SAS - D.S.A.P. Aljarafe

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  • Publication
    Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study.
    (2022-10-08) Béjar, Luis M; García-Perea, María Dolores; Mesa-Rodríguez, Pedro
    Mediterranean diet (MD) is potentially one of the best diets regarding health benefits and sustainability. However, it is faced with serious difficulties staying alive, even in traditionally Mediterranean regions. The objective was to evaluate the effectiveness of an application (e-12HR) to improve adherence to the MD (AMD) in university students. This study was a controlled, randomized, and multicentric clinical trial with two parallel groups (control group (CG) and intervention group (IG)), a 28-day follow-up period, and 286 participants (74.1% women). There were two versions of e-12HR: 'feedback' e-12HR (IG) and 'non-feedback' e-12HR (CG). Only the 'feedback' e-12HR had two specific automatic functions: 1. Evaluation of the user's AMD; 2. Identification of the food groups for which the user has not fulfilled the MD recommendations. Both versions of the application allowed the collection of data on dietary intake in order to calculate the AMD. When comparing CG and IG at 14-, 21-, and 28-days follow-up (no significant statistical differences at baseline), there were significant statistical improvements in favor of IG in AMD index (0.71, 1.56, and 1.43 points, respectively), and in the percentage of participants with medium/high AMD index (14.4%, 20.6%, and 23.7%, respectively). In conclusion, e-12HR could improve AMD among university students.
  • Publication
    An Exercise and Educational and Self-management Program Delivered With a Smartphone App (CareHand) in Adults With Rheumatoid Arthritis of the Hands: Randomized Controlled Trial.
    (2022-04-07) Rodríguez Sánchez-Laulhé, Pablo; Luque-Romero, Luis Gabriel; Barrero-García, Francisco José; Biscarri-Carbonero, Ángela; Blanquero, Jesús; Suero-Pineda, Alejandro; Heredia-Rizo, Alberto Marcos
    Rheumatoid arthritis (RA) is a prevalent autoimmune disease that usually involves problems of the hand or wrist. Current evidence recommends a multimodal therapy including exercise, self-management, and educational strategies. To date, the efficacy of this approach, as delivered using a smartphone app, has been scarcely investigated. This study aims to assess the short- and medium-term efficacy of a digital app (CareHand) that includes a tailored home exercise program, together with educational and self-management recommendations, compared with usual care, for people with RA of the hands. A single-blinded randomized controlled trial was conducted between March 2020 and February 2021, including 36 participants with RA of the hands (women: 22/36, 61%) from 2 community health care centers. Participants were allocated to use the CareHand app, consisting of tailored exercise programs, and self-management and monitoring tools or to a control group that received a written home exercise routine and recommendations, as per the usual protocol provided at primary care settings. Both interventions lasted for 3 months (4 times a week). The primary outcome was hand function, assessed using the Michigan Hand Outcome Questionnaire (MHQ). Secondary measures included pain and stiffness intensity (visual analog scale), grip strength (dynamometer), pinch strength (pinch gauge), and upper limb function (shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire). All measures were collected at baseline and at a 3-month follow-up. Furthermore, the MHQ and self-reported stiffness were assessed 6 months after baseline, whereas pain intensity and scores on the shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire were collected at the 1-, 3-, and 6-month follow-ups. In total, 30 individuals, corresponding to 58 hands (CareHand group: 26/58, 45%; control group: 32/58, 55%), were included in the analysis; 53% (19/36) of the participants received disease-modifying antirheumatic drug treatment. The ANOVA demonstrated a significant time×group effect for the total score of the MHQ (F1.62,85.67=9.163; P.05). Adults with RA of the hands who used the CareHand app reported better results in the short and medium term for overall hand function, work performance, pain, and satisfaction, compared with usual care. The findings of this study suggest that the CareHand app is a promising tool for delivering exercise therapy and self-management recommendations to this population. Results must be interpreted with caution because of the lack of efficacy of the secondary outcomes. ClinicalTrials.gov NCT04263974; https://clinicaltrials.gov/ct2/show/NCT04263974. RR2-10.1186/s13063-020-04713-4.
  • Publication
    A Personalized Ontology-Based Decision Support System for Complex Chronic Patients: Retrospective Observational Study.
    (2022-08-02) Román-Villarán, Esther; Alvarez-Romero, Celia; Martínez-García, Alicia; Escobar-Rodríguez, German Antonio; García-Lozano, María José; Barón-Franco, Bosco; Moreno-Gaviño, Lourdes; Moreno-Conde, Jesús; Rivas-González, José Antonio; Parra-Calderón, Carlos Luis
    Due to an increase in life expectancy, the prevalence of chronic diseases is also on the rise. Clinical practice guidelines (CPGs) provide recommendations for suitable interventions regarding different chronic diseases, but a deficiency in the implementation of these CPGs has been identified. The PITeS-TiiSS (Telemedicine and eHealth Innovation Platform: Information Communications Technology for Research and Information Challenges in Health Services) tool, a personalized ontology-based clinical decision support system (CDSS), aims to reduce variability, prevent errors, and consider interactions between different CPG recommendations, among other benefits. The aim of this study is to design, develop, and validate an ontology-based CDSS that provides personalized recommendations related to drug prescription. The target population is older adult patients with chronic diseases and polypharmacy, and the goal is to reduce complications related to these types of conditions while offering integrated care. A study scenario about atrial fibrillation and treatment with anticoagulants was selected to validate the tool. After this, a series of knowledge sources were identified, including CPGs, PROFUND index, LESS/CHRON criteria, and STOPP/START criteria, to extract the information. Modeling was carried out using an ontology, and mapping was done with Health Level 7 Fast Healthcare Interoperability Resources (HL7 FHIR) and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT; International Health Terminology Standards Development Organisation). Once the CDSS was developed, validation was carried out by using a retrospective case study. This project was funded in January 2015 and approved by the Virgen del Rocio University Hospital ethics committee on November 24, 2015. Two different tasks were carried out to test the functioning of the tool. First, retrospective data from a real patient who met the inclusion criteria were used. Second, the analysis of an adoption model was performed through the study of the requirements and characteristics that a CDSS must meet in order to be well accepted and used by health professionals. The results are favorable and allow the proposed research to continue to the next phase. An ontology-based CDSS was successfully designed, developed, and validated. However, in future work, validation in a real environment should be performed to ensure the tool is usable and reliable.
  • Publication
    Assessment of pre and postoperative anxiety in patients undergoing ambulatory oral surgery in primary care
    (Medicina oral s l, 2017-11-01) Reyes-Gilabert, Eva; Luque-Romero, Luis-Gabriel; Bejarano-Avila, Gracia; Garcia-Palma, Alfonso; Rollon-Mayordomo, Angel; Infante-Cossio, Pedro; [Reyes-Gilabert, Eva] Dist Aljarafe Sevilla Norte, Odontol, Seville, Spain; [Bejarano-Avila, Gracia] Dist Aljarafe Sevilla Norte, Odontol, Seville, Spain; [Garcia-Palma, Alfonso] Dist Aljarafe Sevilla Norte, Odontol, Seville, Spain; [Luque-Romero, Luis-Gabriel] Unidad Invest Dist Aljarafe Sevilla Norte, Med Familia & Comunitaria, Seville, Spain; [Rollon-Mayordomo, Angel] Hosp Univ Virgen Macarena, Cirugia Oral & Maxilofacial, Seville, Spain; [Infante-Cossio, Pedro] Univ Seville, Fac Med, Dept Cirugia, Seville, Spain
    Background: To analyze the pre- and postoperative anxiety level in patients undergoing ambulatory oral surgery (AOS) in a primary healthcare center (PHC).Material and Methods: Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015. Anxiety analysis was carried out with pre- and postoperative anxiety-state (STAI-S), anxiety-trait (STAI-T) and dental anxiety (MDAS) questionnaires. A descriptive, inferential and binary logistic regression analysis were performed for the variables age, sex, educational level, previous experience of oral treatment, type of oral surgery, degree of third molar impaction, surgical time, intraoperative complications, postoperative complications, and pain score with a visual analogue scale (VAS).Results: The majority were female (57.8%) with a mean age of 33.5 +/- 9.6 years. The most frequent procedure was the lower third molar removal (82.2%). The mean pain score on the VAS was 1.6 +/- 1.8. The incidence of complications was low (7.8%). There was a statistically significant association between post-and preoperative anxiety (r=0.56, p
  • Publication
    Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study.
    (2021-08-25) Meseguer Barros, Carmen Marina; Alzueta Isturiz, Natalia; Sainz de Rozas Aparicio, Rita; Vizcaíno, Rafael Aguilella; López Esteban, Laura; Anaya Ordóñez, Sonia; Lekue Alkorta, Itxasne; Martín Suances, Salvadora; Jiménez Arce, Jorge Ignacio; Fernández Vicente, Maite; Borrego Izquierdo, Yolanda; Prieto Sánchez, Raquel; Casado Casuso, Silvia; Madridejos, Rosa; Verde, Carmen Marquina; Tomás Sanz, Rosa; Oro Fernández, María; Gallardo Borge, Sara; Lázaro López, Eva; Pina Gadea, María Belén; Pereira Pía, Mercedes; Maestre-Sánchez, María Victoria; Ribes-Murillo, Esther; Gómez de Oña, Constanza; María Jesús Lallana, Álvarez; Celaya Lecea, Concepción; Prado Prieto, María Ana; Aranguez Ruiz, Aranzazu; Olmo Quintana, Vicente; Villén Romero, Noemí; Payá Giner, Carolina; Lloret Callejo, Angeles; Fernández Ferreiro, Alvaro; Basagoiti Carreño, Blanca; Iglesias Iglesias, Ana Aurelia; Martín Alonso, Antonio; Díez Alcántara, Ana; Marco Tejón, Esther; Lestón Vázquez, Marta; Ariza Copado, Mª Ángeles; Aparicio Cueva, Marta; Escudero Vilaplana, Belén; Nicieza, Marisa; Picazo Sanchiz, Gracia; Silva Riádigos, Genma María; Sánchez, Lucía Jamart; García Álvarez, Ángel; García Bonilla, Antonio; Herrero Delicado, Rafael; Arroyo Pineda, Virginia; de la Hija, Belén; Troncoso Mariño, Amelia; Tofiño González, Isabel; Mateu García, Mónica Susana; García Vázquez, Pablo; Pérez Martín, Joaquín; Fernández-Urrusuno, Rocío
    The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64-81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p
  • Publication
    Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach.
    (2021-05-16) Azogil-López, Luis Miguel; Coronado-Vázquez, Valle; Pérez-Lázaro, Juan José; Gómez-Salgado, Juan; Medrano-Sánchez, Esther María
    The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient's health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients' skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care.
  • Publication
    Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine.
    (2020-11-06) Tejada Cifuentes, Francisco; Lloret Callejo, Ángeles; Tirado Peláez, María José; Rubio Pulido, Olga; Ruiz-Morote Aragón, Marta; Fernández Urrusuno, Rocío; Muñoz Carreras, María Isabel; Méndez Esteban, María Isabel; Maestre Sánchez, Victoria; García Bonilla, Antonio; Paredero Dominguez, José Manuel; Arroyo Pineda, Virginia; Marco Tejón, Esther; Romero Candel, Gregorio; Fernández Marchante, Ana Isabel; Marco Del Rio, José; Ortiz Martín, Teresa; López Sánchez, Piedad
    To analyze the incidence of Covid-19 in patients who are chronic users of hydroxychloroquine. Cross-sectional retrospective observational multicenter study in health areas and districts from Castilla La-Mancha and Andalucia. Of the 4451 participants included in the first recruitment, 3817 with valid data were selected. The main variable of the study is the presence or absence of Covid-19 infection by clinical, serological or polymerase chain reaction diagnosis. Sociodemographic and clinical variables and treatment and concomitant comorbidities were recorded. 169 (4,45%) patients had Covid-19 infection, of which 12 (7.1%) died and 32 (18.9%) required hospital admission. Previous respiratory pathology was related to Covid-19 infection (P There is no relationship between chronic use of hydroxychloroquine and the incidence of Covid-19.
  • Publication
    Successful improvement of antibiotic prescribing at Primary Care in Andalusia following the implementation of an antimicrobial guide through multifaceted interventions: An interrupted time-series analysis.
    (2020-05-15) Fernández-Urrusuno, Rocío; Meseguer Barros, Carmen Marina; Benavente Cantalejo, Regina Sandra; Hevia, Elena; Serrano Martino, Carmen; Irastorza Aldasoro, Aranzazu; Limón Mora, Juan; López Navas, Antonio; Pascual de la Pisa, Beatriz
    Most effective strategies designed to improve antimicrobial prescribing have multiple approaches. We assessed the impact of the implementation of a rigorous antimicrobial guide and subsequent multifaceted interventions aimed at improving antimicrobial use in Primary Care. A quasi-experimental study was designed. Interventions aimed at achieving a good implementation of the guide consisted of the development of electronic decision support tools, local training meetings, regional workshops, conferences, targets for rates of antibiotic prescribing linked to financial incentives, feedback on antibiotic prescribing, and the implementation of a structured educational antimicrobial stewardship program. Interventions started in 2011, and continued until 2018. Outcomes: rates of antibiotics use, calculated into defined daily doses per 1,000 inhabitants-day (DID). An interrupted time-series analysis was conducted. The study ran from January 2004 until December 2018. Overall annual antibiotic prescribing rates showed increasing trends in the pre-intervention period. Interventions were followed by significant changes on trends with a decline over time in antibiotic prescribing. Overall antibiotic rates dropped by 28% in the Aljarafe Area and 22% in Andalusia between 2011 and 2018, at rates of -0.90 DID per year (95%CI:-1.05 to -0.75) in Aljarafe, and -0.78 DID (95%CI:-0.95 to -0.60) in Andalusia. Reductions occurred at the expense of the strong decline of penicillins use (33% in Aljarafe, 25% in Andalusia), and more precisely, amoxicillin clavulanate, whose prescription plummeted by around 50%. Quinolones rates decreased before interventions, and continued to decline following interventions with more pronounced downward trends. Decreasing cephalosporins trends continued to decline, at a lesser extent, following interventions in Andalusia. Trends of macrolides rates went from a downward trend to an upward trend from 2011 to 2018. Multifaceted interventions following the delivering of a rigorous antimicrobial guide, maintained in long-term, with strong institutional support, could led to sustained reductions in antibiotic prescribing in Primary Care.
  • Publication
    [Scimitar syndrome in adulthood].
    (2020-04-08) Jarroumi-Sellak, Ilham; Arenas-Gordillo, Manuel; García-Sánchez, María Ángeles; Luque-Romero, Luis Gabriel
  • Publication
    Red swamp crayfish collecting: a risk activity for leptospirosis.
    (2020-03-26) Gómez-Martín, M; Lozano, C; Luque, R; Luque-Romero, L; Rodríguez-Benjumeda, L; Aznar-Martin, J
  • Publication
    [Differences between institutionalized patients and those included in a home care program in Seville].
    (2020-02-17) Huesa Andrade, Macarena; Calvo-Gallego, José Luis; Pedregal González, Miguel Ángel; Bohórquez Colombo, Pilar
    To describe the characteristics and clinical differences between institutionalised patients and those included in a home care program. A descriptive, observational, cross-sectional, and multicentre study. Site Seville, 2016. A total 1857 elderly patients of similar characteristics (1441 institutionalised and 416 at home) in Seville in 2016. The variables studied included gender, age, civil status, family support, pathologies, multiple pathology criteria, and medication prescriptions. Functional and cognitive status was evaluated using the Barthel index, and the Lawton-Brody and Pfeiffer scales. The majority of patients (71.40%) were women. The fact of being institutionalised or being included in a home care program were statistically related to the following pathologies and categories: schizophrenia (p Cognitive impairment was related to institutionalisation, being a result of possible neurological (E3 category) and psychiatric diseases. On the other hand, patient comorbidity was not related to it, because it is very high in patients included in a home care program, in whom functional and cognitive independency status is better.
  • Publication
    [Effectiveness of interventions based on telemedicine on health outcomes in patients with multimorbidity in Primary Care: A systematic review].
    (2019-12-05) Pascual-de la Pisa, Beatriz; Palou-Lobato, Marta; Márquez Calzada, Cristina; García-Lozano, María José
    To evaluate the effectiveness of telemedicine interventions to improve health outcomes in patients with multiple morbidities in Primary Health Care. A systematic review. INAHTA, Health Guidelines, NICE, Cochrane Library, Medline/PubMed and EMBASE up to April 2018. Inclusion criteria: patients (adults with 2 or more chronic diseases or a Charlson index greater than three); intervention (telemedicine intervention developed entirely in Primary Health Care); comparator (usual care); health outcomes (mortality, hospital admissions, emergency department visits, health-related quality of life, and satisfaction); study design(clinical practice guideline, systematic review, meta-analysis, randomised controlled clinical trial),and quasi-experimental design). English and Spanish language publication. A total of236 references were located. Duplicated articles were removed. Titles, abstracts, and full text of references identified were assessed using the selection criteria; methodological quality assessment; data extraction, and qualitative analysis. Five articles, corresponding to 3 studies, were included, with 2 randomised controlled clinical trials and one quasi-experimental design. No significant results were observed in reducing mortality or improving health-related quality of life. The effectiveness of telemedicine on the number of hospital admissions or emergency visits showed contradictory results. Satisfaction was not measured in the studies included. The relatively small number of studies, heterogeneity characteristics, and methodological limitations did not confirm the effectiveness of telemedicine intervention on the improvement of mortality, number of hospital admissions, emergency department visits, and health-related quality of life, compared to usual care.
  • Publication
    Outcomes of the PIRASOA programme, an antimicrobial stewardship programme implemented in hospitals of the Public Health System of Andalusia, Spain: an ecologic study of time-trend analysis.
    (2019-07-16) Rodríguez-Baño, J; Pérez-Moreno, M A; Peñalva, G; Garnacho-Montero, J; Pinto, C; Salcedo, I; Fernández-Urrusuno, R; Neth, O; Gil-Navarro, M V; Pérez-Milena, A; Sierra, R; Estella, Á; Lupión, C; Irastorza, A; Márquez, J L; Pascual, Á; Rojo-Martín, M D; Pérez-Lozano, M J; Valencia-Martín, R; Cisneros, J M; PIRASOA Programme Group
    Inappropriate antimicrobial use favours the spread of resistance, and multidrug-resistant microorganisms (MDR) are currently of major concern. Antimicrobial stewardship programmes (ASPs) are essential for improving antibiotic use in hospitals. However, their impact on entire healthcare systems has not been thoroughly assessed. Our objective was to provide the results of an institutionally supported ASP involving 31 public hospitals in Andalusia, Spain. We designed an ecologic time-series study from 1 January 2014 to 31 December 2017. Quarterly, data on indicators were collected prospectively, and feedback reports were provided. PIRASOA is an ongoing clinically based quality-improvement programme whose key intervention is the educational interview, regular peer-to-peer interventions between advisors and prescribers to reinforce the appropriate use of antibiotics. Seventy-two indicators were monitored to measure prescribing quality (inappropriate treatments), antimicrobial consumption (defined daily doses per 1000 occupied bed-days), incidence density of MDR per 1000 occupied bed-days and crude mortality rate associated with bloodstream infections. We used Joinpoint regression software to analyse the trends. The quality of antimicrobial prescribing improved markedly, and the inappropriate treatment rate was significantly lower, with quarterly percentage change (QPC) = -3.0%, p  To date, the PIRASOA programme has succeeded in optimizing the use of antimicrobial agents and has had a positive ecologic result on bacterial resistance at level of an entire healthcare system.
  • Publication
    Waterpipe and cigarette smoking among adolescents in Seville (Spain): prevalence and potential determinants.
    (2019-04-01) Sáenz-Lussagnet, Juan Manuel; Rico-Villademoros, Fernando; Luque Romero, Luis Gabriel
    Letter to the editor.
  • Publication
    [Reasons for deciding to die in hospital or at home. The vision of professionals].
    (2018-05-21) Lima-Rodríguez, Joaquín Salvador; Asensio-Pérez, Mª de Los Reyes; Palomo-Lara, Juan Carlos; Ramírez-López, Encarnación Bella; Lima-Serrano, Marta
    To discover the reasons for deciding to die in hospital or at home, from the perspective of professionals involved. Qualitative phenomenological study. Intentional sample. Four multidisciplinary focus groups were held, two in hospitals and two in primary care centres in Seville (Spain). Twenty-nine professionals with at least two years experience in the care of people with a terminal disease participated, following the theoretical saturation of information criterion. Responses from the first script were gathered in three core categories: patient and the family, professionals and care process. Patients are generally not asked about their preferences as to where they wish to die, and if their family is not aware of their preference, it is not possible to carry out advanced planning of care. Families tend to choose the hospital because of the possibility of monitoring and resources in primary care. Professionals are trained in how to approach death, but they do not feel sufficiently prepared and focus on the clinical and administrative issues. The care process favours oncology patients because it is easier to identify their illness as terminal. Resources are not equal and interlevel communication needs to be improved. The family's involvement in the process is not facilitated, which impedes their decision-making. Advance care planning and use of the advance directive should be promoted, as well as, interlevel communication and coordination, supply resources, especially in primary care, and professionals should receive training on how to approach death.. The patient's family should be involved in the care process and provided the necessary support.
  • Publication
    [Acute bacterial gastroenteritis: 729 cases recruited by a Primary Care national network].
    (2016-09-27) García Vera, César; García Ventura, María; Del Castillo Aguas, Guadalupe; Domínguez Aurrecoechea, Begoña; Esparza Olcina, María Jesús; Martínez Rubio, Ana; Mengual Gil, José María; Red de Vigilancia Epidemiológica de Pediatría de Atención Primaria (PAPenRED)
    To determine the main clinical and epidemiological features of bacterial gastroenteritis in our environment. An observational study of a Spanish population in 17 Autonomous Communities. Questionnaires of children with a stool positive culture to bacteria were collected over a one year period. A bivariate analysis was performed on the variables involved, as well as two multivariate models (for antibiotic treatment variables, and comparison Campylobacter/Salmonella). A total of 729 bacterial gastroenteritis episodes were recorded in the 17 Spanish autonomous regions, of which 41.2% were girls and 58.8% boys. The median age was 3.41 years old (interquartile range 1.55 to 6.72). The bacteria isolated were 59.9% Campylobacter, 31.8% non-Typhi Salmonella, 2.7% Aeromonas, 2.4% Yersinia, and 1.5% had more than one strain. Most infections (70%) were direct contacts, and food poisoning was less probable (25.9%). Salmonella is significantly less frequent than Campylobacter in children under the age of 3 years (adjusted OR 0.61; 95%CI: 0.43 to 0.86; P=.005), and Campylobacter is more frequent in rural areas (adjusted OR 1.48; 95%CI: 1.07 to 2.07; P=.012). Antibiotic was prescribed in 33.2% of cases. There was a greater significant difference if stools contained blood or mucus (adjusted OR 1.53; 95%CI: 1.04 to 2.27; P=.031), if the symptoms lasted more than 7days (adjusted OR 2.81; 95%CI: 2.01 to 3.93; P The aetiology of bacterial diarrhoea in paediatrics is typical of that of a developed country. The transmission mechanism is mainly direct, and more cases than appropriate are treated with antibiotics.
  • Publication
    Impact of a soy drink on climacteric symptoms: an open-label, crossover, randomized clinical trial.
    (2016-01-25) Tranche, Salvador; Brotons, Carlos; Pascual de la Pisa, Beatriz; Macías, Ramón; Hevia, Eduardo; Marzo-Castillejo, Mercè
    The objective of this study is to evaluate the effects of a soy drink with a high concentration of isoflavones (ViveSoy®) on climacteric symptoms. An open-label, controlled, crossover clinical trial was conducted in 147 peri- and postmenopausal women. Eligible women were recruited from 13 Spanish health centers and randomly assigned to one of the two sequence groups (control or ViveSoy®, 500 mL per day, 15 g of protein and 50 mg of isoflavones). Each intervention phase lasted for 12 weeks with a 6-week washout period. Changes on the Menopause Rating Scale and quality of life questionnaires, as well as lipid profile, cardiovascular risk and carbohydrate and bone metabolism were assessed. Statistical analysis was performed using a mixed-effects model. A sample of 147 female volunteers was recruited of which 90 were evaluable. In both sequence groups, adherence to the intervention was high. Regular consumption of ViveSoy® reduced climacteric symptoms by 20.4% (p = 0.001) and symptoms in the urogenital domain by 21.3% (p  Regular consumption of ViveSoy® improves both the somatic and urogenital domain symptoms of menopause, as well as health-related quality of life in peri- and postmenopausal women.
  • Publication
    Guía de Terapéutica Antimicrobiana del Área Aljarafe, 3ª edición
    (Distrito Sanitario Aljarafe-Sevilla Norte y Hospital San Juan de Dios del Aljarafe, 2018-07-31) Acosta García, Héctor; Aibar Remón, Carlos; Alcázar, Francisco Javier; Alonso, Maria Teresa; Alvarado Fernández, Dolores; Anaya Ordóñez, Sonia; Anguis, Juan Ignacio; Aspíroz Sancho, Carmen; Aznar Martín, Javier; Beltrán Calvo, Carmen; Benavente, Regina Sandra; Bernabeu Wittel, José; Bravo Escudero, Carmen; Campa, Azucena de la; Campo Gracia, Angel del; Campos, Juan Miguel; Cansino Romero, Francisco Javier; Carlos Gil, Ana M.; Cantudo Cuenca, M. Dolores; Catalán, José Manuel; Chavez Caballero, Mónica; Corbi Llopis, Rosa; Corral Baena, Susana; Cots, Josep María; Cruces Jiménez, José Miguel; Cruz Navarro, Natalio; Cuétara, Marisol; Cueto, Marina de; Delgado de la Cuesta, Juan; Domínguez Cruz, Javier; Domínguez Jiménez, Mª Carmen; Espín, Beatriz; Espinosa Calleja, Ricardo; Expósito García, Sebastián; Fernández Moyano, Antonio; Fernández Urrusuno, Rocío; Flores Dorado, Macarena; Franco Alvarez de Luna, Francisco; Franco Márquez, M. Luisa; Galván Banqueri, Mercedes; Garabito Sánchez, M. José; García Estepa, Raúl; García Jiménez, Emilio; García López, José Luis; García Moreno, Mercedes; García Sánchez, Cristina; García de la Vega Sosa, Manuel; Garrido Arce, Macarena; Gilaberte Calzada, Yolanda; Huguet, Montse; Jiménez Pavón, Maria Luisa; Giménez Júlvez, Teresa; Gómez Gómez, Maria José; Gómez Vázquez, Ana; Guerrero Casas, Aurora; Hernández, Francisco Javier; Jiménez Vizcaino, Beatriz; Laureano Zarza, Miguel; Lepe Jiménez, José Antonio; Llor, Carles; López Cerero, Lorena; Manzano, M. Carmen; Marmesat, Francisco; Martín Grutmancher, Fernando; Martín Márquez, Fátima; Martínez Granero, Mercedes; Martínez-Gil Pardo de Vera, Cristina; Martínez Roda, M. José; Mata Martín, Ana; Merino de la Torre, Esther; Millán Cantero, Helena; Molina Linde, Juan Máximo; Montero Balosa, M. Carmen; Montes Sánchez, María del Carmen; Muñoz Yribarren, Cristina; Olivencia Pérez, Miguel; Palacios Baena, Zaira R.; Olmedo Rivas, Cinta; Palma Morgado, Daniel; Pascual Hernández, Álvaro; Pascual de la Pisa, Beatriz; Pereira Delgado, Consuelo M.; Pérez Pérez, Pastora; Pérez Santos, M. Jesús; Periáñez Párraga, Leonor; Pinilla Cordero, Sonia; Poyato, Manuel; Praena Segovia, Julia; Ramírez Arcos, Mercedes; Reinosa Santiago, Alfredo; Retamar Gentil, Pilar; Rigueira, Ana; Robustillo Cortés, M. de las Aguas; Rodríguez Baño, Jesús; Rodríguez Benjumeda, Luis Miguel; Rodríguez Pappalardo, Vicente; Roldán Valenzuela, Andrés; Romero García, Ana; Rosario Lozano, M. Piedad; Ruiz Pérez de Pipaón, Maite; Sabalete Moya, Trinidad; Sánchez Fernández, Norma; Sánchez Moreno, María; Santos Lozano, José Manuel; Serrano Martino, Carmen; Solís de Dios, Miguel; Suárez Barrenechea, Anabel; Taboada Prieto, Salomé; Toro López, M. Dolores; Trueba Lawand, Araceli; Valera Rubio, Marta; Vázquez Florido, Antonio; Yanes Martín, Jaime; [Acosta García,H; Carlos Gil,AM; Galván Banqueri,M; García Estepa,R,Molina Linde,JM; Robustillo Cortés,MA;Rosario Lozano,MP; Sabalete Moya,T; Valera Rubio,M] Agencia de Evaluación de Tecnologías Sanitarias de Andalucía. [Aibar Remón,C] Departamento de Microbiología, Medicina Preventiva y Salud Pública. Universidad de Zaragoza. Servicio de Medicina Preventiva y Salud Pública. Hospital Clínico Universitario Lozano Blesa. Zaragoza. [Alcázar,FJ,Campa,A; Campo Gracia,A; Cantudo Cuenca,MD; Catalán,JM; Chavez Caballero,M; Corral Baena,S; Delgado de la Cuesta,J; Espinosa Calleja,R; Expósito García,S; Fernández Moyano,A; Franco Márquez,ML; Garabito Sánchez,MJ; Garrido Arce,M; Gómez Vázquez,A; Hernández,FJ; Martín Márquez,F; Martínez Roda,MJ; Mata Martín,A,Merino de la Torre,E; Millán Cantero,H; Muñoz Yribarren,C; Olivencia Pérez,M; Olmedo Rivas,C; Pereira Delgado,CM; Poyato,M; Ramírez Arcos,M; Serrano Martino,C; Taboada Prieto,S; Trueba Lawand,A] Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla. [Alonso,MT; Aznar Martín,J; Bernabeu Wittel,J; Corbi Llopis,R; Cruz Navarro,N; Domínguez Cruz,J; Espín,B; García Sánchez,C; Gómez Gómez,MJ; Lepe Jiménez,JA; Praena Segovia,J; Ruiz Pérez de Pipaón,M; Vázquez Florido,A] Hospital Universitario Virgen del Rocío, Sevilla. [Alvarado Fernández,D; Cueto,M; López Cerero,L; Palacios Baena,ZR; Pascual Hernández,A; Retamar Gentil,P; Rodríguez Baño,J; Toro López,MD] Hospital Universitario Virgen Macarena, Sevilla. [Anaya Ordóñez,S] UGC Farmacia Granada Intercentros. [Anguis,JI; Beltrán Calvo,C; Bravo Escudero,C; Campos,JM; Cruces Jiménez,JM; Fernández Urrusuno,R; García de la Vega Sosa,M; Jiménez Pavón,ML; Guerrero Casas,A; Jiménez Vizcaino,B; Laureano Zarza,M; Marmesat,F; Martínez Granero,M; Montero Balosa,MC; Montes Sánchez,MC; Pascual de la Pisa,B; Pinilla Cordero,S; Reinosa Santiago,A; Rodríguez Benjumeda,LM; Rodríguez Pappalardo,V; Roldán Valenzuela,A; Romero García,A; Sánchez Fernández,N; Solís de Dios,M; Yanes Martín,J] Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Sevilla. [Aspíroz Sancho,C] Hospital Royo Villanova, Zaragoza. [Benavente,RS; Domínguez Jiménez,MC] Área de Gestión Sanitaria de Osuna, Sevilla. [Cansino Romero,FJ] Residencia Geriátrica Montetabor. Bollullos de la Mitación, Sevilla. [Cuétara,M] Servicio de Microbiología del Hospital Severo Ochoa de Leganés, Madrid. [Flores Dorado,M] Área de Gestión Sanitaria Norte de Cádiz, Cádiz. [Franco Alvarez de Luna,F] Hospital de Ríotinto, Huelva. [García López,JL; Suárez Barrenechea,A] Servicio de Microbiología, Hospital Virgen de Valme, Sevilla. [García Moreno,M] Residencia de Mayores de la Junta de Andalucía Huerta Palacio. Dos Hermanas, Sevilla. [Gilaberte Calzada,Y; Giménez Júlvez,T] Hospital Miguel Servet, Zaragoza. [Huguet,M] Residencia CER Espartinas, Espartinas, Sevilla. [Martínez-Gil Pardo de Vera,C] Area de Gestión Sanitaria Norte de Jaén, Jaén. [Palma Morgado,D; Santos Lozano,JM] Distrito Sevilla, Sevilla. [Pérez Pérez,P] Observatorio para la Seguridad del Paciente. Agencia de Calidad Sanitaria de Andalucía. Sevilla. [Pérez Santos,MJ] Servicio Microbiología. Hospital de Ronda. Málaga. [Periáñez Párraga,L] Hospital Son Espases, Palma Mallorca. [Regueira,A] Hospital San Agustín, Avilés, Asturias. [Sánchez Moreno,M] Area de Gestión Sanitaria Sur de Sevilla, Sevilla.
    Estas guías son un recurso indispensable en los Programas de Optimización de Antibióticos (PROA). No sólo constituyen una herramienta de ayuda para la toma de decisiones en los principales síndromes infecciosos, proporcionando recomendaciones para el abordaje empírico de dichos procesos, sino que son el patrón/estándar de referencia que permitirá determinar la calidad o adecuación de los tratamientos realizados. Las guías pueden ser utilizadas, además, como herramienta de base para la formación y actualización en antibioterapia, ya que permiten mantener actualizados los conocimientos sobre las nuevas evidencias en el abordaje de las infecciones. Por último, deberían incorporar herramientas que faciliten el proceso de toma de decisiones compartidas con el paciente. El objetivo de esta guía es proporcionar recomendaciones para el abordaje de las enfermedades infecciosas más prevalentes en la comunidad, basadas en las últimas evidencias disponibles y los datos de resistencias de los principales patógenos que contribuyan a mejorar la calidad de la prescripción de antimicrobianos.
  • Publication
    Plan andaluz de enfermedades reumáticas y musculoesqueléticas
    (Consejería de Salud, 2018) Pérez Venegas, José Javier; Lama Herrera, Carmen Mª; Sanz Amores, Reyes; Martínez Concepción, Eugenio; Abad Ramírez, Rocío; Aguiar García, Francisco; Baena Sáez, Rafael; Cuéllar Obispo, Encarnación; Delgado Martinez, Alberto; Fernández Nebro, Antonio; Gallo Vallejo, Francisco Javier; García Montes, Inmaculada; Moyano González, Carlos; Pajares Bernardo de Quirós, Ignacio; Raya Álvarez, Enrique; Rodríguez Mendoza, Encarnación; Velázquez Carranza, Nuria; Aldana Espinal, Josefa; Díaz Borrego Horcajo, José; Irastorza Aldasoro, Arantxa; Bruquetas Callejo, Carlos; Márquez Calderón, Soledad; [Pérez Venegas, JJ] Hospital de Jerez. [Lama Herrera, CM; Sanz Amores, R; Martínez Concepción, E] Consejería de Salud. [Abad Ramírez, R] UGC Mairena del Aljarafe, Distrito Sanitario Aljarafe. [Aguiar García, F] Hospital Comarcal de la Axarquía. [Baena Sáez, R] UGC La Barca-San José del Valle. [Cuéllar Obispo, E] Hospital Regional de Málaga. [Delgado Martinez, A] Hospital Reina Sofía de Córdoba. [Fernández Nebro, A] Hospital Regional de Málaga. [Gallo Vallejo, FJ] Distrito Sanitario de Atencion Primaria Granada-Metropolitano. [García Montes, I] Hospital Virgen de las Nieves de Granada. [Moyano González, C] Centro de Salud Gines, Distrito Sevilla Norte. [Pajares Bernardo de Quirós, I] Distrito Sanitario de Atención Primaria Sevilla. [Raya Álvarez, E] Hospital Universitario San Cecilio, Granada. [Rodríguez Mendoza, E] Hospital de Jerez. [Velázquez Carranza, N] Hospital Universitario Virgen del Rocío. [Aldana Espinal, J; Díaz Borrego Horcajo, J; Irastorza Aldasoro, A] Servicio Andaluz de Salud. [Bruquetas Callejo, C; Márquez Calderón, S] Consejería de Salud
    El Plan Andaluz de Enfermedades Reumáticas y Musculoesqueléticas no sólo propone estrategias y objetivos concretos para la prevención y atención sanitaria de las ERyMEs, sino que, además, tratará de integrar e impulsar actividades saludables para la población general colaborando, así, en la reducción de la morbilidad y en la mejora sustancial de la calidad de vida de la población andaluza, en línea con los objetivos establecidos por el IV Plan Andaluz de Salud.
  • Publication
    Niveles de anticuerpos bactericidas frente a meningococo C tras la vacunación de niños de 2 a 6 años de edad en Andalucía.
    (Ministerio de Sanidad y Consumo, 2000-07) Delgado Torralbo, Elena; Vazquez Moreno, Julio A; García León, Javier; González Enríquez, Jesús; Martínez Navarro, Ferrán; Berrón Morato, Sonsoles; Mayoral Cortés, José María; Rubin Gómez, M Ángeles; Méndez Martínez, Camila; Cortés Majó, Margarita; Chaves Caballero, Mónica; Bernal González, Mª Luisa; [Delgado Torralbo,E; Martínez Navarro ,F] Programa de Epidemiología Aplicada de Campo (PEAC), Instituto de Salud “Carlos III”. [Vazquez Moreno,JA] Centro Nacional de Microbiología, Instituto de Salud “Carlos III”. [Delgado Torralbo,E; García León,J; Bernal González,ML] Dirección General de Salud Pública y Participación, Consejería de Salud de la Junta de Andalucía. [González Enríquez,J] Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III. [Martínez Navarro,F] Centro Nacional de Epidemiología, Instituto de Salud Carlos III. [Mayoral Cortés,JM] Coordinación Epidemiología y Programas, Distrito Sanitario de Camas, Sevilla. [Rubin Gómez,MA] Coordinación Epidemiología y Programas. Distrito Sanitario de Baza, Granada. [Méndez Martínez,C; Cortés Majó,M] Coordinación Epidemiología y Programas, Distrito Sanitario Alcalá de Guadaira-Dos Hermanas-Utrera-Morón, Sevilla. [Chaves Caballero,M] Servicio de Microbiología, Hospital Universitario Ntra. Sra. De Valme, Sevilla.
    BACKGROUND In 1997, 18.5% of the cases of Meningococcal Disease caused b serogroup C in Andalusia were children between 2 and 4 years of age; ages where the initial immune response and the duration of the capsular A + C meningococcal polysaccharide vaccine is less than in older age groups. Research was designed in order to measure the immune response produced by this vaccine in children from 2 to 6 years of age and to compare it with the natural immunity present in unvaccinated children. METHODS I. Dual monitoring study: a) groups of children vaccinated previously and control groups, b) groups of children who were going to be vaccinated, for pre and post-vaccination (1, 6 and 12 months) analysis and a control group. II. The bactericidal activity was measured according to the standardised protocol of the CDC with regard to the strain of N. meningitidis C-11. The sera with bactericidal activity (TAB) > 1:8 were considered to be protective. RESULTS 1 and 2 months following vaccination, the proportion of TAB > 1:8 was significantly higher than that of the control group (65.6% and 73% in comparison to 2.2% and 12%). In the pre-vaccine and post-vaccine (after 6, 7, 12 and 13 months) verification, no significant difference between vaccinated individuals and controls was observed. CONCLUSIONS The differences between vaccinated and unvaccinated individuals 1 and 2 months following vaccination indicate seroconversion in the vaccinated individuals. For the age group of between 2 to 6 years of age, the bactericidal activity acquired decline quickly, as, after 6 months, differences between this group and the control group are no longer observed.