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Since the first cases were detected in China in December 2019, the COVID-19 pandemic has spread rapidly, collapsing many healthcare systems, and forcing them to adapt. Hand surgery has been indirectly affected by this scenario. This article aims to provide an overview on how Spanish hand surgeons have modified their daily practice. Based on a survey conducted nationwide, we observed a decrease in the number of emergency cases and cancellation of elective cases, shift to a more conservative treatment approach, use of personal protective equipment, and decrease in the number of outpatient visits and tests. Without definitive evidence at this point, knowing how we have dealt with the situation so far will help us adopt the needed measures to ensure both the patient's and surgeon's safety and manage available resources in future pandemics.

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A second-generation surveillance system of people infected with human immunodeficiency virus (HIV) has been implemented in Spain. Behavioural and clinical data were collected between 2002 and 2011 through an annual one-day, cross-sectional survey in public hospitals, including all in- and outpatients receiving HIVrelated care on the survey day. Mean age increased over time (from 38.7 years in 2002 to 43.8 years in 2011) and 68.4% of the 7,205 subjects were male. The proportion of migrants increased from 6.1% to 15.9%, while people who inject or used to inject drugs (PWID and Ex-PWID) decreased and men who have sex with men (MSM) and heterosexuals increased. Unprotected intercourse at last sex increased among MSM and PWID/Ex-PWID. Patients receiving antiretroviral treatment increased significantly from 76.0% to 88.2% as did those with CD4 T-cell counts ≥350 (from 48.2% to 66.9%) and viral copies <200 (from 47.0% to 85.2%). HIV-infected people with hepatitis C virus RNA decreased from 36.0% in 2004 to 29.9% in 2011, while those with HBsAg remained stable at around 4.4%. Implementation of a low-cost, sustainable system for second-generation surveillance in people living with HIV is feasible. In Spain, the information obtained has helped to define and refine public health policy and document treatment effectiveness.

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BACKGROUND: To describe utilisation of health care services and motives for consultation in Primary Care in the native and the immigrant population, and compare this with the perception of primary care professionals. METHODS: Data was collected on health care activity during the year 2006 for all people registered (N=86,966) in the 6 basic health care zones with the highest proportion of immigrants (14.4%) and on the following variables: country of origin, age, sex, year of inscription in the public health service. The health card and OMI-AP programme databases were used. A qualitative methodology of focus groups and in-depth interviews was employed. RESULTS: Seventy-two point four percent of immigrants requested care from the primary care professionals in 2006, of whom 50% proceeded from Ecuador and 70% were between 25 and 44 years old. Eighty-two percent of the natives made consultations and required more referrals to specialised care than the immigrants of the same age group. The most frequent consultation with natives and with immigrants was "acute respiratory infections" (7 to 23% according to age group). The second most frequent with immigrants was "administrative problems". The consultations with immigrants were not related to preventive aspects such as smoking and there were more consultations (p>0.001) for gynaeco-obstetric episodes (10.7%) and those related to work (19%) or psychosomatic problems (8.5%). The perception of the primary care professionals was that the immigrants carry out more consultations than the natives and generate a certain "disorder" in the clinic. CONCLUSION: Immigrants use healthcare services less than the native population. Nonetheless, this fact is not perceived in this way by the primary care professionals. Fewer preventive activities are carried out with immigrants, who suffer from more labour and psychosomatic problems.

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Fundamento. Describir la utilización de servicios y motivos deconsulta en Atención Primaria entre población autóctona e inmigrantey contrastarla con la percepción que tienen los profesionalesde atención primaria.Material y métodos. Se recogieron datos de actividad asistencialdurante el año 2006 de la totalidad de personas adscritas(N=86.966) a las 6 zonas básicas con mayor proporción de poblacióninmigrante (14,4 %) y las variables: país de origen, edad,sexo, año de alta en el sistema sanitario. Se utilizaron bases datosde tarjeta sanitaria y de programa OMI-AP. Se utilizó metodologíacualitativa de grupos de discusión y entrevistas en profundidad.Resultados. El 72,4% de inmigrantes solicitaron atención de profesionalesde atención primaria en 2006, de los cuales un 50%procedía de Ecuador y un 70% tenía entre 25 y 44 años. Los autóctonosconsultantes fueron el 82% y requirieron más derivacionesa atención especializada que los inmigrantes del mismo grupode edad. La consulta más frecuente en autóctonos e inmigrantesfue «infecciones respiratorias agudas» (7 al 23%, según gruposde edad). La segunda en inmigrantes fue «problemas administrativos». Las consultas de inmigrantes no se relacionan conaspectos preventivos como tabaquismo y sí tuvieron más consultas(p>0,001) de episodios gineco-obstétricos (10,7%) y de losrelacionados con problemas laborales (19%) o psicosomáticos(8,5%). La percepción de los profesionales de atención primariaera que la población inmigrante consulta más que la autóctona ygenera cierto «desorden» en la consulta.Conclusión. Los inmigrantes son menos utilizadores de serviciossanitarios y frecuentadores que los autóctonos. Sin embargo,este hecho no es percibido así por los profesionales de atenciónprimaria. Con inmigrantes se realizan menos actividades preventivasy padecen más problemas laborales y psicosomáticos(AU)

Background. To describe utilisation of health care services andmotives for consultation in Primary Care in the native and theimmigrant population, and compare this with the perception ofprimary care professionals.Methods. Data was collected on health care activity during theyear 2006 for all people registered (N=86,966) in the 6 basic healthcare zones with the highest proportion of immigrants (14.4%) andon the following variables: country of origin, age, sex, year of inscriptionin the public health service. The health card and OMI-APprogramme databases were used. A qualitative methodology offocus groups and in-depth interviews was employed.Results. Seventy-two point four percent of immigrants requestedcare from the primary care professionals in 2006, of whom 50% proceededfrom Ecuador and 70% were between 25 and 44 years old.Eighty-two percent of the natives made consultations and requiredmore referrals to specialised care than the immigrants of the sameage group. The most frequent consultation with natives and with immigrantswas «acute respiratory infections» (7 to 23% according toage group). The second most frequent with immigrants was «administrativeproblems». The consultations with immigrants were notrelated to preventive aspects such as smoking and there were moreconsultations (p>0.001) for gynaeco-obstetric episodes (10.7%) andthose related to work (19%) or psychosomatic problems (8.5%).The perception of the primary care professionals was that the immigrantscarry out more consultations than the natives and generate acertain «disorder» in the clinic.Conclusion. Immigrants use healthcare services less than thenative population. Nonetheless, this fact is not perceived in thisway by the primary care professionals. Fewer preventive activitiesare carried out with immigrants, who suffer from more labourand psychosomatic problems(AU)

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Se revisa la situación epidemiológica de la infección por el VIH y el sida en Navarra en 2003.Hasta diciembre de 2003 se habían diagnosticado 1.610 infecciones por el VIH en residentes en Navarra, de los cuales el 41 por ciento habían fallecido. Los nuevos diagnósticos de VIH han disminuido un 81 por ciento entre 1993 y 2003, año en que se diagnosticaron 28 casos (4,8 por 100.000 habitantes). El descenso se produjo fundamentalmente en las infecciones en usuarios de drogas inyectadas, ya que los casos por transmisión sexual se han mantenido estables. Más de la mitad de las infecciones diagnosticadas en el período 2000-2003 (58 por ciento) eran atribuibles a transmisión heterosexual, el 18 por ciento ocurrieron en usuarios de drogas por vía parenteral y el 12 por ciento en hombres homosexuales. El 33 por ciento eran personas originarias de otros países. La incidencia de sida ha disminuido de 75 casos en 1996 a 20 en 2003, y la mortalidad de 65 a 8 casos, respectivamente. En el período 2000-2003 la incidencia media anual de sida fue de 4,2 por 100.000 habitantes y la tasa media anual de mortalidad de 1,6 por 100.000 habitantes. A finales de 2003 había 902 personas vivas con diagnóstico de VIH seguidas en el sistema sanitario (1,6 infecciones conocidas por 1.000 habitantes). En 2003 el 65 por ciento de los jóvenes de 15 a 29 años refería relaciones sexuales coitales, porcentaje mayor que en años anteriores, pero su nivel de información sobre prevención del sida fue aceptable. Es preciso insistir en la prevención y adaptarla a las nuevas situaciones (AU)

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