Mónica Contreras-Moreira , Elpidio Calvo Manuel , Joaquín Antonio Álvarez Gregori
{"title":"Neumonía por COVID-19 en urgencias: ecografía pulmonar. Implicaciones pronósticas","authors":"Mónica Contreras-Moreira , Elpidio Calvo Manuel , Joaquín Antonio Álvarez Gregori","doi":"10.1016/j.mcpsp.2024.100486","DOIUrl":"10.1016/j.mcpsp.2024.100486","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In COVID-19 patients, the clinical picture allows estimating a certain pre-test probability of lung involvement; prediction that increases when associating lung ultrasound. This provides greater sensitivity than chest radiography in the detection of infiltrates, and makes it possible to predict the result of pathological pulmonary CT. The characteristic findings of SARS-CoV-2 pneumonia have been described, and the location of the lesions has been related to the prognosis. Few experiences have been published on the prognostic capacity of lung ultrasound, which do not include hospital-obtained laboratory parameters.</div></div><div><h3>Material and methods</h3><div>Through a prospective, multicenter, observational study with consecutive sampling, carried out between April and July 2020, 263 adult patients who attended the emergency department of Spanish hospitals due to symptoms compatible with respiratory infection were recruited. Six fields per lung were explored, and the presence or absence of focal B lines, global B lines, parenchymal consolidation, subpleural consolidation, and pleural effusion were described. The patients underwent a postero-anterior chest X-ray on the same day.</div></div><div><h3>Results</h3><div>Males predominated in the study population. The main comorbidity was neoplasms, followed by chronic kidney disease and ischemic heart disease. Patients with a positive result for SARS-CoV-2 RT-PCR and who required admission were more frequent, and 8% died. The pathological chest x-ray was positive in 75% of the patients, compared to 94.59% of the ultrasound scans. The most frequent findings were focal B lines in zones R6, R3, and L3. The specificity of bilateral consolidation or unilateral patchy infiltrate stands out, and in ultrasound the specificity of global B lines, consolidations, both pulmonary and subpleural, and left pleural effusion.</div></div><div><h3>Conclusions</h3><div>A regression model has been developed that incorporates the findings of the lung ultrasound and predicts the probability of admission in patients presenting to the emergency department, without using other hospital laboratory tests. A tool can be developed that allows the family physician to identify patients with a high probability of being hospitalized from those who will have an outpatient follow-up, to prioritize an early therapeutic approach or referral to the emergency room.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100486"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163000","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}
Claudia Ruiz-Huerta , Gema Vega , Carmen Ferrer , Marcelle V. Canto , María de los Ángeles Díaz , Ana M. Palmar
{"title":"Are hospital workers' healthy habits adequeate? Influence of social determinants on health","authors":"Claudia Ruiz-Huerta , Gema Vega , Carmen Ferrer , Marcelle V. Canto , María de los Ángeles Díaz , Ana M. Palmar","doi":"10.1016/j.mcpsp.2024.100487","DOIUrl":"10.1016/j.mcpsp.2024.100487","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>With regard to people who work in hospitals: Do they have better health habits than the general population? Or, do they have worse, despite most of them have the appropriate knowledge to follow a healthy lifestyle? This is a study to explore the habits of people working in a hospital, to compare them with the general population and to identify higher risk profiles on which to prioritize preventive interventions.</div></div><div><h3>Methods</h3><div>Cross-sectional study on health habits with workers from a hospital in Madrid (<em>n</em> = 399) using a questionnaire based on the National Health Survey. Descriptive and cluster analysis to classify homogeneous individuals according to health habits and identify risk patterns. Logistic regression was used to identify the independent risk factors that determine the unhealthy profile.</div></div><div><h3>Results</h3><div>The health habits of workers in a hospital are similar to those of the general population. Determinants of health influenced its distribution: The higher the spending capacity, the better the health habits; the older their age, more chronic disease is seen; women suffer worse mental health.</div></div><div><h3>Conclusions</h3><div>The results are superimposed onto those of the general population, where they would have been expected to be healthier. There are risk profiles in which to prioritize preventive interventions to promote health.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100487"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162993","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}
Irma D. Sifuentes-Najera , Juan J. Cuervo-Orozco , Ma.G. Treviño-Alanís , María G. Moreno-Treviño , Gerardo Rivera-Silva
{"title":"Carcinoma of the ovary with metastasis to the cerebellum","authors":"Irma D. Sifuentes-Najera , Juan J. Cuervo-Orozco , Ma.G. Treviño-Alanís , María G. Moreno-Treviño , Gerardo Rivera-Silva","doi":"10.1016/j.mcpsp.2024.100483","DOIUrl":"10.1016/j.mcpsp.2024.100483","url":null,"abstract":"","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 1","pages":"Article 100483"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134537","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}
{"title":"Impact of quality of root canal fillings and coronal restorations on the prevalence of apical periodontitis in an adult Saudi subpopulation","authors":"Muhammad Zubair Ahmad","doi":"10.1016/j.mcpsp.2024.100481","DOIUrl":"10.1016/j.mcpsp.2024.100481","url":null,"abstract":"<div><h3>Objectives</h3><div>This cross-sectional study aimed to evaluate the prevalence of apical periodontitis among healthy Saudi adult patients and to examine the impact of root canal filling quality and coronal restoration quality on periradicular health.</div></div><div><h3>Methods</h3><div>We used periapical radiographs for this study and categorized the teeth as either diseased or healthy based on the periapical index scores. Two pre-calibrated examiners independently evaluated the radiographs. Any uncertain situation was discussed with another senior examiner. Data were statistically analyzed by applying the Chi-square test or Fisher exact test at a 5% (<em>P</em> < .05) level of significance using IBM SPSS 29.0 software (IBM Corp, Armonk, NY).</div></div><div><h3>Results</h3><div>The overall prevalence of apical periodontitis in endodontically treated teeth was 29.04%. 47.79% of teeth had adequate endodontic treatments. The success rate for teeth with adequate endodontic treatment was significantly higher at 96%, compared to a 48% success rate in teeth with inadequate endodontic treatment (<em>P</em> < .001). Additionally, 70.1% of the teeth had adequate coronal restorations. Teeth with adequate coronal restorations showed a significantly higher success rate at 78.33% compared to the 53.7% success rate of teeth with inadequate coronal restorations (<em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>The quality of endodontic treatment determines the outcome. Therefore, improvements in root canal treatment procedures are advisable in general and specialist dental practices to enhance periradicular health. The coronal restoration is also an essential component of the overall treatment. The optimal treatment outcome can be achieved with the adequate quality of both endodontic treatment and coronal restoration.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 1","pages":"Article 100481"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698495","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}
{"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> <!-->=<!--> <!-->.011, 95% CI [3.9728, 20.0272]. Before the training, the adherence to quality standards was 83.1% (x̅=26.6, SD<!--> <!-->=<!--> <!-->3.4), while after the training, it increased to 87.5% (x̅=28.0, SD<!--> <!-->=<!--> <!-->3.9), and this difference was statistically significant <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":"8 1","pages":"Article 100479"},"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}
Tania Liliana Molina-Huertas , Sara Carolina Navarro-Salgado
{"title":"Inicio del síndrome de Sjögren con manifestaciones extraglandulares: reporte de caso","authors":"Tania Liliana Molina-Huertas , Sara Carolina Navarro-Salgado","doi":"10.1016/j.mcpsp.2024.100477","DOIUrl":"10.1016/j.mcpsp.2024.100477","url":null,"abstract":"<div><h3>Introduction</h3><div>Sjögren's syndrome is characterized by a broad spectrum of clinical manifestations; classically it presents with dry syndrome, However, less than 10% of these patients may present with extra glandular manifestations.</div></div><div><h3>Case report</h3><div>We present the case of a 36-year-old female patient with a purplish discoloration in two fingers of her hand. During anamnesis and complementary studies, she exhibited an autoimmune profile indicative of SS and cryoglobulinemic vasculitis. Additionally, a salivary gland biopsy was positive for Sjögren's syndrome.</div></div><div><h3>Conclusion</h3><div>The case presented represents a diagnostic challenge due to the atypical initial manifestations. Therefore, only by being aware of the different manifestations that this disease can present can one suspect it and make a timely diagnosis.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 1","pages":"Article 100477"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533229","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}
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