00, 95% CI 2.25–44.49; and OR 10.00, 95% CI 1.99–1.34; respectively). Most imported cases were diagnosed in Indonesia(23%) and Sri Lanka(23.8%). However, registered incidence was lower than expected for each year from 2007 to 2015. For example, in 2007, the expected new cases in immigrants were 8, compared to only one case that were actually detected (a 87.3% difference). Likewise, the author expected to find 24 incident cases among immigrants in 2014 and 2015, but only one new case were reported (95.7% fewer than expected). CONCLUSION: Imported cases of leprosy are low than expected cases in Korea, and the author cannot rule out some under-diagnosis. Clinicians should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic.
Centers for Disease Control and Prevention (U.S.) ; Emigrants and Immigrants ; Emigration and Immigration* ; Humans ; Incidence ; Korea* ; Leprosy* ; Parturition ; Population Groups ; Retrospective Studies ; Spain

PURPOSE: Few studies have been done for spinal injuries after skiing and snowboarding accidents. Assuming that the riding patterns of skiing and snowboarding were different, we analyzed the differences between the mechanisms, diagnoses and levels of spinal injuries caused by them. The purpose of this study was to gain a better understanding of spinal hazards associated with skiing and snowboarding in order to educate skiers and snowboarders. METHODS: We conducted a prospective study of 96 patients who had sustained spinal injuries as a result of skiing and snowboarding accidents from January 2003 to March 2006. We used a questionnaire, radiological studies, history taking, and physical examinations. We analyzed the mechanism of injury, the level of spinal injury, the severity of spinal injury, and the Abbreviated Injury Scale scores (AIS score). We used the t-test and the chi-square test. RESULTS: The skiing and the snowboarding injury group included in 96 patients. The skiing injury group included 30 patients (31.2%), and the snowboarding injury group included the remaining 66 patients (69.8%). The primary mechanism of injury in skiing was collisions and in snowboarding was slip downs (p=0.508). The primary level of spinal injury in skiing and snowboarding was at the L-spine level (p=0.547). The most common athlete ability of the injured person was at the intermediate level (p=0.954). The injured were most commonly at the beginner or the intermediate level (p=0.302). The primary diagnosis of spinal injury in skiing and snowboarding was back spain (p=0.686). The AIS scores did not differed between the two groups (p=0.986). CONCLUSION: The most common spinal injury after skiing and snowboarding accidents was back sprain. There was no difference in the severity of spinal injury between skiing and snowboarding accidents.
Abbreviated Injury Scale ; Athletes ; Diagnosis ; Humans ; Physical Examination ; Prospective Studies ; Surveys and Questionnaires ; Skiing* ; Spain ; Spinal Injuries* ; Sprains and Strains

The incidence of tuberculoma of the brain in different countries varies reatly. They form a high percentage of intracrnial lesions dealt with in countries of Asia, Eastern Europe, Italy, Spain and South America. The recent introduction of the potent antituberculosis remedies, far from diminishing the incidence of tuberculoma of the brain, is more likely to increase it. This case was a 18 year old male who had increased intracranial pressure signs and characteristic signs which was suggestive lesion in posterior fossa. Conray ventriculography revealed nearly total obstruction of distal portion of aqueduct of Sylvius with displacement to the right side. Intensive antituberclous treatment then was started after removal of tuberculoma in cerebellar vermis and then discharged with fully recovery. References were reviewed as will.
Adolescent ; Asia ; Brain ; Cerebral Aqueduct ; Europe, Eastern ; Humans ; Incidence ; Intracranial Pressure ; Italy ; Male ; South America ; Spain ; Tuberculoma*