Medicina de Familia-SEMERGEN最新文献

{"title":"Utilidad de la teleconsulta en cardiología","authors":"F.J. Molano Casimiro,&nbsp;M. González Correa,&nbsp;M.J. Romero Reyes","doi":"10.1016/j.semerg.2024.102195","DOIUrl":"https://doi.org/10.1016/j.semerg.2024.102195","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The development of IT tools and interlevel relationships in the management of the most prevalent processes has led to a semi-presential assessment approach. In cardiology, this form of assessment is possible through a close collaboration with primary care. The aim of this study is to analyze the results of our e-consultation program and to establish the effectiveness of this new form of assistance.</p></div><div><h3>Methods</h3><p>Single-center study that included e-consultations referred from 15 September 2021 to 30 September 2022. Subsequently, we analyzed the events in which patients were discharged directly during the e-consultation with no need for an on-site visit.</p></div><div><h3>Results</h3><p>We included 3,155 e-consultations. The mean age of the patients was 57<!--> <!-->±<!--> <!-->17.6 years. Of the consultations, 75% were answered within 48<!--> <!-->h (62% within 24<!--> <!-->h). A total of 1,988 patients completed one year of follow-up in e-consultation. Out of these, 1,278 patients (64.2%) were discharged from the e-consultation with no need for an on-site visit: 685 patients (53.5%) during the first consultation, and 593 (46.5%) upon request of a complementary test. After one year of follow-up, 13 patients (0.006%) were admitted due to cardiological pathology, and 16 patients (0.008%) died, only one due to cardiovascular causes. The mean age of the deceased was 80.5 years.</p></div><div><h3>Conclusions</h3><p>E-consultation as a single referral system from primary care to cardiology improves patient accessibility, speeds up patient assessment and is effective for patients discharged without the need for an on-site consultation.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113768","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}

{"title":"Long COVID: Factors influencing persistent symptoms and the impact of gender","authors":"A. Rodríguez Onieva ,&nbsp;C.A. Soto Castro ,&nbsp;V. García Morales ,&nbsp;M. Aneri Vacas ,&nbsp;A. Hidalgo Requena","doi":"10.1016/j.semerg.2024.102208","DOIUrl":"https://doi.org/10.1016/j.semerg.2024.102208","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to characterize the prevalence as well as clinical and epidemiological features of persistent symptoms after acute COVID-19, focusing on gender-specific differences in a primary care setting.</p></div><div><h3>Methods</h3><p>A total of 1542 individuals with confirmed SARS-CoV-2 infection were enrolled. The study population comprised 55.77% females (mean age: 45.04 years). Risk factors for persistent COVID-19 were analyzed, revealing disparities between men and women. Symptom clusters and their prevalence were assessed over time, along with functional status using the post-COVID-19 functional status scale.</p></div><div><h3>Results</h3><p>The prevalence of persistent COVID-19 was 12.38%, with females exhibiting a 1.5 times higher risk. Females displayed a higher number of visits and persistent symptoms at 90 days, decreasing after one year. Symptom clusters varied between genders, with females experiencing more dermatological issues. Functional status analysis revealed that females had a better pre-infection status, similar status to males at 90 days, and improved status at 180-, 270-, and 365-days post-infection. Logistic regression analysis showed significant associations between persistence, gender, hospitalization, radiological abnormalities, age, and immunosuppression.</p></div><div><h3>Conclusion</h3><p>This study provides insights into the prevalence and clinical characteristics of persistent COVID-19 in a primary care population. Females exhibited a higher risk of persistent symptoms and displayed distinct patterns in symptom clusters and functional status compared to males. These findings contribute to a better understanding of the long-term effects of COVID-19 and highlight the importance of gender-specific considerations in post-acute care.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103592","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}

{"title":"Impact of an educational intervention about healthy lifestyles in teenagers","authors":"J.C. Medrano-Sánchez ,&nbsp;C. Vela-Meco ,&nbsp;L. Gutiérrez-Ramírez ,&nbsp;Á. Arias-Arias ,&nbsp;A. Tejera-Muñoz","doi":"10.1016/j.semerg.2024.102191","DOIUrl":"https://doi.org/10.1016/j.semerg.2024.102191","url":null,"abstract":"<div><h3>Background</h3><p>During the last years, lifestyle has worsened along the entire European population, causing an alarming boom-up regarding overweight and obese people. Pediatric population is also influenced in this sense, which may predispose to suffer from several diseases in adulthood. Educational interventions at early ages could be an effective strategy to face this situation.</p></div><div><h3>Aim</h3><p>To describe the impact of an educational intervention about healthy lifestyle in adolescents.</p></div><div><h3>Methods</h3><p>A quasi-experimental study analyzing the knowledge of high school students, before and after a brief educational intervention based on a self-elaborated questionnaire including questions from the validated questionnaire CAPA (from Spanish, <em>Conocimientos en Alimentación de Personas Adolescentes</em>).</p></div><div><h3>Results</h3><p>The results of this study show a significant increase in knowledge about healthy lifestyles in the study population after the educational intervention (14.3<!--> <!-->±<!--> <!-->3.8 vs. 16.5<!--> <!-->±<!--> <!-->4.5; <em>p</em> <!-->&lt;<!--> <!-->0.001). In addition, this improvement presents an asymmetric distribution according to gender (13.2<!--> <!-->±<!--> <!-->3.6 vs. 14.9<!--> <!-->±<!--> <!-->4.6; <em>p</em> <!-->=<!--> <!-->0.002 in men; 15.6<!--> <!-->±<!--> <!-->3 vs. 18.1<!--> <!-->±<!--> <!-->3.6; <em>p</em> <!-->&lt;<!--> <!-->0.001 in women) and the type of educational center (14.17<!--> <!-->±<!--> <!-->3.6 vs. 16.48<!--> <!-->±<!--> <!-->4.17; <em>p</em> <!-->&lt;<!--> <!-->0.001 in public schools and 14.86<!--> <!-->±<!--> <!-->4.15 vs. 16.54<!--> <!-->±<!--> <!-->5.32; <em>p</em> <!-->=<!--> <!-->0.047 in private schools). Parents’ educational level was associated with improvement in knowledge about healthy lifestyles (13.44<!--> <!-->±<!--> <!-->2.9 vs. 15.67<!--> <!-->±<!--> <!-->5.37; <em>p</em> <!-->=<!--> <!-->0.132 at low level, 14.22<!--> <!-->±<!--> <!-->3.42 vs. 16.9<!--> <!-->±<!--> <!-->4.68; <em>p</em> <!-->&lt;<!--> <!-->0.001 at medium level and 15.75<!--> <!-->±<!--> <!-->3.3 vs. 17.39<!--> <!-->±<!--> <!-->4.5; <em>p</em> <!-->=<!--> <!-->0.022 at high level).</p></div><div><h3>Conclusion</h3><p>Educational intervention taught by primary health care professionals is a useful and efficient tool for the acquisition of nutritional and healthy lifestyle knowledge in adolescents.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139674600","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}

{"title":"Monacolin K supplementation in patients with hypercholesterolemia: A systematic review of clinical trials","authors":"E. Liasi ,&nbsp;M. Kantilafti ,&nbsp;E. Hadjimbei ,&nbsp;S. Chrysostomou","doi":"10.1016/j.semerg.2023.102156","DOIUrl":"https://doi.org/10.1016/j.semerg.2023.102156","url":null,"abstract":"<div><p>Monacolin K is the major active component in red yeast rice (RYR) which is structurally identical to lovastatin and has the most powerful effect, in terms of reducing blood cholesterol levels. This review aimed to examine the effect and safety of different doses of monacolin K on blood cholesterol levels. PubMed and Cochrane were searched for articles published between 2012 and 2023 for clinical-trials and randomized-controlled-trials. Eligible studies included participants<!--> <!-->&gt;<!--> <!-->18-years-old, of any gender and ethnicity. The intervention/exposure of interest was monacolin K. Hypercholesterolemia was considered the outcome of interest defined as the elevated total or low-density-lipoprotein (LDL) cholesterol levels. 12 randomized-controlled-trials were eligible for inclusion in the analysis including 769 participants<!--> <!-->&gt;<!--> <!-->18-years-old. 11 out of 12 studies were assessed with high methodological quality and one study with low methodological quality. Monacolin K supplementation varied between 2<!--> <!-->mg and 10<!--> <span>mg per day and the maximum period of supplementation was 12 weeks. All studies indicated a beneficial effect of monacolin supplementation on LDL and total cholesterol levels (</span><em>p</em> <!-->&lt;<!--> <!-->0.05) regardless the dose and period of supplementation. Also, 3 of the included studies reported adverse side effects after treatment with monacolin K. Low doses of monacolin K equal to 3<!--> <!-->mg/day exert potential cholesterol-lowering effects although the number of relative studies is limited. Regarding the safety of monacolin K supplementation, findings seem to be more controversial and therefore, it is suggested for all patients treated with monacolin K to be routinely monitored regardless the dose of supplementation.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139675439","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}

{"title":"Prescripción de ejercicio en condición pos-COVID. Un reto en Atención Primaria","authors":"M.M. Yagüe Sebastián ,&nbsp;S. Sánchez Quintanilla","doi":"10.1016/j.semerg.2023.102190","DOIUrl":"https://doi.org/10.1016/j.semerg.2023.102190","url":null,"abstract":"<div><p>After the SARS-CoV-2 pandemic we face a new global epidemic: the Post-COVID Syndrome. This novel condition has fluctuating progression and a wide range of symptoms, such as fatigue, headaches, muscle pain or breathlessness. Although its pathophysiology is not clear, a multiorganic affection is suspected, altering the immune, cardiorespitatory and nervous systems.</p><p>Whereas there is no consensus over its treatment, most of the researches conclude the effectiveness of therapeutic exercise and a multicomponent rehabilitation, coordinating and cooperating between different health professionals. A functional, respiratory and strength evaluation prior to treatment prescription is highly recommended, since it will help professionals to precisely prescribe and objectively measure the evolution of our patients.</p><p>In this article we suggest a few tests, adequate to primary health requirements, to evaluate our patients’ initial condition, as well as the most secure way to initiate a therapeutic exercise programme, together with other healthcare providers.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139675470","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}

{"title":"Control sobre factores de riesgo, intervención sobre estilos de vida, y medicación prescrita en una cohorte de pacientes con cardiopatía isquémica","authors":"C. de Santiago González ,&nbsp;J. Ciudad Martín ,&nbsp;M.M. García Alonso","doi":"10.1016/j.semerg.2023.102175","DOIUrl":"10.1016/j.semerg.2023.102175","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to analyze the recommended prevention measures in our health area for patients discharged after a myocardial infarction.</p></div><div><h3>Methods</h3><p>This was a retrospective descriptive study that selected patients with acute coronary syndrome in our health area in the previous calendar year. Control of the risk factors observed at the time of the coronary event and at 1 year and medication prescribed 1 year after the episode were studied. Variables including age, sex, control of dyslipidemia, hypertension or diabetes mellitus, adherence to treatment and lifestyle habits were analyzed.</p></div><div><h3>Results</h3><p>Risk factor control was insufficient and sometimes even unassessed at the time of infarction. Although a slight improvement was perceived, control remained insufficient 1 year later. Moreover, patients, particularly women, were undertreated: one fifth (20%) more men were receiving appropriate treatment than women year after the myocardial event.</p></div><div><h3>Conclusions</h3><p>An additional effort must be made compared to what is currently being done, both by specialists in Hospital Care and Primary Care, to carry out good control of risk factors, meaning the control of certain diseases such as diabetes, high blood pressure or dyslipidemia, as well as habits or lifestyles that increase the probability of suffering a cardiovascular event. Furthermore, it is important to avoid these cardiovascular diseases and their relapse to reinforce adherence to the prescribed treatments.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673646","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}

{"title":"COPD patient profiles in primary care. Referral criteria","authors":"E. Trillo-Calvo ,&nbsp;J. de Miguel Díez ,&nbsp;C. González Villaescusa ,&nbsp;P. Panero Hidalgo ,&nbsp;J.E. Cimas Hernando ,&nbsp;M. Villanueva Pérez ,&nbsp;F.J. Plaza Zamora ,&nbsp;M. Sanz Almazán ,&nbsp;J.M. Figueira-Gonçalves","doi":"10.1016/j.semerg.2024.102192","DOIUrl":"10.1016/j.semerg.2024.102192","url":null,"abstract":"<div><p><span>COPD is a disease with a high prevalence that diminishes the </span>quality of life<span><span> of many patients. Despite this, there are still high rates of under-diagnosis in Spain, partly due to a lack of recognition of the pathology by patients. In this context, the role played by primary care teams becomes fundamental, as they are one of the first lines of entry into the </span>health system<span>. In this paper we explain the different COPD profiles that may be present, and update the tools for diagnosis and treatment, which, together with an attitude of active suspicion of the disease, can help in the correct management of patients, whether they are undiagnosed or have subsequent complications.</span></span></p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673647","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}

{"title":"En dermatología no solo tratamos con corticoides. Granuloma de Majocchi por Trichophyton rubrum","authors":"J. González Fernández,&nbsp;P. Soto Revuelta,&nbsp;P. Villagrasa Boli","doi":"10.1016/j.semerg.2023.102133","DOIUrl":"10.1016/j.semerg.2023.102133","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673645","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}

{"title":"Asociación entre la adherencia terapéutica y las fases de duelo en pacientes con diabetes mellitus tipo 2","authors":"A. Medina Ávila ,&nbsp;R. Leyva Jiménez","doi":"10.1016/j.semerg.2023.102178","DOIUrl":"10.1016/j.semerg.2023.102178","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the association between therapeutic adherence and the phases of grief in patients with type 2 diabetes mellitus.</p></div><div><h3>Design</h3><p>Cross-sectional observational study.</p></div><div><h3>Site</h3><p>Family Medicine Unit No. 53 of the Mexican Institute of Social Security in the State of Guanajuato.</p></div><div><h3>Participants</h3><p>A total of 354 patients with type 2 diabetes mellitus were recruited, of whom 236 corresponded to the group without therapeutic adherence and 118 to the group with therapeutic adherence.</p></div><div><h3>Interventions</h3><p>Two structured surveys were administered to both groups.</p></div><div><h3>Main measurements</h3><p>The Morisky 8 scale was used to measure therapeutic adherence and the phases of grief scale (EFD-66) to measure grief due to loss of health.</p></div><div><h3>Results</h3><p>The median denial phase and depression phase scores were higher in the nonadherence group than in the adherence group (<em>p</em> <!-->=<!--> <!-->.000). The median negotiation phase and acceptance phase score was higher in the adherence group than in the nonadherence group (<em>p</em> <!-->=<!--> <!-->.000). Multivariate analysis identifies that denial is the main factor associated with non-adherence (OR<!--> <!-->=<!--> <!-->1.25; 95% CI: 1.14–1.37); while negotiation (OR<!--> <!-->=<!--> <!-->0.88; 95% CI: 0.82–0.94) and acceptance are associated with adherence (OR<!--> <!-->=<!--> <!-->0.79; 95% CI: 0.75–0.83).</p></div><div><h3>Conclusions</h3><p>There is an association between therapeutic adherence and phases of grief.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673602","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}

{"title":"La gota, más allá de la articulación: ¿cómo debemos tratarla?","authors":"M.A. Pou ,&nbsp;D. Martinez-Laguna ,&nbsp;C. Diaz-Torne","doi":"10.1016/j.semerg.2023.102176","DOIUrl":"10.1016/j.semerg.2023.102176","url":null,"abstract":"<div><p>Gout is a disease caused by the chronic deposition of monosodium urate crystals. Its clinical presentation as an acute, self-limiting arthritis and the belief that it is a banal, self-inflicted disease have led to its poor management. Despite advances in the knowledge of the disease and the simplicity of its management, no more than 30% of patients are well treated. In Spain, the prevalence of gout is 2.5% and its incidence is increasing.</p><p>In the following article we will review the pathogenesis of gout and hyperuricaemia, highlighting the greater weight of genetics and renal function over diet. We will look at the consequences of crystal deposition. Gout, in addition to its joint presentation and renal involvement, has been shown to be an independent cardiovascular risk factor.</p><p>Hypouricemic therapy is the most important treatment, as it is the one that dissolves the crystals and cures the disease. This requires the sustained achievement of uricemia levels below 6<!--> <!-->mg/dl. We will also review preventive and flares treatment, as well as the role of patient education in terms of both lifestyle and dietary habits and adherence to pharmacological treatment.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673644","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}