SAS - Hospital San Agustín

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A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.
(2018-02-23) Fernández, Anna; Mendive, Juan M; Conejo-Cerón, Sonia; Moreno-Peral, Patricia; King, Michael; Nazareth, Irwin; Martín-Pérez, Carlos; Fernández-Alonso, Carmen; Rodríguez-Bayón, Antonina; Aiarzaguena, Jose Maria; Montón-Franco, Carmen; Serrano-Blanco, Antoni; Ibañez-Casas, Inmaculada; Rodríguez-Sánchez, Emiliano; Salvador-Carulla, Luis; Garay, Paola Bully; Ballesta-Rodríguez, María Isabel; LaFuente, Pilar; Del Mar Muñoz-García, María; Mínguez-Gonzalo, Pilar; Araujo, Luz; Palao, Diego; Gómez, María Cruz; Zubiaga, Fernando; Navas-Campaña, Desirée; Aranda-Regules, Jose Manuel; Rodriguez-Morejón, Alberto; de Dios Luna, Juan; Bellón, Juan Ángel
Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated. ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.
A virtual reality approach to the Trier Social Stress Test: Contrasting two distinct protocols.
(2016) Montero-López, Eva; Santos-Ruiz, Ana; García-Ríos, M Carmen; Rodríguez-Blázquez, Raúl; Pérez-García, Miguel; Peralta-Ramírez, María Isabel
Virtual reality adaptations of the Trier Social Stress Test (TSST-VR) constitute useful tools for studying the physiologic axes involved in the stress response. Here, we aimed to determine the most appropriate experimental approach to the TSST-VR when investigating the modulation of the axes involved in the stress response. We compared the use of goggles versus a screen projection in the TSST-VR paradigm. Forty-five healthy participants were divided into two groups: the first one (goggles condition; 13 females, 11 males) wore goggles while performing the TSST-VR; the second (screen condition; 15 females, six males) was exposed to the TSST-VR projected on a screen. Sympathetic reactivity to stress was measured by continuously recording skin conductance (SC), while the hypothalamic-pituitary-adrenal axis (HPA) was evaluated by sampling salivary cortisol throughout the experiment. At the end of the task, there was an increase in SC and cortisol level for both means of delivering the TSST-VR, although the increase in SC was greater in the goggles condition, while salivary cortisol was comparable in both groups. Immersion levels were reportedly higher in the screen presentation than in the goggles group. In terms of sex differences, females experienced greater involvement and spatial presence, though comparatively less experienced realism, than their male counterparts. These findings help us determine which protocol of the TSST-VR is most suitable for the stress response under study. They also emphasize the need to consider the sex of participants, as males and females show distinct responses in each protocol.
[Accomplishment of preventive activities proposed by resident doctors of Family Medicine in Primary Care and its relationship with communication skills].
(2019-06-04) Zafra-Ramírez, Natalia; Pérez-Milena, Alejandro; Valverde-Bolívar, Francisco Javier; Rodríguez-Bayón, Antonina; Delgado-Rodríguez, Miguel
To determine the offer of preventive activities by resident physicians of family medicine in the Primary Care consultations and the relation with their communication habilities. A descriptive multicentre study assessing medical consultations video recording. Eight Primary Healthcare centres in Jaen (Andalucia). Seventy-three resident physicians (4th year) filmed and observed with patients. Offer of preventive activities (according to the Spanish Program of Preventive Activities and Health Promotion -PAPPS-). Doctor, patient and consultation characteristics. Peer-review of the communication between physicians and patients, using a CICAA scale. A descriptive, bivariate, logistic regression analysis was performed. Two hundred and sixty interviews were evaluated (duration 8.5±4.0min) of 73 residents (50.7% women, mean age 32.9±7.7 years, 79% urban environment). The patient is more frequently a woman (60%) who comes alone (72%) due to acute processes (80%) and with 2.1±1.0 demands. Preventive activities are offered in 47% (duration less than one minute) of primary (70%) and secondary (59%) prevention, offered through advice (72%) or screening (52%) and focused on the cardiovascular area (52%) and lifestyles (53%). Eighty percent related to the patient's reason for consultation. Communication skills 41% improvable, 26% adequate, 23% excellent. The offer of preventive activities is related to the duration of the consultation (OR=1.1, 95% CI 1.01; 1.16) and communication skills (OR=1.03, 95% CI 1.01; 1.10). Preventive activities are carried out in almost half of the consultations, although focused on advice and screening and linked to the patient's demand. Consultation time and communication skills favor a greater preventive offer.
Actividad asistencial en Unidades de Salud Bucodental del Servicio Andaluz de Salud durante la desescalada del SARS-CoV-2
(Ministerio de Sanidad, Consumo y Bienestar Social, 2020-06-03) Expósito Delgado, Antonio; Visuerte Sánchez, José Manuel; Soto Ibarreta, María Teresa; Hernández Nieto, Josefina; Cerviño Ferradanes, Santiago; [Expósito Delgado,A] Centro Salud Virgen de Linarejos. Área Gestión Sanitaria Norte de Jaén. Linares (Jaén). España. [Visuerte Sánchez,JM] Unidad Funcional Pacientes con Discapacidad Hospital San Carlos. Distrito Sanitario Bahía de Cádiz La Janda. San Fernando (Cádiz). España. [Soto Ibarreta,MT] Centro Salud Cantillana. Distrito Sanitario Sevilla Norte. Cantillana (Sevilla). España. [Hernández Nieto,J] Centro Periférico de Especialidades Bola Azul. Distrito Sanitario Almería. Almería. España. [Cerviño Ferradanes,S] Centro de Salud La Laguna. Distrito Sanitario Bahía de Cádiz-La Janda. Cádiz. España.
The pandemic declared by SARS-CoV-2 has meant a crisis in the health system that forced the urgent implementation of preventive public health measures. The respiratory transmission virus remains stable on surfaces, being able to spread by air in respiratory droplets or in procedures that generate aerosols. Dental activity is one of the professional sectors with the highest exposure index, both due to the generation of aerosols in most interventions, as well as the impossibility of maintaining a safe distance between patients and professionals. The postponement of scheduled and non-urgent healthcare activities in dental offices is one of the measures implemented to reduce the risk that it posed for the health and well-being of citizens. This report addresses the recommendations and measures to be taken into account to minimize risks in the Oral Health Units of the Andalusian Public Health System, to address the oral pathology of the population assigned in the scenario of improvement of the pandemic and its partial lack of confinement.
[Adaptation and validation of an instrument to evaluate the competence on a Brief Tobacco Intervention. BTI-Prof©].
(2022-10-27) Ramos-Morcillo, Antonio Jesús; García-Moral, Ana Teresa; Fernández-Salazar, Serafín; Leal-Costa, César; Ruzafa-Martínez, María; Granero-Moya, Nani
Adaptation and validation of the BTI-St© to assess the level of competence in brief tobacco intervention in general practitioners and nurses in Primary Health Care. Cross-sectional study of adaptation and psychometric validation of a criterion-referenced test. Primary Health Care. One hundred fifty-five general practitioners and nurses working at Primary Health Care. Three clinical scenarios were designed. Using an online platform, participants first viewed each scenario in which brief tobacco intervention was given. Health professional had to assess whether or not the scenarios were carried out in accordance with the 5A+5R model. Competence in brief tobacco intervention measured by the BTI-Prof©. Results related to reliability were obtained through Kuder-Richardson coefficient, being for scenario 1, 0.880, for scenario 2, 0.829, and for scenario 3, 0.826. The test-retest shows adequate temporal stability: intraclass correlation coefficient for scenario 1 0.857 (95% CI 0.734-0.923), p The BTI-Prof© is a robust tool with adequate psychometric properties to assess competence in brief tobacco intervention in Primary Health Care general practitioners and nurses.
Analyses of hair and salivary cortisol for evaluating hypothalamic-pituitary-adrenal axis activation in patients with autoimmune disease.
(2017-08-30) Montero-López, Eva; Santos-Ruiz, Ana; González, Raquel; Navarrete-Navarrete, Nuria; Ortego-Centeno, Norberto; Martínez-Augustín, Olga; Rodríguez-Blázquez, Manuel; Peralta-Ramírez, María Isabel
Although many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic-pituitary-adrenal axis (HPA), controversial results have been described. Our objective was to study HPA axis activity in women with autoimmune disease compared to healthy women. Therefore, we analyzed salivary cortisol over the course of a day, and hair cortisol concentrations from the three preceding months, from 65 women divided into two groups: healthy women (n = 30), with a mean age of 44.70 ± 11.65 years; and women with autoimmune disease (n = 35), with a mean age of 48.26 ± 9.04 years. The latter group comprises women with systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and systemic sclerosis (SSc). Perceived stress and psychopathological symptomatology were also evaluated. Autoimmune disease group scored higher on the somatization subscale SCL-90-R and lower on the anxiety subscale than the control group. Regarding HPA axis activation, the area under curve for cortisol levels during the day was higher for the autoimmune disease group. In addition, higher cortisol levels in hair were found in the group with autoimmune disease. Our findings show greater short and long-term HPA axis activity in women with autoimmune disease than in healthy women.
Anatomy variant symptomatic of the duplication of the common bile duct type IV.
(2020) Alberca-Páramo, Ana; García-Santos, Esther Pilar; Padilla-Valverde, David; Villarejo-Campos, Pedro; Estaire-Gómez, Mercedes; Fernández, Jesús Martín
Duplicity of the common bile duct (BCBD) is an unusual congenital disorder. A 80-year-old woman with duplication of the common bile duct with retrograde endoscopic cholangiopancreatography (ERCP) who did not resolve the symptoms. Our case is a variant of type IV to the classification of DCBC. The MR cholangiography and presurgical ERCP allows assessment of the bile ducts, their caliber, and assessment of abnormalities. The treatment before DCBC will depend on the clinic and the type of opening of the CBCA. It is important to perform a pre-surgical study and during surgery with CIO.
Assessment of body composition and prognosis in chronic heart failure. Beyond the "obesity paradox''
(Inst nacional cardiologia ignacio chavez, 2016-10-01) Luis Gamez-Lopez, Antonio; Luis Bonilla-Palomas, Juan; Cristina Lopez-Ibanez, Maria; Moreno-Conde, Mirian; Anguita-Sanchez, Manuel; Villar-Raez, Antonia; [Luis Gamez-Lopez, Antonio] Hosp San Juan de la Cruz, Serv Med Interna, Area Cardiol, Jaen, Spain; [Luis Bonilla-Palomas, Juan] Hosp San Juan de la Cruz, Serv Med Interna, Area Cardiol, Jaen, Spain; [Cristina Lopez-Ibanez, Maria] Hosp San Juan de la Cruz, Serv Med Interna, Jaen, Spain; [Moreno-Conde, Mirian] Hosp San Juan de la Cruz, Serv Med Interna, Jaen, Spain; [Villar-Raez, Antonia] Hosp San Juan de la Cruz, Serv Med Interna, Jaen, Spain; [Anguita-Sanchez, Manuel] Hosp Univ Reina Sofia, Unidad Gest Clin Cardiol, Cordoba, Spain
Objective: It is unknown the influence of body composition in the inverse relationship of mortality with overweight and obesity in heart failure patients.Methods: 234 patients with chronic heart failure were evaluated. Body mass index, tricipital skinfold thickness, brachial muscle circumference and body fat percentage determined by bioelectrical impedance analysis were measured. The influence of previous anthropometric variables on total mortality was analyzed.Results: Mean follow-up was 21 +/- 10.7 months. We observed an inverse relationship of total mortality with body mass index (hazard ratio =0.91, 95% confidence interval, 0.87-0.96; P
Atención al trauma grave en el embarazo: documento de apoyo.
(Consejería de Salud y Consumo, 2024) Guerrero López, Francisco; Fernández Gutiérrez, Beatriz; Alkourdi Martínez, Amira; Angulo González, Diego M.; Aranda Narváez, José Manuel; Colmena de Celis, Belén; Fuentes Fernández, M. Andrea; Mayor García, Dolores María; Navarrete Jiménez, Juan de Dios; Pérez Díaz, Mario Jesús; Serrano Carmona, José Luis; Vega Reyes, Juan Antonio; Forcada Falcón, Mercedes; [Guerrero López,F; Alkourdi Martínez,A; Navarrete Jiménez,JD] Hospital Universitario Virgen de las Nieves, Granada.; [Fernández Gutiérrez,B] AGS Axarquía. Málaga; [Angulo González,DM] Hospital Universitario Virgen del Rocío. Sevilla.; [Aranda Narváez,JM] Hospital Regional Universitario de Málaga. Málaga.; [Colmena de Celis,B; Pérez Díaz,MJ] Centro de emergencias sanitarias 061. Sevilla; [Fuentes Fernández,MA] Hospital Universitario San Agustín de Linares. Jaén; [Mayor García,DM] Hospital Universitario Torrecárdenas. Almería; [Serrano Carmona,JL; Vega Reyes,JA] Hospital Universitario Reina Sofía. Córdoba; [Forcada Falcón,M] Consejería de Salud y Consumo. Sevilla.
Para recoger recomendaciones de buena práctica clínica en relación al manejo de las mujeres embarazadas con trauma grave o potencialmente grave que ayuden en la toma de decisiones clínicas que disminuyan la variabilidad no justificada en la práctica clínica y consigan una atención de calidad desde el principio del proceso asistencial se plantea este documento de apoyo.
Breastfeeding experiences during the COVID-19 pandemic in Spain:a qualitative study.
(2022-02-22) Rodríguez-Gallego, Isabel; Strivens-Vilchez, Helen; Agea-Cano, Irene; Marín-Sánchez, Carmen; Sevillano-Giraldo, María Dolores; Gamundi-Fernández, Concepción; Berná-Guisado, Concepción; Leon-Larios, Fatima
The pandemic caused by COVID-19 has affected reproductive and perinatal health both through the infection itself and, indirectly, as a consequence of changes in medical care, social policy or social and economic circumstances. The objective of this study is to explore the impact of the pandemic and of the measures adopted on breastfeeding initiation and maintenance. A qualitative descriptive study was conducted by means in-depth semi-structured interviews, until reaching data saturation. The study was conducted between the months of January to May 2021. Participants were recruited by midwives from the Primary Care Centres of the Andalusian provinces provinces of Seville, Cádiz, Huelva, Granada, and Jaén. The interviews were conducted via phone call and were subsequently transcribed and analysed by means of reflexive inductive thematic analysis, using Braun and Clarke's thematic analysis. A total of 30 interviews were conducted. Five main themes and ten subthemes were developed, namely: Information received (access to the information, figure who provided the information), unequal support from the professionals during the pandemic (support to postpartum hospitalization, support received from Primary Health Care during the postpartum period), social and family support about breastfeeding (support groups, family support), impact of confinement and of social restriction measures (positive influence on breastfeeding, influence on bonding with the newborn), emotional effect of the pandemic (insecurity and fear related to contagion by coronavirus, feelings of loneliness). The use of online breastfeeding support groups through applications such as WhatsApp®, Facebook® or Instagram® has provided important breastfeeding information and support sources. The main figure identified that has provided formal breastfeeding support during this period was that of the midwife. In addition, the social restrictions inherent to the pandemic have exerted a positive effect for women in bonding and breastfeeding, as a consequence of the increase in the time spent at their homes and in the family nucleus co-living.
Clinical characterization of brief psychotic disorders triggered by the COVID-19 pandemic: a multicenter observational study.
(2021-04-03) Valdés-Florido, María José; López-Díaz, Álvaro; Palermo-Zeballos, Fernanda Jazmín; Garrido-Torres, Nathalia; Álvarez-Gil, Paula; Martínez-Molina, Iván; Martín-Gil, Victoria Eugenia; Ruiz-Ruiz, Elena; Mota-Molina, Macarena; Algarín-Moriana, María Paz; Guzmán-Del Castillo, Antonio Hipólito; Ruiz-Arcos, Ángela; Gómez-Coronado, Rafael; Galiano-Rus, Sara; Rosa-Ruiz, Alfonso; Prados-Ojeda, Juan Luis; Gutierrez-Rojas, Luis; Crespo-Facorro, Benedicto; Ruiz-Veguilla, Miguel
This study aimed to characterize the clinical profile of patients with brief psychotic disorders (BPD) triggered by the psychosocial distress derived from the COVID-19 crisis. A multicenter study was conducted from March 14 to May 14, 2020 (the peak weeks of the pandemic in Europe). All consecutive patients presenting non-affective psychotic episodes with a duration of untreated psychosis of less than 1 month and whose onset was related to the COVID-19 crisis were recruited, but only those patients meeting Diagnostic Statistical Manual 5th edition (DSM-5) criteria for "BPD with marked stressors" (DSM-5 code: 298.8) during follow-up were finally included. Patients' sociodemographic and clinical characteristics were collected at baseline and summarized with descriptive statistics. During the study period, 57 individuals with short-lived psychotic episodes related to the emotional stress of the COVID-19 pandemic were identified, of whom 33 met DSM-5 criteria for "BPD with marked stressors". The mean age was 42.33 ± 14.04 years, the gender distribution was almost the same, and the majority were rated as having good premorbid adjustment. About a quarter of the patients exhibited suicidal symptoms and almost half presented first-rank schizophrenia symptoms. None of them were COVID-19 positive, but in more than half of the cases, the topic of their psychotic features was COVID-19-related. The coronavirus pandemic is triggering a significant number of BPD cases. Their risk of suicidal behavior, their high relapse rate, and their low temporal stability make it necessary to closely monitor these patients over time.
Clinical Features, Familial History, and Migraine Precursors in Patients With Definite Vestibular Migraine: The VM-Phenotypes Projects.
(2017-12-04) Teggi, Roberto; Colombo, Bruno; Albera, Roberto; Asprella Libonati, Giacinto; Balzanelli, Cristiano; Batuecas Caletrio, Angel; Casani, Augusto; Espinoza-Sanchez, Juan Manuel; Gamba, Paolo; Lopez-Escamez, Jose A; Lucisano, Sergio; Mandalà, Marco; Neri, Giampiero; Nuti, Daniele; Pecci, Rudy; Russo, Antonio; Martin-Sanz, Eduardo; Sanz, Ricardo; Tedeschi, Gioacchino; Torelli, Paola; Vannucchi, Paolo; Comi, Giancarlo; Bussi, Mario
The aim of this work was to assess through a questionnaire the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors in a sample of 252 subjects with a diagnosis of definite vestibular migraine. Migraine is a common neurological disorder characterized by episodic headaches with specific features. About two-thirds of cases run in families, and patients may refer symptoms occurring in infancy and childhood, defined as episodic syndromes that may be associated with migraine. Migraine is associated with episodic vertigo, called vestibular migraine, whose diagnosis mainly relies on clinical history showing a temporary association of symptoms. In this cross-sectional multicentric study, 252 subjects were recruited in different centers; a senior specialist through a structured questionnaire assessed features of vestibular symptoms and accompanying symptoms. The age of onset of migraine was 23 years, while onset of vertigo was at 38 years. One hundred and eighty-four subjects reported internal vertigo (73%), while 63 subjects (25%) reported external vertigo. The duration of vertigo attacks was less than 5 minutes in 58 subjects (23%), between 6 and 60 minutes in 55 (21.8%), between 1 and 4 hours in 29 (11.5%), 5 and 24 hours in 44 (17.5%), up to 3 days in 14 (5.5%), and more than 3 days in seven (2.8%); 14 subjects (5.5%) referred attacks lasting from less than 5 minutes and up to 1 hour, nine (3.6%) referred attacks lasting from less than 5 minutes and up to 1 to 4 hours, six (2.4%) referred attacks lasting from less than 5 minutes and up to 5 to 24 hours, and five (2%) cases referred attacks lasting from less than 5 minutes and up to days. Among accompanying symptoms, patients referred the following usually occurring, in order of frequency: nausea (59.9%), photophobia (44.4%), phonophobia (38.9%), vomiting (17.8%), palpitations (11.5%), tinnitus (10.7%), fullness of the ear (8.7%), and hearing loss (4%). In total, 177 subjects referred a positive family history of migraine (70.2%), while 167 (66.3%) reported a positive family history of vertigo. In the sample, 69% of patients referred at least one of the pediatric precursors, in particular, 42.8% of subjects referred motion sickness. The age of onset of the first headache was lower in the subsample with a familial history of migraine than in the total sample. Among the pediatric precursors, benign paroxysmal vertigo - BPV, benign paroxysmal torticollis, and motion sickness were predictive of a lower age of onset of vertigo in adulthood; cyclic vomiting was predictive for vomiting during vertigo attacks in adults. Our results may indicate that vestibular symptoms in pediatric patients may act as a predisposing factor to develop vestibular migraine at an earlier age in adulthood.
Communication skills of tutors and family medicine physician residents in Primary Care clinics
(Ediciones doyma s a, 2016-12-01) Valverde Bolivar, Francisco Javier; Pedregal Gonzalez, Miguel; Perez Fuentes, Maria Francisca; Alcalde Molina, Maria DoloreS; Torio Durantez, Jesus; Delgado Rodriguez, Miguel; [Valverde Bolivar, Francisco Javier] Dist Sanitario Jaen Jaen Sur, Teaching Unit Family & Community Med Jaen, Ave Ejercito Espanol 10, Jaen 23007, Spain; [Valverde Bolivar, Francisco Javier] Andalusian Res Grp, Dev & Innovat Plan CTS 982, Malaga, Spain; [Pedregal Gonzalez, Miguel] Dist Sanitario Huelva Costa, Teaching Unit Family & Community Med Huelva, Calle Cuesta Tres Caidas S-N, Huelva 21001, Spain; [Perez Fuentes, Maria Francisca] Area Sanitaria Norte Jaen, Linares Hlth Care Ctr Virgen Linarejos, Ave San Sebastian S-N, Jaen 23700, Spain; [Alcalde Molina, Maria DoloreS] Dist Sanitario Jaen Jaen Sur, Hlth Ctr Virgen Capilla, Calle Arquitecto Berges 10, Jaen 23007, Spain; [Torio Durantez, Jesus] Territorial Delegat Equal Hlth & Social Policies, Med Examinat, Paseo Estn 15, Jaen 23071, Spain; [Delgado Rodriguez, Miguel] Univ Jaen, Dept Preventat Med & Publ Hlth, Campus Lagunillas, Jaen 23071, Spain; [Delgado Rodriguez, Miguel] Minist Hlth, Biomed Res Ctr Epidemiol & Publ Hlth Net Biomed R, ISCIII Minist Sci & Innovat, C Sinesion Delgado 6, Madrid 29071, Spain; Junta de Andalusia (Regional Government of Andalusia)
Aim: To determine the communicative profiles of family physicians and the characteristics associated with an improved level of communication with the patient.Design: A descriptive multicentre study.Location: Primary Healthcare Centres in Almeria, Granada, Jaen and Huelva.Participants: 119 family physicians (tutors and 4th year resident physicians) filmed and observed with patients.Principal measurements: Demographic and professional characteristics. Analysis of the communication between physicians and patients, using a CICAA (Connect, Identify, Understand, Agree and Assist, in English) scale. A descriptive, bivariate, multiple linear regression analysis was performed.Results: There were 436 valid interviews. Almost 100% of physicians were polite and friendly, facilitating a dialogue with the patient and allowing them to express their doubts. However, few physicians attempted to explore the state of mind of the patient, or enquire about their family situation or any important stressful events, nor did they ask open questions. Furthermore, few physicians summarised the information gathered. The mean score was 21.43 +/- 5.91 points (maximum 58). There were no differences in the total score between gender, city, or type of centre. The linear regression verified that the highest scores were obtained from tutors (B: 2.98), from the duration of the consultations (B: 0.63), and from the age of the professionals (B: 0.1).Conclusion: Physicians excel in terms of creating a friendly environment, possessing good listening skills, and providing the patient with information. However the ability to empathise, exploring the psychosocial sphere, carrying out shared decision-making, and asking open questions must be improved. Being a tutor, devoting more time to consultations, and being younger, results in a significant improvement in communication with the patient. (C) 2016 Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
COST OF ILLNESS IN PATIENTS WITH PSORIASIS AND PSORIATIC ARTHRITIS. COEPSO STUDY
(Bmj publishing group, 2020-06-01) Castaneda, S.; Vicente, E.; Llamas Velasco, M.; Sanchez Perez, J.; Pardo, J.; Cabeza-Martinez, R.; Miranda-Fontes, M.; Marquez, J.; Calvo, J.; Armesto, S.; Belinchon, I.; Gomez, A.; Miranda, M. D.; Martinez Pardo, S.; Merino-Melendez, L.; Casado, M. A.; Yebenes, M.; Casado, A.; [Castaneda, S.] HU Princesa, EPID Future, Catedra UAM ROCHE, IIS Princesa,Rheumatol, Madrid, Spain; [Vicente, E.] HU Princesa, IIS Princesa, Rheumatol, Madrid, Spain; [Llamas Velasco, M.] HU Princesa, IIS Princesa, Dermatol, Madrid, Spain; [Sanchez Perez, J.] HU Princesa, IIS Princesa, Dermatol, Madrid, Spain; [Pardo, J.] HGU Santa Lucia, Cartagena, Spain; [Cabeza-Martinez, R.] HU Puerta Hierro Majadahonda, Madrid, Spain; [Miranda-Fontes, M.] HU Rio Hortega, Valladolid, Spain; [Marquez, J.] HG Jerez Frontera, Cadiz, Spain; [Calvo, J.] HU Araba, Vitoria, Spain; [Armesto, S.] HU Marques Valdecilla, Santander, Spain; [Belinchon, I.] HGU Alicante, Alicante, Spain; [Gomez, A.] HU Infanta Sofia, Madrid, Spain; [Miranda, M. D.] HG San Agustin Linares, Jaen, Spain; [Martinez Pardo, S.] H Mutua Terrassa, Barcelona, Spain; [Merino-Melendez, L.] H San Pedro, Logrono, Spain; [Casado, M. A.] Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain; [Yebenes, M.] Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain; [Casado, A.] Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain
EEG Multiscale Complexity in Schizophrenia During Picture Naming.
(2018-09-07) Ibáñez-Molina, Antonio J; Lozano, Vanessa; Soriano, María F; Aznarte, José I; Gómez-Ariza, Carlos J; Bajo, M T
Introduction: Patients with schizophrenia show cognitive deficits that are evident both behaviourally and with EEG recordings. Recent studies have suggested that non-linear analyses of EEG might more adequately reflect the complex, irregular, non-stationary behavior of neural processes than more traditional ERP measures. Non-linear analyses have been mainly applied to EEGs from patients at rest, whereas differences in complexity might be more evident during task performance. Objective: We aimed to investigate changes in non-linear brain dynamics of patients with schizophrenia during cognitive processing. Method: 18 patients and 17 matched healthy controls were asked to name pictures. EEG data were collected at rest and while they were performing a naming task. EEGs were analyzed with the classical Lempel-Ziv Complexity (LZC) and with the Multiscale LZC. Electrodes were grouped in seven regions of interest (ROI). Results: As expected, controls had fewer naming errors than patients. Regarding EEG complexity, the interaction between Group, Task and ROI indicated that patients showed higher complexity values in right frontal regions only at rest, where no differences in complexity between patients and controls were found during the naming task. EEG complexity increased from rest to task in controls in left temporal-parietal regions, while no changes from rest to task were observed in patients. Finally, differences in complexity between patients and controls depended on the frequency bands: higher values of complexity in patients at rest were only observed in fast bands, indicating greater heterogeneity in patients in local dynamics of neuronal assemblies. Conclusion: Consistent with previous studies, schizophrenic patients showed higher complexity than controls in frontal regions at rest. Interestingly, we found different modulations of brain complexity during a simple cognitive task between patients and controls. These data can be interpreted as indicating schizophrenia-related failures to adapt brain functioning to the task, which is reflected in poorer behavioral performance. - We measured classical and multiscale Lempel-Ziv Complexity (LZCN and MLZC) of the EEG signal of patients with schizophrenia and controls at rest and while performing a cognitive task. - We found that patients and controls showed a different pattern of brain complexity depending on their cognitive state (at rest or under cognitive challenge). - Our results illustrate the value of the MLZC in the characterization of the pattern of brain complexity in schizophrenia on function of frequency bands. - Nonlinear methodologies of EEG analysis can help to characterize brain dysfunction in schizophrenia.
Effect of omega-3 fatty acids on hypoalbuminemia in acute heart failure patients with increased inflammatory activity
(Aran ediciones, s l, 2021-09-01) Bonilla Palomas, Juan Luis; Gamez Lopez, Antonio Luis; Moreno Conde, Mirian; Lopez Ibanez, Maria Cristina; Moreno Villar, Maria Amparo; [Bonilla Palomas, Juan Luis] Hosp San Juan de la Cruz, Unidad Gest & Clin Med Interne, Area Cardiol, Ave Linares S-N, Jaen 23400, Spain; [Gamez Lopez, Antonio Luis] Hosp San Juan de la Cruz, Unidad Gest & Clin Med Interne, Area Cardiol, Ave Linares S-N, Jaen 23400, Spain; [Moreno Conde, Mirian] Hosp San Juan de la Cruz, Unidad Gest Clin Med Interna, Jaen, Spain; [Lopez Ibanez, Maria Cristina] Hosp San Juan de la Cruz, Unidad Gest Clin Med Interna, Jaen, Spain; [Moreno Villar, Maria Amparo] Hosp San Juan de la Cruz, Unidad Gest Clin Farm, Jaen, Spain
Introduction: inflammatory activity (IA) is a cause of hypoalbuminemia in patients with acute heart failure (AHF).Objectives: the main objective of this study was to evaluate whether an AI modulator treatment contributes to correcting albuminemia in this context.Methods: in this clinical trial 43 patients with AHF, hypoalbuminemia (serum albumin = 25 mg/l] were randomly assigned to receive omega-3 fatty acids (4 g daily) or placebo for 4 weeks. Albuminemia and CRP were reassessed at weeks 1 and 4. An analysis of variance for repeated measures was performed.Results: mean age was 75.6 +/- 8.8 years, 72.1 % were male, and the most frequent etiology was ischemic (46.5 %). The two groups were homogeneous in their baseline characteristics. A significant increase in albumin concentration was found at week 4 from baseline (p for the effect of time
Effectiveness of Psychological and Educational Interventions to Prevent Depression in Primary Care: A Systematic Review and Meta-Analysis.
(2017) Conejo-Cerón, Sonia; Moreno-Peral, Patricia; Rodríguez-Morejón, Alberto; Motrico, Emma; Navas-Campaña, Desirée; Rigabert, Alina; Martín-Pérez, Carlos; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Luna, Juan de Dios; García-Campayo, Javier; Roca, Miquel; Bellón, Juan Ángel
Although evidence exists for the efficacy of psychosocial interventions to prevent the onset of depression, little is known about its prevention in primary care. We aimed to evaluate the effectiveness of psychological and educational interventions to prevent depression in primary care. We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs) examining the effect of psychological and educational interventions to prevent depression in nondepressed primary care attendees. We searched MEDLINE, PsycINFO, Web of Science, OpenGrey Repository, Cochrane Central Register of Controlled Trials, and other sources up to May 2016. At least 2 reviewers independently evaluated the eligibility criteria, extracted data, and assessed the risk of bias. We calculated standardized mean differences (SMD) using random-effects models. We selected 14 studies (7,365 patients) that met the inclusion criteria, 13 of which were valid to perform a meta-analysis. Most of the interventions had a cognitive-behavioral orientation, and in only 4 RCTs were the intervention clinicians primary care staff. The pooled SMD was -0.163 (95%CI, -0.256 to -0.070; P = .001). The risk of bias and the heterogeneity (I2 = 20.6%) were low, and there was no evidence of publication bias. Meta-regression detected no association between SMD and follow-up times or SMD and risk of bias. Subgroup analysis suggested greater effectiveness when the RCTs used care as usual as the comparator compared with those using placebo. Psychological and educational interventions to prevent depression had a modest though statistically significant preventive effect in primary care. Further RCTs using placebo or active comparators are needed.
Effectiveness of Psychological and/or Educational Interventions in the Prevention of Anxiety: A Systematic Review, Meta-analysis, and Meta-regression.
(2017) Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Rubio-Valera, Maria; Fernández, Anna; Navas-Campaña, Desirée; Rodríguez-Morejón, Alberto; Motrico, Emma; Rigabert, Alina; Luna, Juan de Dios; Martín-Pérez, Carlos; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Luciano, Juan Vicente; Bellón, Juan Ángel
To our knowledge, no systematic reviews or meta-analyses have been conducted to assess the effectiveness of preventive psychological and/or educational interventions for anxiety in varied populations. To evaluate the effectiveness of preventive psychological and/or educational interventions for anxiety in varied population types. A systematic review and meta-analysis was conducted based on literature searches of MEDLINE, PsycINFO, Web of Science, EMBASE, OpenGrey, Cochrane Central Register of Controlled Trials, and other sources from inception to March 7, 2017. A search was performed of randomized clinical trials assessing the effectiveness of preventive psychological and/or educational interventions for anxiety in varying populations free of anxiety at baseline as measured using validated instruments. There was no setting or language restriction. Eligibility criteria assessment was conducted by 2 of us. Data extraction and assessment of risk of bias (Cochrane Collaboration's tool) were performed by 2 of us. Pooled standardized mean differences (SMDs) were calculated using random-effect models. Heterogeneity was explored by random-effects meta-regression. Incidence of new cases of anxiety disorders or reduction of anxiety symptoms as measured by validated instruments. Of the 3273 abstracts reviewed, 131 were selected for full-text review, and 29 met the inclusion criteria, representing 10 430 patients from 11 countries on 4 continents. Meta-analysis calculations were based on 36 comparisons. The pooled SMD was -0.31 (95% CI, -0.40 to -0.21; P Psychological and/or educational interventions had a small but statistically significant benefit for anxiety prevention in all populations evaluated. Although more studies with larger samples and active comparators are needed, these findings suggest that anxiety prevention programs should be further developed and implemented.
Effects of Physical Exercise on Sexual Function and Quality of Sexual Life Related to Menopausal Symptoms in Peri- and Postmenopausal Women: A Systematic Review.
(2020-04-14) Carcelén-Fraile, María Del Carmen; Aibar-Almazán, Agustín; Martínez-Amat, Antonio; Cruz-Díaz, David; Díaz-Mohedo, Esther; Redecillas-Peiró, María Teresa; Hita-Contreras, Fidel
During the menopausal period, sexual dysfunction is associated with the development or worsening of psychological conditions, causing deterioration in women's mental health and quality of life. This systematic review aims to investigate the effects of different exercise programs on sexual function and quality of sexual life related to menopausal symptoms. With this purpose, a systematic literature search was conducted in PubMed, CINAHL, Scopus, Web of Science, and Cochrane Plus. A total of 1787 articles were identified in the initial search and 11 prospective studies (including 8 randomized controlled trials) were finally included. The most commonly recommended training programs are based on exercising pelvic floor muscles, as they seem to have the largest impact on sexual function. Mind-body disciplines also helped in managing menopausal symptoms. However, as far as the most traditional programs were concerned, aerobic exercises showed inconsistent results and resistance training did not seem to convey any benefits. Although positive effects have been found, evidence supporting physical exercise as a strategy to improve sexual function and quality of sexual life related to menopausal symptoms is limited, and further studies on this topic are needed.
Efficacy and safety evaluation of nilotinib and dasatinib (2G -TKI) on first line treatment in 73 patients with CML-CP outside of clinical trials. Andalusian CML registry (RALMC)
(Ferrata Storti Foundation, 2016-06) Puerta, JM; Jiménez Velasco, A; García, MJ; Molina, JR; Ruiz, C; Ferrer, C; Durán, MS; Simón, I; Clavero, E; Avellaneda, MC; Rosell, A; Ballesteros, I; Ramírez, S; Portero, MA; Ramírez, MJ; Fernández, M; Jiménez, M; Fe, R; Mulero, N; López, P; [Puerta,JM] Hematology, Complejo Hospitalario Universitario de Granada, Granada. [Jiménez Velasco,A; Ruiz,C] Hospital Regional Universitario Carlos Haya, Málaga. [García,MJ] Complejo Hospitalario Torrecardenas,Almeria. [Molina,JR] Hospital Reina Sofia, Cordoba. [Ferrer,C] Hospital Comarcal San Juan de la Cruz, Ubeda. [Durán,MS] Complejo Hospitalario de Jaen, Jaen. [Simón,I] Hospital Nuestra Senora de Valme, Sevilla. [Clavero,E] Hospital Comarcal Santa Ana, Motril. [Avellaneda,MC] Hospital Comarcal San Agustin, Linares. [Rosell,A] Hematology, Hospital Universitario Virgen de la Victoria, Malaga. [Ballesteros,I] Hospital Comarcal de la Axarquia, Velez-Malaga. [Ramírez,S] Hospital Juan Ramon Jimenez, Huelva. [Portero,MA] Hematology, Hospital Universitario Virgen de Macarena, Sevilla. [Ramírez,MJ] Hospital de Jerez de la Frontera, Jerez de la Frontera. [Fernández,M] Hospital Infanta Margarita, Cabra. [Jiménez,M] Hospital General de Riotinto, Riotinto. [Fe,R] Hospital Punta de Europa, Algeciras. [Mulero,N] Hospital de la Linea, La Linea de la Concepcion. [López,P] Complejo Hospitalario Universitario de Granada, Granada, Spain.
Even though they were approved last June 2011 to be used on first line, it is not a common procedure to begin treatment of CML-CP with 2GTKI, despite it has been demonstrated its efficacy and safety against imatinib on ENESTnd and Dasision clinical trials.

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