SAS - D.S.A.P. Córdoba Norte

Permanent URI for this collectionhttps://hdl.handle.net/10668/22688

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Liver Enzymes Correlate With Metabolic Syndrome, Inflammation, and Endothelial Dysfunction in Prepubertal Children With Obesity.
(2021-02-16) Valle-Martos, Rosario; Valle, Miguel; Martos, Rosario; Cañete, Ramón; Jiménez-Reina, Luis; Cañete, María Dolores
Background: Metabolic syndrome (MetS) can start in children with obesity at very young ages. Non-alcoholic fatty liver disease (NAFLD) is considered to be the hepatic component of metabolic syndrome. If left untreated, the clinical course of NAFLD can be progressive and can become chronic if not detected at an early stage. Objective: We aimed to quantify the differences in liver enzymes between prepubertal children with obesity and children with normal weight to determine any associations between them and parameters related to MetS, adipokines, or markers of endothelial dysfunction and inflammation. Methods: This cross-sectional study included 54 prepuberal children with obesity (aged 6-9 years) and 54 children with normal weight, matched by age and sex. Liver enzymes, C-reactive protein (CRP), interleukin-6, soluble intercellular adhesion molecule-1 (sICAM-1), adipokines, and parameters related to metabolic syndrome (MetS) were all measured. Results: Alanine aminotransferase (ALT) levels, serum butyryl cholinesterase (BChE), leptin, CRP, sICAM-1, triglycerides, blood pressure, and homeostasis model assessment for insulin resistance were significantly higher in children with obesity, while Apolipoprotein A-1, HDL-cholesterol, and adiponectin were significantly lower. In the children with obesity group, ALT and BChE levels correlated with anthropometric measurements, insulin resistance, and lipid parameters, leptin, interleukin-6, CRP, and sICAM-1 while BChE levels negatively correlated with adiponectin. Conclusions: Compared to children with normal weight, prepubertal children with obesity had elevated values for liver enzymes, leptin, markers of insulin resistance, inflammation, and endothelial dysfunction, and variables associated with MetS. There was also a correlation between these disorders and liver enzyme levels.
Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study.
(Elsevier, 2019-05-20) Romero-Rodriguez, Esperanza; Perula-de-Torres, Luis Angel; Fernandez-Garcia, Jose Angel; Roldan-Villalobos, Ana; Ruiz-Moral, Roger; Parras-Rejano, Juan Manuel
To assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. A quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p  PC providers' communication skills and attitudes showed significant improvements in the variables studied (p  The present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. Training activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.
Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática.
(Elsevier, 2018-07-05) Romero-Rodriguez, Esperanza Maria; Perula-de-Torres, Luis Angel; Linares-Ruiz, Alejandro; Fernandez-Garcia, Jose Angel; Parras-Rejano, Juan Manuel; Roldan-Villalobos, Ana; Sociedad Andaluza de Medicina Familiar y Comunitaria (SAMFyC) 2015; Grupo colaborativo Estudio Alco-AP
To evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems. A systematic review of randomised controlled trials. Trip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017. The final sample was n=3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included. The main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required. Three Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention. The development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques.
Resolución a corto plazo de las líneas B en la ecografía torácica con edema agudo de pulmón tras tratamiento.
(Permanyer Mexico, 2018-04-07) Valle-Alonso, Joaquin; Fonseca-Del-Pozo, Francisco Javier; Vaquero-Alvarez, Manuel
La ecografía torácica (ET) se ha consolidado como una herramienta novedosa para los médicos de los servicios de urgencias en la evaluación de pacientes con disnea aguda, habiéndose descrito recientemente como útil para estimar el grado de congestión pulmonar y monitorizar la efectividad del tratamiento, especialmente por la presencia sonográfica de las líneas B, que se asocian con estados de sobrecarga de líquidos. Ha demostrado ser particularmente eficaz para diferenciar entre enfermedad pulmonar obstructiva crónica (EPOC) e insuficiencia cardíaca congestiva (ICC). Aunque las líneas B aisladas pueden observarse en pulmones normales, su presencia difusa en múltiples zonas sugiere edema intersticial, hallazgo característico del edema agudo de pulmón. La ET podría utilizarse no solo para diagnosticar dicho edema, sino también para seguir su evolución y evaluar la respuesta al tratamiento. Sin embargo, a pesar de estos hallazgos, la ET aún no se emplea de forma rutinaria para monitorizar la evolución o la efectividad terapéutica en pacientes con edema agudo pulmonar en el contexto de la ICC. En este sentido, presentamos el caso clínico de una paciente con edema agudo de pulmón que, tras tratamiento médico, mostró una resolución de las líneas B en la ET a tan solo dos horas y media, lo que evidencia una respuesta favorable en un plazo muy corto.

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