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Aims: To detect modifiable factors and target populations associated with uncontrolled type 2 diabetes in primary care., Design: Retrospective cross-sectional descriptive study., Location: Health center of Barranco Grande, Tenerife., Participants: Random selection of patients with DM2 attended by 12 family doctors and 12 nurses., Main Measurements: In addition to the control of DM2, sociodemographic, clinical data, lifestyle and follow-up of preventive and therapeutic measures were obtained. After bivariate analysis, a multilevel multivariate model was adjusted by taking the quota of patients assisted by each physician as a second-level mixed-effect variable and the rest as first-level variables., Results: 587 patients were recruited (46.5% female), treated with 1.9-1.1 antidiabetic drugs, with 4.1% therapeutic non-compliance, and suffering 13.8% therapeutic inertia. 23.7% showed poor DM2 control, being significantly worse (p<0.05) in male sex, age <65 years, evolution DM2 -5 years, work-active, upper-middle studies, inadequate diet, metabolic syndrome, ratio TG/HDL-3, complications of DM2, Charlson index<5, nursing visits <3/year, without ECG in the last year, and more drugs prescribed for DM2. The doctor-nurse quota was associated with poor control with an intraclass coefficient of 0.01., Conclusions: Men under 65 years of age with DM2 evolution longer than 5 years are a target population to intensify interventions. Therapeutic non-compliance, inadequate diet, lack of adherence protocols and ratio TG/HDL>3 are the main modifiable factors on which to intervene. The association of the doctor-nurse quota with the control of DM2 is weak, probably due to adequate follow-up of preventive programs., (Copyright © 2021. Publicado por Elsevier España, S.L.U.)

In Spain, HIV incidence has remained stable and higher than the European average since 2000 due to insuf-ficient prevention measures. An estimated 130,000-160,000 people are believed to be living with HIV in Spain, including 18% who do not know they are infected, and half are late diagnoses, with a poorer clinical course, lower quality of life and life expectancy, as well as higher costs. Late diagnosis is more common in heterosexuals, intravenous drug users, people over 50 years of age and immigrants, whereas men who have sex with men are the only group where the rate of new diagnoses is increasing. An estimated 34% of people with HIV have a detectable viral load, mainly due to barriers that hinder diagnosis such as insufficient testing availability and the low risk perception of undiagnosed individuals and healthcare professionals., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)

Past economic crises have increased the impact of communicable diseases especially on groups particularly vulnerable to the social and health consequences of the recession. However, it has been shown that the impact of these crises largely depends on the response of governments and the inhabitants of affected countries. We describe the consequences of the current crisis in the causal chain of infectious disease, including the response of the health system, and explore whether there is evidence of its impact in Spain. It is assumed that the possible effect of the crisis on living and working conditions is due to individual and social debt coupled with high unemployment as defining features of the crisis. We highlight the potential negative consequences of healthcare cuts on vulnerable populations, which have been partly excluded with the recent reform of health coverage. We compare mortality and morbidity data between two periods: before and after 2008, integrating, where possible, observed trends and institutional reports. Overall, no effect on infectious disease has been detected so far, although some signs of worsening, which could be compatible with the effects of the crisis, have been observed and need to be monitored and confirmed. We review the limitations of data sources that may not be sufficiently sensitive or up-to-date to detect changes that may require a latency period to become manifest. Instead of cutting resources, surveillance of these diseases should be improved, and an equitable social health response, which targets the population most affected by the crisis, should be guaranteed., (Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.)