Medicina Clinica Practica最新文献

Improving the quality of primary healthcare in Kosovo: Impact of targeted training of Quality Coordinators 提高科索沃初级保健质量：有针对性地培训质量协调员的影响

Medicina Clinica Practica Pub Date : 2024-10-24 DOI: 10.1016/j.mcpsp.2024.100479

Ardita Baraku , Gordana Pavleković

{"title":"Improving the quality of primary healthcare in Kosovo: Impact of targeted training of Quality Coordinators","authors":"Ardita Baraku , Gordana Pavleković","doi":"10.1016/j.mcpsp.2024.100479","DOIUrl":"10.1016/j.mcpsp.2024.100479","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>This study focuses on enhancing the professional skills of Quality Coordinators (QCs) in primary healthcare (PHC) in Kosovo. The QCs are responsible for internal quality supervision of public PHC institutions, but their competencies for quality improvement are unknown. The objective was to enhance the professional skills of QCs through targeted training, aiming to improve healthcare quality.</div></div><div><h3>Methods</h3><div>The study involved determining the basic characteristics of QCs, assessing knowledge of quality standards before and after the training via a questionnaire; providing 2 training sessions; and, evaluating the impact of training on organizational adherence to healthcare quality standards. Mean, percentage, <em>p</em>-value, confidence interval, <em>t</em>-test, and rmcor were used as test statistics.</div></div><div><h3>Results</h3><div>There was a statistically significant increase in the QCs' knowledge of the quality standards before (x̅=11.4, SD=2.9) and after the training (x̅=23.4, SD=8.3), <em>p</em>      =.047, 95% CI [0.0303, 2.8268].</div></div><div><h3>Conclusion</h3><div>The study highlights the need for continuous quality-related training and appropriate tools and resources to improve and maintain quality in PHC. Further research is needed to evaluate the impact of sex and age and the possible role redefinition of QCs.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inicio del síndrome de Sjögren con manifestaciones extraglandulares: reporte de caso 发病时伴有腺体外表现的斯约格伦综合征：病例报告

Medicina Clinica Practica Pub Date : 2024-10-18 DOI: 10.1016/j.mcpsp.2024.100477

Tania Liliana Molina-Huertas , Sara Carolina Navarro-Salgado

引用次数: 0

Lesiones por animal ponzoñoso, raya de agua dulce: serie de casos 有毒动物伤害，淡水黄貂鱼：病例系列

Medicina Clinica Practica Pub Date : 2024-10-18 DOI: 10.1016/j.mcpsp.2024.100478

María Alejandra Ríos González , Natalia Sánchez Coronel , Dayra Constanza Rojas Duran , William Mauricio Acero Moreno , Lorena García Agudelo

{"title":"Lesiones por animal ponzoñoso, raya de agua dulce: serie de casos","authors":"María Alejandra Ríos González , Natalia Sánchez Coronel , Dayra Constanza Rojas Duran , William Mauricio Acero Moreno , Lorena García Agudelo","doi":"10.1016/j.mcpsp.2024.100478","DOIUrl":"10.1016/j.mcpsp.2024.100478","url":null,"abstract":"<div><h3>Introduction</h3><div>The toxin produced by the freshwater stingray has a histolytic, anaphylactic and highly painful effect.</div></div><div><h3>Objective</h3><div>To present a series of clinical cases of accident with a poisonous animal, the stingray, and its clinical and epidemiological characterization.</div></div><div><h3>Results</h3><div>32 study series, 87,50% male and 12,50% female, age range 7-74 years, mean was 40,59 years, 59,38% were from rural areas and 40,62% urban, 34,37% consulted in the first 24 hours after the event, from one day to seven days 6,25%, from seven to 15 days 15,62%, and more than 15 days 43,75%, lesion in foot 53,13%, in neck of foot 21,87%, in leg 25%, symptoms presented: pain 100%, 71,87% signs of local infection, 59,37% purulent discharge, 56,25% lesion with necrosis. Complications: 9,37% compartment syndrome, 43,75% abscess, 12,50% osteomyelitis, 59,37% coverage defect. The range of surgical procedures performed per patient was 1-7. Isolation 83,33% gram negative, 93,75% in-hospital management and 6,25% were referred due to the severity of the lesions, mortality in this study was 3,12%.</div></div><div><h3>Conclusion</h3><div>Fluvial stingray causes serious lesions in lower limbs that cause prolonged hospital stays, multiple surgical procedures, large coverage defects that merit the investment of high-tech materials and reconstructive plastic surgery.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolución del paciente hospitalizado con gripe durante 2016–2020 según su estado vacunal 根据疫苗接种情况划分的 2016-2020 年流感住院病人分布情况

Medicina Clinica Practica Pub Date : 2024-10-17 DOI: 10.1016/j.mcpsp.2024.100471

Jacobo Martín Ramos , Francisco Javier Cuevas Fernández , Álvaro Torres Lana , Armando Aguirre Jaime

{"title":"Evolución del paciente hospitalizado con gripe durante 2016–2020 según su estado vacunal","authors":"Jacobo Martín Ramos , Francisco Javier Cuevas Fernández , Álvaro Torres Lana , Armando Aguirre Jaime","doi":"10.1016/j.mcpsp.2024.100471","DOIUrl":"10.1016/j.mcpsp.2024.100471","url":null,"abstract":"<div><h3>Introduction</h3><div>Influenza vaccination is an effective measure to reduce hospital admissions and mortality. The objective of this study is to quantify the effectiveness of influenza vaccination in patients hospitalized for influenza to prevent its evolution to severity, considering other known factors that influence such severity.</div></div><div><h3>Methods</h3><div>Cross-sectional study of the 2016–2017 to 2019–2020 influenza epidemiological seasons with patients hospitalized at the Nuestra Señora de la Candelaria University Hospital in Tenerife diagnosed with influenza. Basic demographic and evolution variables were studied. The criteria for clinical severity used is that established by the Spanish National Epidemiology Center. Using multivariable binary logistic regression, the risk of progression to severity associated with influenza vaccination status was estimated.</div></div><div><h3>Results</h3><div>A total of 1,416 patients were collected. Of whom 50% were women, 56% older than 64 years, 17% with flu vaccination, 24% evolved to severity, 3% died, 72% treated with oseltamivir, 23% (CI95%: 19–27) not treated with oseltamivir were admitted to the ICU, compared to 1.5% (CI95%: 1–2) treated, 25% (CI95%: 23–28) of the non-vaccinated patients developed severity, compared to 18% (CI95%: 13–23) of the vaccinated. The odds ratio (OR) to severe evolution was 1.6 (CI95%: 1.1–2.2) for those not vaccinated.</div></div><div><h3>Conclusions</h3><div>Patients hospitalized for influenza who have not received influenza vaccination have a more than double the risk of a serious evolution of influenza compared to correctly vaccinated patients. The combination of oseltamivir and vaccination reduces their admission to the ICU by almost a fifth.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142444718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lyme disease: An ultrastructural analysis 莱姆病超微结构分析

Medicina Clinica Practica Pub Date : 2024-10-14 DOI: 10.1016/j.mcpsp.2024.100480

María G. Moreno-Treviño, David I. Orozco-Pasadas, José F. Yañez-Mijares, Ma. G. Treviño-Alanís, Gerardo Rivera-Silva

引用次数: 0

El misterio de la orina lila 丁香尿之谜

Medicina Clinica Practica Pub Date : 2024-10-10 DOI: 10.1016/j.mcpsp.2024.100474

María del Pino Pérez-García , Marta Moreno Hernández , Airam Infante Guedes , Juan Francisco García-Granado

引用次数: 0

Schwannoma del nervio facial con afectación temporal y extratemporal 颞部和颞外侧受累的面神经许旺瘤

Medicina Clinica Practica Pub Date : 2024-10-10 DOI: 10.1016/j.mcpsp.2024.100476

Miguel Saro-Buendía , Catalina Bancalari Díaz , Maria Dolores Sánchez-Alcón , Carlos de Paula Vernetta , Joan Carreres Polo , Miguel Armengot Carceller

引用次数: 0

Coriorretinitis placoide posterior luética 后叶状胎膜脉络膜炎

Medicina Clinica Practica Pub Date : 2024-10-10 DOI: 10.1016/j.mcpsp.2024.100475

Mariola Michelini Sola , Magdalena Muelas Fernandez , Iñaki Cascajares Quesada

引用次数: 0

¿La combinación dolutegravir y rifampicina en los pacientes no incluidos en los ensayos clínicos es también eficaz y segura en el binomio VIH-infección micobacteriana? Casos de la práctica clínica 对于未纳入临床试验的患者，多鲁曲韦和利福平的联合用药在艾滋病毒-霉菌感染二联症中是否同样有效和安全？临床实践案例

Medicina Clinica Practica Pub Date : 2024-10-04 DOI: 10.1016/j.mcpsp.2024.100472

Sara Fontserè Recuenco , Rafael Luque-Márquez

{"title":"¿La combinación dolutegravir y rifampicina en los pacientes no incluidos en los ensayos clínicos es también eficaz y segura en el binomio VIH-infección micobacteriana? Casos de la práctica clínica","authors":"Sara Fontserè Recuenco , Rafael Luque-Márquez","doi":"10.1016/j.mcpsp.2024.100472","DOIUrl":"10.1016/j.mcpsp.2024.100472","url":null,"abstract":"<div><h3>Introduction</h3><div>Mycobacterial infections and HIV is still a relevant topic. Rifampicin complicates antiretroviral drugs management, influencing the prognostic of both conditions. Dolutegravir is a first option drug, but rifampicin diminishes its levels. Doubling dolutegravir doses until two weeks after completing rifampicin treatment has good results. Our goal is to confirm in our daily practice the efficacy and safety of this scheme.</div></div><div><h3>Methods</h3><div>Eighteen HIV patients were included with mycobacterial infections. Rifampicin was administered with dolutegravir twice a day as commented. Viral suppression and mycobacterial curation were analyzed until the end of the follow-up.</div></div><div><h3>Results</h3><div>Thirteen from 18 were men, 46 years (interquartile range [IQR]: 38–49), diagnosed of HIV or treated since 1.8 years (IQR: 0.1–12), presenting mainly disseminated mycobacterial infections (11 of 18 cases). From which completed follow-up, 91.6% achieved mycobacterial curation (11 of 12) and 92.9% viral load suppression (13 of 14).</div></div><div><h3>Conclusion</h3><div>The treatment of rifampicin with adjusted dolutegravir doses seems to be a proper combination even in severe immunosuppresed population.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elongated uvula and chronic pharyngitis 悬雍垂和慢性咽炎

Medicina Clinica Practica Pub Date : 2024-09-26 DOI: 10.1016/j.mcpsp.2024.100473

Miguel Saro-Buendía MD , Raúl Mellídez Acosta MD , Diego Collado Marín MD , María Lucía Escabias Criado MD , Carlos de Paula Vernetta MD PhD , Miguel Armengot Carceller MD PhD

引用次数: 0