Atencion Primaria Practica最新文献_第5页

Hemorragia por metástasis cerebrales por carcinoma infiltrante de mama: a propósito de un caso 乳腺浸润性癌脑转移出血1例

Atencion Primaria Practica Pub Date : 2023-04-01 DOI: 10.1016/j.appr.2023.100173

Josep Guil-Sànchez

引用次数: 0

Prevención y VIH. Mucho hecho, mucho por hacer en el manejo compartido de las personas que viven con el VIH 预防和艾滋病毒。在共同管理艾滋病毒感染者方面做了很多工作，还有很多工作要做

Atencion Primaria Practica Pub Date : 2023-04-01 DOI: 10.1016/j.appr.2023.100172

Juanjo Mascort-Roca , Ricard Carrillo-Muñoz

引用次数: 0

Cura seca versus cura en ambiente húmedo aplicadas a la cirugía menor en la exéresis de fibromas blandos: ensayo clínico aleatorizado 干固化与湿固化在软肌瘤切除小手术中的应用:随机临床试验

Atencion Primaria Practica Pub Date : 2023-04-01 DOI: 10.1016/j.appr.2023.100174

Laura Paloma Fürstenheim Milerud , Gemma Amat-Camats

{"title":"Cura seca versus cura en ambiente húmedo aplicadas a la cirugía menor en la exéresis de fibromas blandos: ensayo clínico aleatorizado","authors":"Laura Paloma Fürstenheim Milerud , Gemma Amat-Camats","doi":"10.1016/j.appr.2023.100174","DOIUrl":"10.1016/j.appr.2023.100174","url":null,"abstract":"<div><h3>Objective</h3><p>To compare which skin tag approach tecniques, while adding a new technique, in order to find which produces less complications, less cost and an earlier healing.</p></div><div><h3>Design</h3><p>Non-blinded randomized clinical trial with consecutive sampling.</p></div><div><h3>Site</h3><p>Área Básica de Salud Balaguer.</p></div><div><h3>Participants</h3><p>N = 240 skin tags.</p></div><div><h3>Interventions</h3><p>The corresponding randomized technique was performed and subsequent follow-up until epithelialization.</p></div><div><h3>Main measurements</h3><p>Sex, age, family history of skin tags, location of the lesion, diabetes, cost, healing time, complications and technique used. The techniques used were: cryotherapy, electrosurgery, excision with silver nitrate application (SNA) and excision with moist wound healing treatment (MWH).</p></div><div><h3>Results</h3><p>According to techniques, healing time is lower in MWH (3.3[±1.0] days) than in dry healing (cryotherapy 4.5[±2.3] days, electrosurgery 8.2[±4, 2] days and SNA 10.7 [±4.8] days), p < 0.001. There was also a significant difference in the number of complications in MWH (0.0%) compared to dry-healing techniques: cryotherapy 1 (3.0%), electrosurgery 4 (11.4%), SNA 22 (57.9%), p < 0.001. Finally, a lower economic cost was observed in skin tags treated with MWH (146[±9.0] euros) versus those treated with dry cure (cryotherapy 235[±22.2] euros, electrosurgery 272[±41.1] euros, SNA 213[±43.2] euros), p < 0.001.</p></div><div><h3>Conclusions</h3><p>Treatment of skin tags by MWH is the best technique to treat these lesions because of its shorter healing time, lower cost and fewer complications. SNA stands out as the technique that has the highest number of complications and the longest healing time.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42119288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Torus palatinus en 2 hermanas 2姐妹中的Torus Palatinus

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2022.100161

Salvador Labrador-Descalzo , Nerea Cortina-Garmendia , Marta Valle-Coca

引用次数: 0

Otitis media aguda y pérdida auditiva neurosensorial permanente 急性中耳炎和永久性感音神经性听力损失

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2023.100167

Ignacio Fernández Granell , Soraya Senao Fernández , Alexia Cruz Pérez , Enriqueta González Domínguez

引用次数: 0

Neuropatía crónica por síndrome tirogástrico: caso clínico y revisión de la literatura 甲状腺胃综合征慢性神经病变:临床病例及文献综述

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2022.100166

Luis Ángel Rodríguez Chávez , Franco Mariano Nazario Huaranga , Melissa Ysabel Romero Díaz , Víctor Alexander Lozano Araujo , Christian Alberto Vargas Machuca Carranza

引用次数: 0

Orientación comunitaria en los equipos de atención primaria 初级保健团队的社区指导

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2022.100165

Daniel García-Blanco , Jara Cubillo-Llanes

引用次数: 0

Teleconsultation, a tool for the future? - The Portuguese Family Doctors' perspective 远程咨询，未来的工具？-葡萄牙家庭医生的观点

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2023.100169

Rosana Dantas , Nelson Campos , Andreia Cunha Castro , Elodie Santos , Susana M. de Sá Laranjeira , Cristina Ramos Silva

{"title":"Teleconsultation, a tool for the future? - The Portuguese Family Doctors' perspective","authors":"Rosana Dantas , Nelson Campos , Andreia Cunha Castro , Elodie Santos , Susana M. de Sá Laranjeira , Cristina Ramos Silva","doi":"10.1016/j.appr.2023.100169","DOIUrl":"10.1016/j.appr.2023.100169","url":null,"abstract":"<div><h3>Objective</h3><p>The COVID-19 pandemic led to a mass use of teleconsultation. The aim of this study is to understand the family doctors' perspective over the utility of teleconsultation in their future clinical practice.</p></div><div><h3>Methods</h3><p>A cross-sectional study was realized through the application of an online survey, between September 18th and December 4th, 2020. The target population were family medicine physicians and residents who worked in a primary health unit belonging to the portuguese National Healthcare Service. A descriptive analysis of the characteristics of the participants and of their answers to the survey was performed.</p></div><div><h3>Results</h3><p>377 responses were received. It was identified as the main advantage the greater accessibility (68,7%), as the main disadvantage the impossibility to perform physical examination (81,2%) and as the main obstacle the lack of appropriate resources to teleconsultation (70,0%). The majority of the participants acknowledge that teleconsultation represents a valuable asset to the future of medicine (83,6%). 80,6% of the doctors would like to implement a teleconsultation period in their schedule and 76,1% think that teleconsultation will become essential to future clinical practice.</p></div><div><h3>Conclusion</h3><p>Published studies support our findings, regarding advantages, disadvantages and obstacles. It is acknowledged that currently neither portuguese population nor family medicine are ready for teleconsultation, although this is considered to be a useful tool to future clinical practice.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44740639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive factors for hospitalization in a cohort of primary healthcare patients with suspected COVID-19 疑似COVID-19初级保健患者队列住院的预测因素

Atencion Primaria Practica Pub Date : 2023-01-01 DOI: 10.1016/j.appr.2023.100168

Marta Massó-Muratel , Laura Granés , Laia Cayuelas , Joan Gené-Badia , Ethel Sequeira , Marta Catalán , Elisenda Sant , Sira Casablancas , Carmen Herranz , Ángela Martínez , Sandra Estévez

{"title":"Predictive factors for hospitalization in a cohort of primary healthcare patients with suspected COVID-19","authors":"Marta Massó-Muratel , Laura Granés , Laia Cayuelas , Joan Gené-Badia , Ethel Sequeira , Marta Catalán , Elisenda Sant , Sira Casablancas , Carmen Herranz , Ángela Martínez , Sandra Estévez","doi":"10.1016/j.appr.2023.100168","DOIUrl":"10.1016/j.appr.2023.100168","url":null,"abstract":"<div><h3>Background</h3><p>The objective of the study was to identify clinical and demographic factors predictive of hospitalization in primary healthcare patients diagnosed with suspected COVID-19 at the beginning of the pandemic.</p></div><div><h3>Methods</h3><p>A retrospective cohort study design was used. Patients attended in Casanova primary healthcare centre (CAP) (Barcelona, Spain) for symptoms compatible with possible or confirmed SARS-CoV-2 infection between February 24 and May 30, 2020, were included. Data was collected through the electronic medical record and by telephone interview.</p></div><div><h3>Results</h3><p>518 patients were included, of whom 283 (54.6%) were female. The median age was 50.2 years and 19.3% were aged ≥65 years: 79% were followed on an outpatient basis while the rest were hospitalized. Predictive factors for hospital admission were male sex, older age, a history of ischemic heart disease and the presence of dyspnoea, haemoptysis, nausea and vomiting, with a sensitivity of 48% and a specificity of 95.4%. Odynophagia and nasal congestion were predictors of a good prognosis. Mortality was 2.3% and 25% of deaths did not occur in hospital.</p></div><div><h3>Conclusions</h3><p>Nearly 80% of primary healthcare patients received only outpatient care. Male sex, older age, a history of ischemic heart disease and symptoms like dyspnoea, haemoptysis, nausea and vomiting could lead to a greater risk of an unfavorable evolution during COVID-19. Patients with at least one of the above factors, which correlate with a higher hospital admission rate, should receive a closer follow-up to early detect when they can benefit from a hospital evaluation based on their clinical evolution.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49155184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Propuestas para salir de la crisis 摆脱危机的建议

Atencion Primaria Practica Pub Date : 2022-12-01 DOI: 10.1016/j.appr.2022.100158

Joan Gené-Badia

{"title":"Propuestas para salir de la crisis","authors":"Joan Gené-Badia","doi":"10.1016/j.appr.2022.100158","DOIUrl":"10.1016/j.appr.2022.100158","url":null,"abstract":"<div><p>Primary health care crisis is shown in user satisfaction surveys and in the discouragement of professionals. Government, scientific societies, and unions have drawn up numerous documents with proposals to get out of the crisis, but very few have been applied or ended up with a significant change. The crisis is inherent to the primary care discipline because person centered care and population health condition interventions are not aligned with the growing medicalization of a health system focused on health problems care. The proposals are along the following lines: the integration of services in order to deal with the growing increase in chronic pathologies and comorbidity; the transition from control and command leadership to shared leadership; innovations aimed at easing the shortage of family doctors, including increasing other team members and the incorporation of new professions; organizational innovations aimed to improve accessibility, but at the same time increase continuity; the rational use of telemedicine; the modification of the undergraduate curriculum to finally include the discipline of family medicine; and the generalization of successful local community care projects. The future economic crisis, the shortage of professionals and the growing population aging could lead to the gradual application of some of these proposals, since it is not expected that a radical reform will take place.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073022000359/pdfft?md5=db0f976da7dcdd7b224dabcfa6ea9632&pid=1-s2.0-S2605073022000359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42447498","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: 1