Anales del sistema sanitario de Navarra最新文献

{"title":"[Implementation of an early HIV diagnosis and treatment program in a hospital emergency department].","authors":"Hugo Martínez Faya, Amaia Ibarra Bolt, Jorge Abadía Durán, Ana García-Arellano, Carmen Ezpeleta Baquedano, Carlos Ibero Esparza","doi":"10.23938/ASSN.1114","DOIUrl":"10.23938/ASSN.1114","url":null,"abstract":"<p><strong>Background: </strong>To determine the prevalence of undiagnosed HIV infection among individuals presenting to a hospital emergency department with specific clinical conditions, and to describe the characteristics of those diagnosed with HIV.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted in the emergency department of the University Hospital of Navarra (Pamplona, Spain) over the first 18 months following the implementation of an early HIV diagnosis program. Adults presenting with herpes zoster, sexually transmitted infections, mononucleosis-like syndrome, community-acquired pneumonia, post-exposure prophylaxis, or chemsex were included. Non-urgent HIV serology tests were requested. In the event of a positive result, patients were informed and referred for consultation to initiate treatment.</p><p><strong>Results: </strong>Two hundred and fifty-two patients were included (mean age: 37.15 years; 63% male); of these, 37% presented with community-acquired pneumonia, 25% with sexually transmitted infections, and 27% had previous HIV serology. Nine individuals (3.6%) tested positive: six were aged 35 to 55, seven were male, with CD4 counts <500 cells/µL and viral loads <3,400 copies/mL. All accepted antiretroviral treatment and were seen in consultation within =6 days.</p><p><strong>Conclusions: </strong>The early HIV diagnosis program in our emergency department proved effective in identifying HIV infection, particularly among individuals with limited interaction with the healthcare system. These findings support the protocol's utility, its performance, and potential for further optimization.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049714","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":"[Triple synchronous primary lung adenocarcinoma: A diagnostic challenge].","authors":"Pablo Andrés Ordóñez Lozano, Marco Patricio Bravo Mendoza, Andrea Carilla Sanromán","doi":"10.23938/ASSN.1104","DOIUrl":"10.23938/ASSN.1104","url":null,"abstract":"<p><p>Multiple primary lung cancer can be synchronous or metachronous based on the timing of lesion onset. Despite the existing classification criteria for lung cancer with multiple lung involvement, it is sometimes challenging to distinguish between lung cancer with multiple lung involvement and intrapulmonary metastases. Moreover, differentiating synchronous multiple primary lung cancer from multifocal ground-glass/lepidic-pattern lung cancer is crucial. While histologic evaluation can aid in diagnosis, molecular analyses are often necessary. We present the case of a female patient diagnosed with triple synchronous primary lung adenocarcinomas. Although the lesions shared the same histological subtype, they exhibited distinct histological patterns and molecular profiles. In cases of lung cancer with multiple lung involvement, it is essential to perform a detailed pathological study for an accurate diagnosis and appropriate therapeutic interventions.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061837","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":"[Progress and challenges in Anales del Sistema Sanitario de Navarra. Insights from 2024].","authors":"Clara Bermúdez-Tamayo, Carmen Beorlegui","doi":"10.23938/ASSN.1121","DOIUrl":"10.23938/ASSN.1121","url":null,"abstract":"","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047872","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":"[Perception of professionalism among Latin American physicians in 2024: A multi-national survey].","authors":"Raúl Emilio Real-Delor, Alberto Guevara Tirado, Eduardo Enrique Chibas Muñoz, Ruth Stephany Benítez Penayo, Bárbara Girhfietl Caje Román, Jonatas De Oliveira Borba, Lucio Fabián Duarte Irala, Mirtha Sofía Fleitas Armoa, Elena Cecilia Franco Cáceres, Alberto Martins Junior, Hugo Javier Peralta Echagüe, María Selva Vega Tande","doi":"10.23938/ASSN.1112","DOIUrl":"10.23938/ASSN.1112","url":null,"abstract":"<p><strong>Background: </strong>Medical professionalism encompasses the values, attitudes, and behaviors that prioritize the service of patients and society. This study aimed to evaluate the perception of professionalism among Latin American physicians in 2024.</p><p><strong>Methodology: </strong>We conducted an observational, cross-sectional study involving Latin American physicians from various specialties. A telematic survey was administered, which included sociodemographic variables (age, sex, country, specialty) and the modified Kwon et al. professionalism questionnaire, comprising 43 questions across seven dimensions.</p><p><strong>Results: </strong>Four hundred and twenty-four physicians participated (median age of 40 years, 57.6% female, and 69.8% from clinical specialties) from Paraguay (72.9%), Peru (24.3%), and Cuba (2.8%). A threshold score of 1.223 out of 4 identified the lowest 40% in perceived professionalism. The lowest scoring indicators - reflecting less frequents behavior - were: I recommend illegal drugs for recreational use and I maintain inappropriate body contact during the physical examination. In contrast, the highest scoring (more frequent) were: I am late for work and I overlook colleagues' medical errors. Male physicians demonstrated significantly lower professionalism in three areas: Inappropriate body contact during physical examination, abusive treatment of other healthcare professionals, and discriminatory behavior toward colleagues or patients (adjusted effect).</p><p><strong>Conclusions: </strong>Sixteen indicators show a significant association with professionalism self-perceived professionalism, with four showing notable differences by sex. Ongoing implementation of such assessment at different professional stages is recommended, along with educational strategies at the university level to reinforce the core values of medical professionalism.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061192","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 body composition and psychological state on executive functions in individuals with obesity].","authors":"Mario Tomé-Fernández, Marina Berbegal-Bernabeu, Miriam Sánchez-Sansegundo, José Antonio Hurtado-Sánchez, José Tuells, Ana Zaragoza-Martí","doi":"10.23938/ASSN.1113","DOIUrl":"10.23938/ASSN.1113","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the relationship between anthropometric and psychological variables and executive functions in individuals with obesity.</p><p><strong>Method: </strong>Adults with obesity were recruited in Alicante (Spain). Participants underwent interviews to collect sociodemographic data (sex, age, educational level, marital status, and employment status) and anthropometric assessments measuring weight, body mass index, visceral fat, fat mass, and muscle mass. Psychological evaluations were carried out using the DASS-21. Executive functions were assessed through the M-WCST (cognitive flexibility), WAIS-IV (working memory), TMTA (processing speed), and TMTB (inhibitory control).</p><p><strong>Results: </strong>The sample comprised 48 participants (52% female) with a mean age of 47.58 years. Most participants had secondary education, were married, and employed. Women exhibited higher values in weight, body mass index, and fat mass (% and kg). Multiple linear regression analyses revealed that anthropometric variables -weight, body mass index, visceral fat, fat mass, and muscle mass- significantly influenced performance on working memory, processing speed, and inhibitory control performance. Additionally, anxiety levels were associated with cognitive flexibility and working memory, while depression levels were linked to inhibitory control.</p><p><strong>Conclusions: </strong>Anthropometric variables -weight, body mass index, visceral fat, fat mass, and muscle mass- are associated with variations in executive function performance, particularly in working memory, processing speed, and inhibitory control. Psychological states -anxiety and depression- are related to specific aspects of executive functioning.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056988","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":"[Effectiveness of a training program in the approach to gender-based violence in emergency professionals: A quasi-experimental study].","authors":"María Gracia Adánez-Martínez, Carlos Pérez-Cánovas, César Leal-Costa, María Belén Conesa Ferrer, Jose Luis Díaz-Agea, Ismael Jiménez Ruiz","doi":"10.23938/ASSN.1111","DOIUrl":"10.23938/ASSN.1111","url":null,"abstract":"<p><strong>Background: </strong>Health systems play a key role in the detection and management of gender-based violence. This study aimed to evaluate the effectiveness of a training program designed to enhance the knowledge, skills, and attitudes of emergency healthcare professionals in addressing gender-based violence.</p><p><strong>Methodology: </strong>A quasi-experimental pre-post study was conducted with 115 emergency health professionals from the Murcian Health Service. Participants completed a 10-hour online training program utilizing active learning methodologies, including guided reflection on didactic and dramatized problem-based videos. The Knowledge, Skills, and Attitudes on Gender-Based Violence Questionnaire (CCHA-VioGen) was administered before and after the training.</p><p><strong>Results: </strong>Statistically significant improvements were observed in all three dimensions. Knowledge and skills showed medium effect sizes (d=2.07 and d=1.99, respectively), while attitude improved with small effect size (d=0.61). Participants rated the course highly in terms of learning consolidation and applicability, indicating that the course content was perceived as relevant and useful. The perceived need for further training was low, suggesting a strong sense of preparedness following the intervention.</p><p><strong>Conclusions: </strong>The training program is highly effective in enhancing healthcare professionals´ competencies in managing cases of gender-based violence. Short, online courses that incorporate innovative resources such as dramatized problem videos represent a feasible and impactful strategy for professional development, especially in setting with limited resources.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049470","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":"[Lessons learned from the evaluation of the Third Addiction Prevention Plan of Navarre].","authors":"Fernando Nicolas Baigorria Feltrin, Mikele Jauregui Elso, Jose Miguel Razkin Orobengoa, Itzal Puchol Martínez","doi":"10.23938/ASSN.1119","DOIUrl":"10.23938/ASSN.1119","url":null,"abstract":"","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805029","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":"[Long-term persistence of post-COVID-19 symptoms: A two-year follow-up of a Primary Care cohort].","authors":"Yolanda Barrera Martínez, Gerardo Andrés Boillat Oriani, Pedro Vega Montes, Elena Martínez Moreno, Alejandro Pérez Pérez, Ricardo José Casajuana Pérez, Francisca Muñoz Cobos","doi":"10.23938/ASSN.1101","DOIUrl":"10.23938/ASSN.1101","url":null,"abstract":"<p><strong>Background: </strong>This study aims to determine the prevalence of long COVID two years after initial infection, identify prognostic factors, and assess its impact on quality of life.</p><p><strong>Methodology: </strong>An ambispective cohort study was conducted with patients aged = 18 years from two health centers in Málaga, Spain, who tested positive for SARS-CoV-2 between October 2020 and May 2021. Systematic random sampling was performed in October 2022, with 5% precision, 5% alpha error, and 25% expected losses. The cohort was followed until May 2023. Dependent variables included long COVID (= 1 symptom lasting =8 weeks), symptom count, quality of life (EuroQol 5-D), and global health perception (EQ-EVA). Independent variables included age, sex, severity of initial infection severity, vaccination status, comorbidities, and reinfection.</p><p><strong>Results: </strong>Of 914 eligible individuals, 173 patients were sampled (mean age 47 years, 58.4% female). Long COVID was observed in 32.36% of participants, with 23% affected two years after infection. Fatigue and anosmia/dysgeusia were the most frequent symptoms. Prognostic factors for long COVID included higher initial infection severity, younger age, and reinfection. For symptom count, factors were depression, initial infection severity, and reinfection. Health perception was eight points lower in long COVID patients (77.72: SD=17.10 vs 86.15; SD=16.25; p<0.001). Female sex, older age, fewer comorbidities, and more vaccine doses were associated with better quality of life.</p><p><strong>Conclusions: </strong>Thirty-two percent of patients experienced long COVID, mainly fatigue and anosmia/dysgeusia. It associates with higher initial severity, younger age, and reinfection, negatively impacting quality of life.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627317","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":"[Interventions to enhance the experience of family members and companions during surgical waiting: A systematic review].","authors":"María José Moreno, Elena Martín-Gómez, Mónica Vázquez-Calatayud","doi":"10.23938/ASSN.1094","DOIUrl":"10.23938/ASSN.1094","url":null,"abstract":"<p><strong>Background: </strong>Family members and companions play a crucial role in supporting a patient's postoperative recovery, fostering a positive attitude toward the hospital, and promoting overall well-being. This study aimed to identify effective interventions designed to enhance the experience of family members and companions during surgical waiting periods.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. A comprehensive search was performed in the PubMed, CINAHL, PsycINFO, and Cochrane databases for articles published in Spanish or English between January 2013 and December 2023. Data extracted from the studies included: country of origin, publication year, study design, sample size, study objective, characteristics of the interventions, tools used to measure effectiveness, and key findings. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools.</p><p><strong>Results: </strong>Eight studies were included, evealingr three main types of interventions: structured communication, telematic communication, and continuous communication. These interventions were heterogeneous in terms of key components, including provider, timing, location, format, frequency, and duration. Not all studies provided detailed information on these elements. Telematic communication, particularly explanatory videos lasting at least 20 minutes in the waiting room, was found to be effective in significantly reducing family anxiety, as measured by the STAI scale.</p><p><strong>Conclusions: </strong>The results highlight the limited number of interventions designed to improve the experience of families and companions during surgical waiting periods. There is a clear need for standardized interventions and outcome measurement tools to optimize emotional support, ultimately improving the family experience and well-being in this context.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517728","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":"Association between pre-existing cardiovascular risk factors and post-acute sequelae of COVID-19 in older adults.","authors":"Guilherme José Silva Ribeiro, André de Araújo Pinto, Gabriela Corrêa Souza, Emilio Hideyuki Moriguchi","doi":"10.23938/ASSN.1103","DOIUrl":"10.23938/ASSN.1103","url":null,"abstract":"<p><strong>Background: </strong>The long-term health impacts of COVID-19, including post-acute sequelae of SARS-CoV-2, remain insufficiently explored, especially concerning pre-existing cardiovascular risk factors in older adults. This study examines the association between these risk factors and post-acute sequelae of SARS-CoV-2 in this population.</p><p><strong>Methods: </strong>A retrospective study of Brazilian adults aged = 60 years assessed the persistence of post-acute sequelae of SARS-CoV-2 three months after infection in 2020. Cardiovascular risk factors (obesity, smoking, high blood pressure, diabetes mellitus, hypercholesterolemia, and chronic kidney disease) were analyzed in relation to sequelae and adjusting for sociodemographic variables. Data were obtained from the Department of Epidemiological Surveillance in Roraima, Brazil.</p><p><strong>Results: </strong>Of the 1,322 participants (55% female; mean age 70.4 years, SD = 7.87), 61.7% (95% CI: 59.1-63.9) reported at least one post-acute sequelae of SARS-CoV-2 at the three-month follow-up. The likelihood of post-acute sequelae of SARS-CoV-2 was significantly higher in participants with diabetes mellitus (OR = 4.39; 95% CI: 3.42-5.66), tobacco use (OR = 3.93; 95% CI: 2.47-6.23), hypertension (OR = 3.62; 95% CI: 2.73-4.78), or hypercholesterolemia (OR = 3.58; 95% CI: 2.80-4.59). Chronic kidney disease (OR = 2.28; 95% CI: 1.59-3.25) and obesity (OR = 1.83; 95% CI: 1.28-2.61) were less strongly associated.</p><p><strong>Conclusions: </strong>Pre-existing cardiovascular risk factors are linked to a higher likelihood of long-term COVID-19 sequelae in adults aged = 60 years old. Preventing and managing these factors are crucial for reducing the long-term effects of COVID-19, particularly during a pandemic.</p>","PeriodicalId":500996,"journal":{"name":"Anales del sistema sanitario de Navarra","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416650","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}