Objetivo Describir la evolución de los diagnósticos de infecciones de transmisión sexual de declaración individualizada en la ciudad de Barcelona entre 2007 y 2024, y analizar su asociación con variables sociodemográficas y tipo de centro de notificación. Método Análisis de tendencia temporal basado en datos poblacionales de los casos de sífilis, gonorrea, clamidiasis y linfogranuloma venéreo de la ciudad de Barcelona. Se calcularon tasas de incidencia anuales y razones de tasas de incidencia ajustadas mediante regresión de Poisson robusta, ajustando por variables sociodemográficas y estratificando por tipo de centro. Resultados El 44,3% de los diagnósticos se realizaron en atención comunitaria, el 30,6% en atención primaria y el 24,9% en atención hospitalaria. Los hombres concentraron el 78,6% de los casos, predominando en atención comunitaria, mientras que las mujeres se diagnosticaron sobre todo en atención primaria. En comparación con el grupo de 25-34 años, la probabilidad de ser diagnosticado en cualquier tipo de atención disminuyó con la edad. Haber nacido en América Central o del Sur aumentó la probabilidad de ser diagnosticado en atención primaria un 112% y en atención hospitalaria un 144%. Un nivel socioeconómico bajo incrementó en un 238% la probabilidad de ser diagnosticado en atención primaria. Conclusiones Los diagnósticos de infecciones de transmisión sexual en Barcelona presentan potenciales desigualdades según el sexo, el origen y el nivel socioeconómico, que se reflejan en el tipo de centro donde se diagnostican. La pandemia de COVID-19 parece haber amplificado estas brechas, desplazando la carga asistencial hacia los dispositivos comunitarios. Existe una necesidad de fortalecer la atención primaria y mejorar la coordinación entre dispositivos asistenciales para avanzar hacia un modelo de atención sexual más equitativo.

OBJECTIVE:To describe the evolution of individually notifiable sexually transmitted infections diagnoses in the city of Barcelona between 2007 and 2024, and to analyse their association with sociodemographic variables and the type of reporting centre. METHOD:Temporal trend analysis based on population-level data on cases of syphilis, gonorrhoea, chlamydia and lymphogranuloma venereum in the city of Barcelona. Annual incidence rates and adjusted incidence rate ratios were estimated using robust Poisson regression, adjusting for sociodemographic variables and stratifying by type of centre. RESULTS:Overall, 44.3% of diagnoses were made in community-based services, 30.6% in primary care and 24.9% in hospital-based care. Men accounted for 78.6% of cases and were predominantly diagnosed in community settings, whereas women were mainly diagnosed in primary care. Compared with the 25-34-year age group, the probability of being diagnosed in any type of care setting decreased with increasing age. Being born in Central or South America was associated with a 112% higher probability of diagnosis in primary care and a 144% higher probability in hospital care. Low socioeconomic status was associated with a 238% higher probability of diagnosis in primary care. CONCLUSIONS:Sexually transmitted infections diagnoses in Barcelona show potential inequalities by sex, country of birth and socioeconomic level, which are reflected in the type of healthcare setting where diagnoses are made. The COVID-19 pandemic appears to have accentuated these patterns, with a relative shift in diagnostic activity towards community-based services. Strengthening primary care and improving coordination between healthcare settings are needed to move towards a more equitable model of sexual health care.

BackgroundIn May 2022, after the suspension of the mobility restrictions due to the COVID-19 pandemic, the first outbreak of MPOX virus, transmitted from human to human, was detected outside of Africa, affecting mostly sexually active men who have sex with men. Our aim is to report the first outbreak of MPOX in Barcelona city in the period from 5/2022 to 5/2023 and the subsequent surge of cases in 8/2023.MethodsWe performed a descriptive study of all notified cases in city residents, obtained through epidemiological surveys. The analyses are presented for the hospitalized cases and the key population of men who have sex with men.ResultsOf 2037 notified cases, 82.6% were confirmed. The cumulative incidence in the general population was 1.03 (95%CI 1.00-1.06) per 1000 inhabitants and 2.13 (2.01-2.17) per 1000 in men. Men were older than women, with a median age of 37 years (interquartile range 31-43). While 84.5% of men reported having sex with partners of the same gender, 70.9% of women only reported sex with partners of the opposite gender. Complications occurred in 4.1% of infected persons, 1.6% required hospitalization, and no deaths were registered. Georeferencing was highly associated with gay venues. Gay, bisexual and other men who have sex with men (GBMSM) accounted for most cases and severe cases, and were associated with attending public sex venues and not providing contact tracing information. Digital and printed prevention campaign materials were developed for GBMSM.DiscussionThe 2022 MPOX outbreak posed a major challenge to surveillance and sexual health services worldwide. With new cases and re-infections on the rise, MPOX may become a regular infection to be incorporated in STI testing and management guidelines. Barcelona has some characteristics that may facilitate the occurrence and spread of emergencies related to sexual health.

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017–2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections.

On 16 March 2018, a nursing home notified a possible acute gastroenteritis outbreak that affected 11 people. Descriptive and case-control studies and analysis of clinical and environmental samples were carried out to determine the characteristics of the outbreak, its aetiology, the transmission mechanism and the causal food. The extent of the outbreak in and outside the nursing home was determined and the staff factors influencing propagation were studied by multivariate analysis. A turkey dinner on March 14 was associated with the outbreak (OR 4.22, 95% CI 1.11-16.01). Norovirus genogroups I and II were identified in stool samples. The attack rates in residents, staff and household contacts of staff were 23.49%, 46.22% and 22.87%, respectively. Care assistants and cleaning staff were the staff most frequently affected. Cohabitation with an affected care assistant was the most important factor in the occurrence of cases in the home (adjusted OR 6.37, 95% CI 1.13-36.02). Our results show that staff in close contact with residents and their household contacts had a higher risk of infection during the norovirus outbreak.

Resumen Esta etnografía se realizó en Barcelona, ciudad que ofrece diferentes recursos de ocio homosexual, como las saunas gay. El objetivo fue analizar desde los estudios sobre género y masculinidades, cómo se articula la sexualidad, la percepción sobre la infección por VIH y otras infecciones de transmisión sexual (ITS), y las medidas preventivas en trabajadores sexuales masculinos (TSM) usuarios de saunas gay. Se realizaron 10 entrevistas en profundidad y observación entre 2012 y 2016. Las prácticas de sexo seguro son más frecuentes con clientes, mientras que las de riesgo se realizan más con parejas no comerciales. La orientación sexual juega un rol relevante, los homosexuales asumen más prácticas de riesgo en el trabajo sexual que los heterosexuales. Consumo de drogas o la escasez de redes de apoyo se relacionaron con mayor vulnerabilidad social y conductas de riesgo. Contraer el VIH aún genera miedo, mientras que tener otras ITS se percibe como parte de la vida sexual de un hombre. El TSM afianza una masculinidad con múltiples parejas sexuales, breadwinner y por otra parte, cuestiona un modelo heteronormativo. Las intervenciones para la prevención del VIH e ITS en este colectivo, deberían considerar los determinantes sociales como las precarias alternativas laborales y el ofrecer mayor soporte social.

BACKGROUND:The contacts of people with pulmonary tuberculosis (PTB) have a high risk of becoming infected and developing tuberculosis (TB). Our aim was to determine the incidence of TB and its risk factors in a cohort of contacts with latent TB infection (LTBI) detected through contact tracing of smear-positive PTB cases.METHODS AND FINDINGS:We performed a population-based retrospective cohort study including contacts that had LTBI, and were contacts of people with PTB who started treatment between 2008 and 2014. We followed up contacts until they developed TB or until the end date for follow-up (31st December 2016). We used Kaplan-Meier curves to compute incidence at 2 and 5 years, and Cox regression to compute hazard ratios (HR) and their 95% confidence intervals (CI). We analyzed 3097 close contacts of 565 PTB cases. After exclusion of 81 co-prevalent TB cases, 953 contacts had LTBI, of which 14 developed TB. Their risk of developing TB after two and five years was 0.7% (CI: 0.3-1.6) and 1.8% (CI: 1.1-3.1) respectively. Contacts who had not been referred for LTBI treatment had a 1.0% (CI: 0.2-4.0) risk at 5 years. Risk of developing TB at 5 years was 1.2% (CI: 0.5-3.0) among people who completed treatment, and 11.1% (CI: 5.1-23.3) for those who did not. Risk factors for TB were not completing LTBI treatment (HR 9.4, CI: 2.9-30.8) and being female (HR 3.5, CI: 1.1-11-3).CONCLUSIONS:LTBI treatment plays a fundamental role in decreasing the risk of developing TB. It is necessary to achieve a maximum contact tracing coverage and the highest possible compliance with LTBI treatment.

This ethnography was conducted in Barcelona, a city that provides different gay leisure resources, such as gay saunas. We aimed to analyze from studies on gender and masculinities, how sexuality, perception of HIV infection and other sexually transmitted infections (STIs), and preventive measures are articulated in gay sauna male sex workers (MSW). Ten in-depth interviews and observation were conducted between 2012 and 2016. Safe sex practices are more frequent with clients, while risk practices are carried out more with non-commercial partners. Sexual orientation plays an important role. Homosexuals assume riskier practices in sex work than heterosexuals. Drug use or lack of support networks were associated with higher social vulnerability and risk behaviors. Contracting HIV still creates fear, while having other STIs is perceived as part of a man's sexual life. The MSW affirms masculinity with concurrent sexual partners, breadwinner, and on the other hand, questions a heteronormative model. Interventions for the prevention of HIV and STIs in this group should consider social determinants such as inferior work alternatives and the provision of more significant social support.

INTRODUCTION AND OBJECTIVE:The purpose of this study was to describe the evolution of meningococcal disease (MD) in the city of Barcelona between 1988 and 2015 and to assess the impact of the vaccine against serogroup C.MATERIALS AND METHODOLOGY:The evolution of MD and by serogroup was analysed using the information included in the mandatory notification diseases registry. Incidences of all serogroups between the periods of before and after the implementation of the serogroup C vaccine in 2000 were compared. Vaccination coverage among cases, serogroup among vaccinated cases and mortality and case fatality rates were analysed.RESULTS:MD has evolved from an incidence rate in children aged under 1 of 63.09 cases per 100,000 in 1997-2000 to 15.44 per 100,000 in 2001-2015. All MD serogroups incidences decreased after the implementation of the vaccine, especially for serogroup C among children aged between 1 and 4. Since 2000 vaccine coverage in MD cases by this serogroup was 7.6% while in those affected by serogroup B it was 35.0% (p<.01). Among those vaccinated, 66.4% of cases were serogroup B and 5.2% were C (p<.01). Mortality and case fatality rates were 7.7% and 0.19/100,000 respectively, without significant changes in time regarding case fatality.CONCLUSIONS:Incidence caused by serogroups B and C has decreased after the systematic vaccination against serogroup C. Vaccination against serogroup B could further reduce the impact of this lethal disease which has not decreased during this period.

Introduction and objective: The purpose of this study was to describe the evolution of meningococcal disease (MD) in the city of Barcelona between 1988 and 2015 and to assess the impact of the vaccine against serogroup C. Materials and methodology: The evolution of MD and by serogroup was analysed using the information included in the mandatory notification diseases registry. Incidences of all serogroups between the periods of before and after the implementation of the serogroup C vaccine in 2000 were compared. Vaccination coverage among cases, serogroup among vaccinated cases and mortality and case fatality rates were analysed. Results: MD has evolved from an incidence rate in children aged under 1 of 63.09 cases per 100,000 in 1997-2000 to 15.44 per 100,000 in 2001-2015. All MD serogroups incidences decreased after the implementation of the vaccine, especially for serogroup C among children aged between 1 and 4. Since 2000 vaccine coverage in MD cases by this serogroup was 7.6% while in those affected by serogroup B it was 35.0% (p<.01). Among those vaccinated, 66.4% of cases were serogroup B and 5.2% were C (p<.01). Mortality and case fatality rates were 7.7% and 0.19/100,000 respectively, without significant changes in time regarding case fatality. Conclusions: Incidence caused by serogroups B and C has decreased after the systematic vaccination against serogroup C. Vaccination against serogroup B could further reduce the impact of this lethal disease which has not decreased during this period. (C) 2018 Elsevier Espana, S.L.U. All rights reserved.

The aims of this study were to describe the evolution of acute hepatitis C virus (HCV) infections since 2004 and to determine its associated factors. Acute HCV infections diagnosed in Barcelona from 2004 to 2015 were included. Incidence ratios (IR) were then estimated for sex and age groups. Cases were grouped between 2004-2005, 2006-2011 and 2012-2015, and their incidence rate ratios (IRR) were calculated. In addition, risk factors for acute HCV infection were identified using multinomial logistic regression for complete, available and multiple imputed data. 204 new HCV cases were identified. Two peaks of higher IR of acute HCV infection in 2005 and 2013 were observed. Men and those aged 35-54 had higher IR. IRR for men was 2.9 times greater than in women (95% confidence intervals (CI): 1.8 ‒ 4.7). Factors related to the period 2012-2015 (versus 2006-2011) were: a) sexual risk factor for transmission versus nosocomial (relative-risk ratio (RRR): 13.0; 95% CI: 2.3 ‒ 72.1), b) higher educated versus lower (RRR: 5.4; 95% CI: 1.6 ‒ 18.7), and c) HIV co-infected versus not HIV-infected (RRR: 53.1; 95% CI: 5.7 ‒ 492.6). This is one of the few studies showing IR and RRRs of acute HCV infections and the first focused on a large city in Spain. Sexual risk for transmission between men, higher educational level and HIV co-infection are important factors for understanding current HCV epidemic. There has been a partial shift in the pattern of the risk factor for transmission from nosocomial to sexual.

La retinosis pigmentaria comprende un grupo muy importante de enfermedadesdegenerativas de la retina, dentro del amplio conjunto delas retinopatías hereditarias, para las cuales no existe curación en laactualidad. Las mutaciones en diversas proteínas relacionadas con elmetabolismo de las células fotorreceptoras y el proceso de fototransducciónvisual se encuentran en el origen de esta enfermedad. La rodopsina,fotorreceptor responsable de la absorción de luz y proteínafundamental en las primeras etapas del proceso visual, es una de lasmoléculas más estudiadas de la retina. Las mutaciones en el gen dela opsina son responsables del 25% de todos los casos de la formaautosómica dominante de la retinosis pigmentaria. La reciente cristalizaciónde este receptor en su estado inactivo ha puesto de manifiestonuevos detalles estructurales que permiten avanzar en la comprensiónde los mecanismos intra e intermoleculares en los que laproteína participa como consecuencia de su activación. Asimismo, elestudio in vitro –mediante diversas técnicas espectroscópicas y funcionales–de rodopsinas con mutaciones detectadas previamente enpacientes con retinosis pigmentaria permite entender cuáles debenser los requerimientos estructurales mínimos de la molécula para sufuncionamiento correcto, así como los defectos que subyacen en elmecanismo molecular desencadenante de la muerte de las células fotorreceptoras.En este trabajo se presentan los principales aspectos delas investigaciones realizadas en los últimos años en este campo. Lainformación molecular obtenida ha de facilitar el avance en la obtenciónde posibles soluciones terapéuticas para diversas enfermedadesdegenerativas de la retina, en particular de la retinosis pigmentaria. Re tinitis pigmentosa is a group of retinal degenerative diseases, withinthe broad family of hereditary retinopathies, for which there is no cureat present. Mutations in different genes coding for proteins related tothe metabolism of photoreceptor cells, and to the visual phototransductioncascade, are the cause of this disease. Rhodopsin, the photoreceptorprotein responsible for light absorption--and key in the first stages ofvision--is one of the most studied molecules of the retina. Mutations inthe opsin gene account for about 25% of all cases of autosomal dominantretinitis pigmentosa. Recent crystallization of this receptor in itsinactive dark state has revealed new structural details yielding furtherinsights into the intra and intermolecular mechanisms in which the proteinis involved as a result of its activation. Furthermore, the in vitrostudy of recombinant rhodopsins carrying mutations previously found inretinitis pigmentosa patients (by means of spectroscopic and functionaltechniques) has shed new light on the structural requirements for itscorrect function, as well as the molecular defects underlying the mechanismof photoreceptor cell death. In this study, the main findingsof the recent investigations carried out in this field are presented. Therelevant information obtained at the molecular level is bound to facilitateour understanding of the molecular processes that will allow suitabletherapies for different retinal degenerative diseases, particularly retinitispigmentosa, to be proposed.

Detergent-solubilized bovine rhodopsin produces mixed detergent/lipid/protein micelles. The effect of dodecyl maltoside detergent on the thermal stability of dark-state rhodopsin, and upon formation of the different intermediates after rhodopsin photobleaching (metarhodopsin II and metarhodopsin III), and upon transducin activation has been studied. No significant effect is observed for the thermal stability of dark-state rhodopsin in the range of detergent concentrations studied, but a decrease in the stability of metarhodopsin II and an increase in metarhodopsin III formation is observed with decreasing detergent concentrations. The transducin activation process is also affected by the presence of detergent indicating that this process is dependent on the lipid micro-environment and membrane fluidity, and this stresses the importance of the native lipid environment in rhodopsin normal function.

Point mutations found in rhodopsin associated with the retinal degenerative disease retinitis pigmentosa have been expressed in mammalian COS-1 cells, purified, and characterised. The mutations characterised-most of them for the first time-have been Met44Thr, Gly114Asp, Arg135Leu, Val137Met, and Pro171Leu in the transmembrane domain; Leu328Pro and Ala346Pro in the C-terminal tail of the cytoplasmic domain; and Gly106Trp in the intradiscal domain. Several of these mutations cause misfolding which results in impaired 11-cis-retinal binding. Two of them, Met44Thr and Val137Met, show spectral and structural features similar to those of wild type rhodopsin (Type I mutants) but significantly increased transducin initial activation rates. We propose that, in the case of these mutants, abnormal functioning resulting in faster activation kinetics could also play a role in retinitis pigmentosa by altering the stoichiometric balance of the different proteins involved in the phototransduction biochemical reactions.

Retinitis pigmentosa is a group of retinal degenerative diseases, within the broad family of hereditary retinopathies, for which there is no cure at present. Mutations in different genes coding for proteins related to the metabolism of photoreceptor cells, and to the visual phototransduction cascade, are the cause of this disease. Rhodopsin, the photoreceptor protein responsible for light absorption--and key in the first stages of vision--is one of the most studied molecules of the retina. Mutations in the opsin gene account for about 25% of all cases of autosomal dominant retinitis pigmentosa. Recent crystallization of this receptor in its inactive dark state has revealed new structural details yielding further insights into the intra and intermolecular mechanismsin which the protein is involved as a result of its activation.Furthermore, the in vitro study of recombinant rhodopsins carrying mutations previously found in retinitis pigmentosa patients (by means of spectroscopic and functional techniques) has shed new light on the structural requirements for its correct function, as well as the molecular defects underlying the mechanism of photoreceptor cell death. In this study, the main findings of the recent investigations carried out in this field are presented. The relevant information obtained at the molecular level is bound to facilitate our understandingof the molecular processes that will allow suitable therapiesfor different retinal degenerative diseases, particularly retinitis pigmentosa, to be proposed.

Mutation of L125R in trasmembrane helix III of rhodopsin, associated with the retinal degenerative disease retinitis pigmentosa, was previously shown to cause structural misfolding of the mutant protein. Also, conservative mutations at this position were found to cause partial misfolding of the mutant receptors. We report here on a series of mutations at position 125 to further investigate the role of Leu125 in the correct folding and function of rhodopsin. In particular, the effect of the size of the substituted amino‐acid side chain in the functionality of the receptor, measured as the ability of the mutant rhodopsins to activate the G protein transducin, has been analysed. The following mutations have been studied: L125G, L125N, L125I, L125H, L125P, L125T, L125D, L125E, L125Y and L125W. Most of the mutant proteins, expressed in COS‐1 cells, showed reduced 11‐cis‐retinal binding, red‐shifts in the wavelength of the visible absorbance maximum, and increased reactivity towards hydroxylamine in the dark. Thermal stability in the dark was reduced, particularly for L125P, L125Y and L125W mutants. The ability of the mutant rhodopsins to activate the G protein transducin was significantly reduced in a size dependent manner, especially in the case of the bulkier L125Y and L125W substitutions, suggesting a steric effect of the substituted amino acid. On the basis of the present and previous results, Leu125 in transmembrane helix III of rhodopsin, in the vicinity of the β‐ionone ring of 11‐cis‐retinal, is proposed to be an important residue in maintaining the correct structure of the chromophore binding pocket. Thus, bulky substitutions at this position may affect the structure and signallling of the receptor by altering the optimal conformation of the retinal binding pocket, rather than by direct interaction with the chromophore, as seen from the recent crystallographic structure of rhodopsin.