Atencion Primaria最新文献

{"title":"¿Cuándo derivar a endocrinología el paciente con obesidad? Indicaciones actuales de la cirugía bariátrica","authors":"Laura Rius Acebes ,&nbsp;Myriam Sánchez-Pacheco-Tardon ,&nbsp;Domingo Orozco Beltrán","doi":"10.1016/j.aprim.2024.102961","DOIUrl":"10.1016/j.aprim.2024.102961","url":null,"abstract":"<div><p>Bariatric surgery (BS) has been shown to be effective and efficient, but only 1% of selected patients will ever receive it.</p><p>Compared to medical treatment of obesity, BS has demonstrated greater long-term sustained weight loss, a reduction in both total and cardiovascular (CV) mortality, improvement or remission of CV risk factors and other comorbidities associated with obesity, as well as improved mobility and quality of life.</p><p>BS presents similar risks to other abdominal surgeries, with obesity as an added risk factor. However, mortality after this type of surgery is less than 1%, being in specialised centres even lower than 0.3%, with a morbidity of less than 7%.</p><p>The most commonly performed surgical procedures at present are vertical gastrectomy and Roux---Y gastric bypass, preferably by laparoscopic approach.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724001033/pdfft?md5=009d9a2a85a2a4391367522e1076da82&pid=1-s2.0-S0212656724001033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equidad y ética en la era digital de la atención médica: reflexiones a partir de un artículo reciente","authors":"César Antonio Bonilla-Asalde ,&nbsp;Isabel Cristina Rivera-Lozada ,&nbsp;Oriana Rivera Lozada","doi":"10.1016/j.aprim.2024.102960","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102960","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724001021/pdfft?md5=97ee65f6f11469b32d0bc31ee2a6f24c&pid=1-s2.0-S0212656724001021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ordenación profesional y medicina familiar y comunitaria","authors":"José Ramón Vázquez Díaz","doi":"10.1016/j.aprim.2024.102956","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102956","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000982/pdfft?md5=84acefdd2680713de030cbf317a5bea2&pid=1-s2.0-S0212656724000982-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teleconsulta en Atención Primaria: aprendizajes en contextos distintos","authors":"Henry César Rivas Sucari ,&nbsp;José Luis Rodríguez Eguizabal","doi":"10.1016/j.aprim.2024.102897","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102897","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000398/pdfft?md5=0db710662d17fa9831d77d1b349b90f6&pid=1-s2.0-S0212656724000398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalencia de insuficiencia cardiaca diagnosticada en pacientes diabéticos en el ámbito de la atención primaria. ¿Debemos mejorar el cribado?","authors":"Manuel Sánchez Molla ,&nbsp;Juan Manuel Zazo Menargues ,&nbsp;Inmaculada Candela Garcia","doi":"10.1016/j.aprim.2024.102952","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102952","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000945/pdfft?md5=b803516b0a4ebf2d467df7d6fd545111&pid=1-s2.0-S0212656724000945-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140843489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efectos cardiometabólicos de la pérdida de peso","authors":"Idoia Genua ,&nbsp;Helena Sardà ,&nbsp;Antonio Pérez","doi":"10.1016/j.aprim.2024.102953","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102953","url":null,"abstract":"<div><p>The prevalence of overweight and obesity, and, consequently, associated comorbidities, is increasing significantly worldwide. The guidelines recommend a percentage of weight loss<!--> <!-->&gt; 5% to achieve beneficial effects on metabolic comorbidities associated with obesity. Furthermore, greater weight losses (&gt; 10%) produce more significant improvements, and may even produce remission of some of these comorbidities. In this chapter, we review the evidence of the effect of weight loss through different strategies (lifestyle intervention, pharmacological treatment, or bariatric surgery) on the main cardiometabolic pathologies associated with excess adipose tissue (type 2 diabetes, high blood pressure, dyslipidemia, metabolic dysfunction-associated steatotic liver disease, inflammation, cardiovascular diseases, and mortality).</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000957/pdfft?md5=7396f606d8f8cf4cfab756509d13af01&pid=1-s2.0-S0212656724000957-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140825686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Madrid Primary Health-Care staff for the implementation of exercise prescription","authors":"Sergio Calonge-Pascual ,&nbsp;Miguel-Ángel Gómez ,&nbsp;Susana Belmonte-Cortés ,&nbsp;José Antonio Casajús Mallén ,&nbsp;Marcela González-Gross ,&nbsp;on behalf of EXERNET Study Group","doi":"10.1016/j.aprim.2024.102946","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102946","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the self-perception of nurses and general practitioners (GPs) toward Physical Activity on Prescription (PAP) in Madrid Primary Health-Care (PHC).</p></div><div><h3>Design</h3><p>A survey-cohort study.</p></div><div><h3>Site</h3><p>Nurses and GPs of Madrid PHC System.</p></div><div><h3>Participants</h3><p>A total of 319 GPs and 285 nurses’ responders.</p></div><div><h3>Measurements</h3><p>Data were analyzed under a classification tree analysis by four predictor variables: (i) Health professional (Nurses/GPs); (ii) Exercise prescription collaboration with all health professionals: physicians, nurses, psychologists, physical therapists, sports medicine physicians, sports scientists, nutritionists, and teachers (Yes/No); (iii) PA promotion collaboration with Sports Scientists (Yes/No); and (iv) The stage of change of PHC staff to PA promotion (0–4 Likert scale).</p></div><div><h3>Results</h3><p>Regarding the predictor variable (i), responders without PA guidelines knowledge and positive attitude to collaborate with nurses in PA promotion are more GPs of female sex (nurses <em>n</em> <!-->=<!--> <!-->33 and GPs <em>n</em> <!-->=<!--> <!-->175) than male sex (nurses <em>n</em> <!-->=<!--> <!-->3 and GPs <em>n</em> <!-->=<!--> <!-->59) (<em>p</em> <!-->&lt;<!--> <!-->.001). For the predictor variable (ii) only 9.30% of PHC staff with a positive attitude to collaborate with all health professionals in PA promotion and exercise prescription. For the predictor variable (iii) was shown low collaboration with sports physicians and sports scientists under a multidisciplinary PAP approach (26.50% responders). Finally, in the predictor variable (iv) Staff maintaining PAP for at least 6 months, self-considered active, and with PAP knowledge want to collaborate with Sports scientists (Yes<!--> <!-->=<!--> <!-->233; No<!--> <!-->=<!--> <!-->133).</p></div><div><h3>Conclusions</h3><p>Nurses and GPs are conscious of health-related PA benefits despite the lack of PAP knowledge and lack of willingness to collaborate with other health personnel, exercise professionals, and community resources available.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021265672400088X/pdfft?md5=d5037a3dd8b7acd52a7fac0ae048dad7&pid=1-s2.0-S021265672400088X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140825685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factores asociados a la sobrecarga del cuidador en cuidadores primarios de personas adultas mayores con diabetes tipo 2","authors":"Ricardo Alejandro Sánchez Bárcenas ,&nbsp;Daniel López Hernández ,&nbsp;Leticia Brito-Aranda ,&nbsp;Brenda Berenice García Mantilla ,&nbsp;María del Rocío Thompson Bonilla ,&nbsp;Ernestina Pavón Delgado ,&nbsp;Luis Beltrán Lagunes ,&nbsp;Roberto Durán Rojo ,&nbsp;Emmanuel Melgarejo-Estefan ,&nbsp;Tania Castillo-Cruz ,&nbsp;Tabata Gabriela Anguiano Velázquez ,&nbsp;Arisbel Orozco-Valencia","doi":"10.1016/j.aprim.2024.102948","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102948","url":null,"abstract":"<div><h3>Objective</h3><p>To characterize the profile of the informal primary caregiver (IPC) of adult patients with type<!--> <!-->2 diabetes (T2D) and the possible factors associated with caregiver collapse (CC).</p></div><div><h3>Design</h3><p>Observational, descriptive, cross-sectional and analytical study.</p></div><div><h3>Site</h3><p>Ambulatory Care Medical Unit.</p></div><div><h3>Participants</h3><p>Mexican CPIs of adult patients with T2D.</p></div><div><h3>Main measurements</h3><p>Data were collected through a prolective design using the Zarit scale and a structured survey on sociodemographic factors. A descriptive statistical analysis and univariate and multivariate logistic regression models were performed.</p></div><div><h3>Results</h3><p>The CPI profile is assumed by: women, people aged 36-58, daughters, people with a secondary and high school educational level, married, Catholic, with income &lt;<!--> <!-->8,900 Mexican pesos, own home, inhabited by a maximum of 5 inhabitants, with support networks, who have dedicated &gt;<!--> <!-->5<!--> <!-->years to the care of their patient, without training and with chronic diseases. The risk factors that increase the risk of CC are: being a woman (OR<!--> <!-->=<!--> <!-->11.03; 95%<!--> <!-->CI: 1.49-81.95), having a history of more than 5<!--> <!-->years of having assumed the role of caregiver (OR<!--> <!-->=<!--> <!-->2, 65; 95%<!--> <!-->CI: 1.07-6.55), living in one's own house (OR<!--> <!-->=<!--> <!-->3.03; 95%<!--> <!-->CI: 1.04-8.82), with 6 or more inhabitants (OR<!--> <!-->=<!--> <!-->2.41; 95%<!--> <!-->CI: 1.08-5.38). The support of other family members and/or friends was associated as a protective factor (OR<!--> <!-->=<!--> <!-->0.15; 95%<!--> <!-->CI: 0.07-0.33).</p></div><div><h3>Conclusions</h3><p>Prevention programs are required to avoid CC and complications, as well as interventions to improve the quality of life of the CPI and patients in care, incorporating strategies to generate and/or increase their family and social support networks.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000908/pdfft?md5=a5dd7f54130c71f9e17daabba6225d56&pid=1-s2.0-S0212656724000908-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening primary health care in Europe with digital solutions","authors":"Jordi Piera-Jiménez ,&nbsp;Toni Dedeu ,&nbsp;Claudia Pagliari ,&nbsp;Tatjana Trupec","doi":"10.1016/j.aprim.2024.102904","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102904","url":null,"abstract":"<div><p>This article provides an in-depth analysis of digital transformation in European primary healthcare (PHC). It assesses the impact of digital technology on healthcare delivery and management, highlighting variations in digital maturity across Europe. It emphasizes the significance of digital tools, especially during the COVID-19 pandemic, in enhancing accessibility and efficiency in healthcare. It discusses the integration of telehealth, remote monitoring, and e-health solutions, showcasing their role in patient empowerment and proactive care. Examples are included from various countries, such as Greece's ePrescription system, Lithuania's adoption of remote consultations, Spain's use of risk stratification solutions, and the Netherlands’ advanced use of telemonitoring solutions, to illustrate the diverse implementation of digital solutions in PHC. The article offers insights into the challenges and opportunities of embedding digital technologies into a multidisciplinary healthcare framework, pointing towards future directions for PHC in Europe.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000465/pdfft?md5=1d16240957d7d0cfc4bba74a0a24a0cc&pid=1-s2.0-S0212656724000465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140815401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrategias para la prevención y tratamiento no farmacológico de la diabetes. Modelos de atención","authors":"Manuel Antonio Botana López","doi":"10.1016/j.aprim.2024.102947","DOIUrl":"https://doi.org/10.1016/j.aprim.2024.102947","url":null,"abstract":"<div><p>Diabetes is a highly prevalent, chronic disease that over time generates potentially serious complications. In the treatment of diabetes, the use of drugs that have shown significant benefits is important, but, in addition, the use of non-pharmacological interventions is essential, which constitute an efficient and effective way to reduce the appearance of diabetes itself and the complications of the disease. These interventions, which are described here, include health education, aimed at incorporating a healthier lifestyle, dietary modifications, increased physical activity or psychological support. Finally, the characteristics that a care system for people with diabetes must meet to achieve the established objectives are discussed.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724000891/pdfft?md5=a93a2287a415bbe6ba4a85090e3d80e9&pid=1-s2.0-S0212656724000891-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140807235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}