Dr. Josep Vidal-Alaball

Josep Vidal i Alaball berguedà actual 11/10/07 La grip és una malaltia infecciosa vírica de les vies respiratòries molt contagiosa. Es calcula que entre el 5% i el 20% de la població general i fins el 50% o més de les persones internades en institucions tancades emmalalteix de grip cada any. Això dóna lloc a un important nombre de consultes mèdiques i dies laborables perduts com a conseqüència de la malaltia i la seva convalescència, que pot oscil·lar entre dies i setmanes. La grip pot ser mortal, principalment en persones grans o amb factors de risc preexistents. A diferència d’altres virus com el de l’hepatitis B o xarrampió, el virus de la grip varia les seves característiques amb facilitat, per això les vacunes s’han d’elaborar cada temporada i cal que ens vacunem cada any.

Josep Vidal i Alaball berguedà actual 11/10/07 El sistema mèdic aconsella la vacunació a col·lectius de risc com: persones grans, malalts respiratoris i professionals exposats El dia 1 d’octubre va començar la campanya de vacunació antigripal a Catalunya que s’allargarà fins al 30 de novembre de 2007. Les vacunes estan disponibles de forma gratuïta en els centres d’atenció primària de la nostra comarca. La temporada 2005-2006 es van distribuir a Catalunya 1.336.507 vacunes als centres d’atenció primària i altres centres vacunals de Catalunya, això va suposar un 70,2% de les persones susceptibles de vacunació. La vacunació antigripal està adreçada principalment a les persones que tenen un alt risc de complicacions si pateixen la grip com són: persones de 60 anys d’edat o més, persones internades en institucions tancades (residències geriàtriques, centres de malalties cròniques i malalties mentals, etc), adults i infants amb malalties pulmonars (inclòs l’asma) o cardiovasculars cròniques...

Josep Vidal i Alaball Bergueda Actual Es poden analitzar les passades eleccions municipals del 27 de maig a Berga de moltes maneres i en moltes claus diferents; la pèrdua de l’Alcaldia quasi segura per part del PSC i la recuperació de la mateixa per CiU, l’irrupció de la CUP, la davallada d’ERC, el nou fracàs d’Iniciativa per Catalunya per ser representada a l’ajuntament de la ciutat .... Jo però les voldria valorar des d’un altre punt de vista ja que crec que aquestes eleccions municipals a Berga han representat un canvi generacional per als polítics berguedans. Si es confirma la notícia que en Ramon Camps no continuarà com a líder del PSC de Berga, desapareixerà l’últim dels tres grans protagonistes de la vida política que en la meva opinió ha tingut Berga en els darrers 25 anys juntament amb en Jaume Farguell i en Josep Badia. Si en Farguell va ser apartat de l’ajuntament l’any 1999, fa uns mesos l’hi va tocar el torn a en Badia que ja no va ser present a les llistes de CiU. Això h...

Per Josep Vidal i Alaball He tornat a viure a Berga després de molts anys d'estar a la Gran Bretanya. És evident que la ciutat ha canviat molt en el últims anys i per això m'he proposat escriure de manera més o menys periòdica al Berguedà Actual per descriure els canvis que he trobat la la meva ciutat i també a la comarca en general. La meva intenció inicial no és la de ser crític amb la ciutat i la comarca però la condició humana sempre tendeix a notar més les coses negatives que les positives. També és cert que quan es veuen més els problemes és quan fa un temps que no vius en un lloc, quan els pateixes diàriament ja t’hi acostumes. Em volia estrenar amb un tema polèmic; la circulació viària a Berga. Com ha empitjorat el trànsit a Berga en els últims 10 anys és una de les coses que m'han xocat més des de que he tornat. Fa uns anys era impensable haver de fer 10 o 15 minuts de cua en una cruïlla de la ciutat, però ara això és una norma que es repeteix cada matí i cada tard...

Per Josep Vidal i Alaball (metge) Ja son uns quants els països, principalment europeus, que han prohibit fumar en els llocs públics. A la Gran Bretanya, Escòcia ho va fer el març passat i l'any vinent tenen previst fer-ho Anglaterra i Gal.les. Aquestes prohibicions han fet renéixer un debat interessant sobre on comença i on acaba la llibertat personal per fumar, beure o menjar aliments que perjudiquen la salut. Els auto-anomenats "llibertaris" creuen que tothom te el dret a fer el que vulgui amb la seva salut i que ningú t'ha de dir el que pots menjar, veure o si pots fumar o no. Creuen fermament que la llibertat personal està per sobre de qualsevol altre consideració. A l'altre costat de l'argument hi han els quins creuen que cal evitar que la gent tingui estils de vida que se sap que perjudicaran la seva salut. Creuen que els governs han d'intervenir per tal de crear les condicions necessàries perquè la població ho tingui més fàcil per assolir estils de ...

Eur J Gen Pract. 2006;12(4):169-73. Vidal-Alaball J , Butler CC , Potter CC . National Public Health Service for Wales, Swansea, UK, Wales. Objective: To establish whether savings could be made by changing patients from intramuscular to high doses of oral vitamin B12 in primary care without compromising their wellbeing. Methods: Cost-minimization analysis from a UK perspective, using secondary data obtained from the literature available and expert opinion. Results: The cost of the resources used to treat patients with vitamin B12 deficiency with intramuscular vitamin B12 was calculated as between pound55.99 (euro83.1) and pound99.99 (euro148.5) per year. The cost of treating patients with high doses of oral vitamin B12 during the first year was between pound125.55 (euro186.5) and pound248.55 (euro369.1). However, once patients receiving intramuscular treatment had been converted to oral treatment, or in new patients treated orally from the outset, the cost was pound35.55 per year (eu...

EXPERT'S WARNING ON WARSHIP ILLNESS 02 September 2006 An expert in public health has warned that more potentially deadly illnesses on a front-line warship could follow after two further cases of active tuberculosis (TB) were diagnosed on a Westcountry-based vessel. The Ministry of Defence (MoD) has confirmed that five crew members of HMS Ocean, the Devonport-based amphibious helicopter carrier and assault ship, now have the infectious form of the disease after TB first emerged in May. The unidentified crewmen have been prescribed with up to six months of antibiotics to keep the life-threatening illness under control. The MoD last night said that all five cases of active TB were confined to the marine engineering department, which is responsible for mechanics and electrics. Fifty-five latent forms of the illness emerged on board following a screening process of the entire crew. The latent form produces no symptoms and is not contagious, as the bacteria are not active, although they ...

Eurosurveillance weekly releases 2006 > Volume 11 / Issue 9 J Vidal-Alaball ( Josep.Vidal-Alaball@nphs.wales.nhs.uk ), S Hayes, R Jones National Public Health Service for Wales, Health Protection Team, Mid and West Wales Region, Swansea, United Kingdom On 10 February 2004, the specialist respiratory nurse for a hospital in a city in South Wales alerted the local health authorities that Mycobacterium tuberculosis infections in a particular area of the city appeared to be higher than expected in a relatively young age group. All the cases were in patients who reported visiting a particular pub (bar) regularly. As a result of this alert, an outbreak investigation team compiled an initial list of six possible associated cases in five men and one woman who were aged between 25 and 55 years and all lived in the city. Initial interviews established that there were many shared social links between the patients, who were part of a network of regular drinkers at four pubs in a suburb of the ...

28/07/06 Disorders of Erythropoiesis • Brief Report Andrew Goringe, Richard Ellis, Ian McDowell, Josep Vidal-Alaball , Christopher Jenkins, Christopher Butler, Mark Worwood Treatment of B12 deficiency is important to prevent progressive neurological and/or hematologic disease but requires a secure diagnosis. The aim of this study was to evaluate second line tests of B12 status as prognostic indicators of a hematologic response to vitamin B12 therapy. Forty-nine patients referred with low, serum vitamin B12 concentrations were treated with intramuscular B12 and re-assessed after 3 months. Methylmalonic acid, homocysteine, holotranscobalamin and neutrophil hypersegmentation index were measured before and after treatment. Before treatment 27/49 patients were anemic or macrocytic of whom 15 had a clear hematologic response. All the tests had a similar prognostic accuracy. Symptomatic improvement did not correlate with hematologic response. Supplementary tests of vitamin B12 status were not...

Wednesday, 10 August 2005 From The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd. All rights reserved. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency (Cochrane Review) Vidal-Alaball J, Butler CC, Cannings-John R, Goringe A, Hood K, McCaddon A, McDowell I, Papaioannou A ABSTRACT Background : Vitamin B12 deficiency is common and rises with age. Most people with vitamin B12 deficiency are treated in primary care with intramuscular vitamin B12 which is a considerable source of work for health care professionals. Several case control and case series studies have reported equal efficacy of oral administration of vitamin B12 but it is rarely prescribed in this form, other than in Sweden and Canada. Doctors may not be prescribing oral formulations because they are unaware of this option or have concerns regarding effectiveness. Objectives: To assess the effectiveness of oral vitamin B12 versus intramuscular vitamin B12 for vitamin B1...

Dr Josep Vidal-Alaball Public Health Medicine July 2006 Risk Communication • Is an interactive process of exchange of information • People’s fears should be taken seriously and steps should be taken to address them even if they are not necessary from a technical perspective • Management of Environmental Health issues requires more than technical expertise. Social issues such as house prices, house ownership or stigma of the neighbourhood are also important and should be considered from day one Risk perception • Clearly, emotions play a large role in public perception of risk • When people become aware of a threat, they are naturally inclined to: – Fear the unknown – Want to maintain control – Protect home and family – Be alienated by dependence on others (government, industry officials) – Protect their belief in a just world • Experts and responsible authorities often think that the perception of the public is mistaken and irrational. • They then try to correct the mistaken perception ...

Cochrane Library, reproduced with permission Butler CC, Vidal-Alaball J, Cannings-John R, McCaddon A, Hood K, Papaioannou A, McDowell I and Goringe A. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: a systematic review of randomized controlled trials. Family Practice 2006; Pages 1–7 of 7. Background . Vitamin B12 deficiency is common, increasing with age. Most people are treated in primary care with intramuscular vitamin B12. Several studies have reported equal efficacy of oral administration of vitamin B12. Objectives . We set out to identify randomized controlled trial (RCT) evidence for the effectiveness of oral versus intramuscular vitamin B12 to treat vitamin B12 deficiency. Methods . We conducted a systematic review searching databases for relevant RCTs. Outcomes included levels of serum vitamin B12, total serum homocysteine and methylmalonic acid, haemoglobin and signs and symptoms of vitamin B12 deficiency. Results . Two RCTs comparing oral with in...

Dr Josep Vidal-Alaball 2005 Who is it for? GPs and any doctor with an interest in family planning. When did you do it? In 2002, during my GP registrar year. Why did you do it? In general practice we see many patients wanting advice on family planning and I wanted to have a diploma certifying my proficiency in this specialty. I like the way the diploma is assessed—it requires practical and theoretical training. How much effort did it entail? The diploma has two components; a basic theoretical course and a practical training. There are several approved courses available around the country, which take place over three consecutive days. You organise your own practical training, which needs to be supervised by a faculty approved instructing doctor. Is there an exam? (and fee) No, this is the great thing about the DFFP; no exam is required to obtain the diploma. There is a fee to go to the theoretical course and you may need to pay a small fee to attend practical training. Top tip Book yo...

Friday, 02 April 2004 I am in favour of Appraisal and Continuous Professional Development for health care professionals but I also strongly believe that any intervention in Health Services needs to be evaluated. The efficacy of Revalidation and Appraisal needs to be evaluated moreover when this is going to be an expensive intervention. I was surprised to find very vague references about evaluation on the Department of Health web side mainly regarding at the number of doctors appraised and the quality of the process. In a discussion group during one session of the Masters of Public Health at the UWCM in Cardiff I asked how we could possible evaluate Revalidation and Appraisal. We though that it is difficult to evaluate an intervention when the objectives of the intervention are not clear. According to the objectives of the intervention we can design a correct evaluation. Looking at the numbers of doctors appraised and revalidated is a measure of activity but not a measure of outcome of ...