Background: Patients with inflammatory bowel disease (IBD) have a higher risk of developing opportunistic infections due to either the disease itself or to treatment with immunosuppressants. This risk can be reduced through vaccination. The aim of this study was to determine the prevalence of compliance with the guidelines on recommended immunization schedule in patients with IBD in the health district of Lleida, Spain. Methods: Descriptive, cross-sectional, retrospective study of data at December 31, 2016. The reference population was formed by adults with a clinical diagnosis of IBD. The dependent variable was “compliance with the guidelines on recommended immunization schedule”. Variables were sex, age, residence, diagnosis, vaccination against measles, mumps, rubella, varicella, tetanus-diphtheria, influenza, pneumococcus, meningococcus C, hepatitis B, and hepatitis A. Data were obtained from electronic medical records. For the data analysis, mean (standard deviation), prevalence with 95% confidence intervals, χ² test and Mann-Whitney test were used. Results: Compliance did not exceed 65% for any of vaccines analysed in the 1722 studied patients with ulcerative colitis or Crohn’s disease. Significant differences across age groups were found in compliance for measles, mumps, rubella, varicella, tetanus, diphtheria and influenza in both ulcerative colitis and Crohn’s disease and for meningococcus C and hepatitis A exclusively in ulcerative colitis. Conclusions: Compliance in patients with IBD is low. Thus, prevention of immunopreventable diseases or their complications is not maximized in this kind of patients. Greater awareness of how vaccines can reduce the risk of vaccine-preventable infections is needed among both patients and healthcare professionals.

Background: Evidence supports a causal relationship between circadian disturbance and impaired glucose homeostasis. Methods: To determine the effect of an educational intervention delivered by primary care nurses to improve sleep hygiene, a parallel, open-label clinical trial in subjects aged 18 and older with impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM) was performed. Study variables were sex, age, fasting glucose, glycated haemoglobin A1c (HbA1c), Pittsburgh Sleep Quality Index (PSQI), sleep duration and efficiency, body mass index, antidiabetic treatment, diet and physical exercise. An individual informative educational intervention was carried out following a bidirectional feedback method. The intervention aimed to develop skills to improve sleep through nine simple tips. An analysis of covariance was performed on all the mean centred outcome variables controlling for the respective baseline scores. Results: In the intervention group, PSQI dropped, the duration and quality of sleep increased, and a decrease in fasting glucose and in HbA1c levels was observed. Conclusion: The proposed intervention is effective for improving sleep quality, length and efficiency, and for decreasing fasting glucose and HbA1c levels in only 3 months. These findings support the importance of sleep and circadian rhythm education focused on improving IFG and T2DM.

Patients with inflammatory bowel disease (IBD) have a dysregulated immune system, being at high risk of opportunistic infections. Low vaccination rates hinder the prevention of such diseases. Therefore, we implemented an intervention to increase vaccination rates, and we aimed to evaluate the effect. We determined the change in professionals and the change in the vaccination rates after the intervention. A quasi-experimental study was carried out using data from 31 December 2016 to 31 December 2021. First, healthcare professionals specializing in IBD agreed on a vaccination protocol; then, this protocol was passed on to the professionals involved in vaccination. We evaluated the perception of knowledge, capacity, and intention to vaccinate patients with IBD among the professionals before and after the intervention with a survey. We also described the effectiveness of the intervention for already diagnosed patients and compared the vaccination rates between patients diagnosed prior to the intervention and newly diagnosed patients. The intervention resulted in an improved perception of knowledge, capacity, and intention to vaccinate patients with IBD among the professionals (p < 0.05). Moreover, during the post-intervention period, in the 315 patients, the vaccination rate increased for all immune-preventable diseases (p < 0.05). The professionals positively valued the intervention, and compliance with the recommended vaccination protocol in patients with IBD improved significantly.

The aim of this study is to assess the influence of living in nursing homes on COVID-19-related mortality, and to calculate the real specific mortality rate caused by COVID-19 among people older than 20 years of age in the Balaguer Primary Care Centre Health Area during the first wave of the pandemic. We conducted an observational study based on a database generated between March and May 2020, analysing COVID-19-related mortality as a dependent variable, and including different independent variables, such as living in a nursing home or in the community (outside nursing homes), age, sex, symptoms, pre-existing conditions, and hospital admission. To evaluate the associations between the independent variables and mortality, we calculated the absolute and relative frequencies, and performed a chi-square test. To avoid the impact of the age variable on mortality and to assess the influence of the “living in a nursing home” variable, we established comparisons between infected population groups over 69 years of age (in nursing homes and outside nursing homes). Living in a nursing home was associated with a higher incidence of COVID-19 infection, but not with higher mortality in patients over 69 years of age (p = 0.614). The real specific mortality rate caused by COVID-19 was 2.27⁰/₀₀. In the study of the entire sample, all the comorbidities studied were associated with higher mortality; however, the comorbidities were not associated with higher mortality in the infected nursing home patients group, nor in the infected community patients over 69 years of age group (except for neoplasm history in this last group). Finally, hospital admission was not associated with lower mortality in nursing home patients, nor in community patients over 69 years of age.

Introduction: Numerous studies have established both arterial hypertension and white coat hypertension as cardiovascular risk factors. An abnormal circadian rhythm of blood pressure may increase cardiovascular risk. Objective: To determine the existence of a clinically relevant relationship between an abnormal circadian rhythm of blood pressure and an increase in cardiovascular risk in patients with hypertension or white coat hypertension. Methods: A descriptive study in 166 patients older than 18 years was carried out. Patients were from the Basic Health Area of Balaguer, who had an ambulatory blood pressure monitoring, conducted between June 2014 and March 2018 and met the inclusion and exclusion criteria. Univariate and bivariate analyses of the variables were performed. Results: In almost all means nighttime blood pressure, the riser pattern stands out, showing that 25% had a cardiovascular risk greater than or equal to 10%, followed by extreme dippers 16.67%, dippers 9.4% and non-dippers 8.27%. Conclusion: An altered circadian rhythm is related to a higher cardiovascular risk and a worse control of the related factors.

Background/Objectives: Chronic insomnia is a prevalent condition with important health implications. However, its recognition in clinical practice is often limited. This study evaluated the alignment between population-based estimates of chronic insomnia and the prevalence recorded in primary care, assessing the diagnostic reliability of healthcare services. Design: We conducted a comparative cross-sectional analysis using two independent data sources: (1) the Epidemiology Study of Insomnia in Spain (EPINSOM) survey, which applied the International Classification of Sleep Disorders, Third Edition (ICSD-3), criteria to a representative sample of the Spanish adult population (n = 2243; Catalonia subsample n = 363) and (2) the SIDIAP Electronic Health Record (EHR) database, comprising anonymized primary care data from adults in Catalonia (N = 4,131,754). Methods: Prevalence estimates of insomnia symptoms, chronic insomnia syndrome, and chronic insomnia disorder were extracted from the EPINSOM survey and compared with ICD-10-coded insomnia diagnoses in the SIDIAP. Pairwise comparisons of proportions were conducted using z-tests for independent samples. For transparency, 95% confidence intervals (CI) were calculated using the Wilson method. Results: In Catalonia, the population-based prevalence of chronic insomnia disorder was 13.6% (95% CI: 10.1–17.1), whereas the prevalence of coded insomnia diagnoses in primary care was significantly lower at 5.1% (95% CI: 5.08–5.12). Among adults aged ≥55 years, the prevalence estimates were more closely aligned between the survey (18.2%) and SIDIAP records (18.5%). The survey-derived prevalence of insomnia symptoms reached 41.39% (95% CI: 39.2–43.6), highlighting substantial underrecognition in clinical practice. Conclusions: Our findings indicate that primary care insomnia diagnoses substantially underestimate insomnia prevalence compared with ICSD-3-based population estimates, particularly in younger adults. While diagnoses appear to be more like to prevalence in older adults (>55 years), this discrepancy highlights the need for improved identification and management of insomnia in primary care settings, especially among younger populations who may be underdiagnosed.