Artículos (Medicina Preventiva y Salud Pública)
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Artículo Nursing participation in health technology assessment: a pending issue?(Escuela de Enfermería de Ribeirão Preto, 2024-11-04) Lacalle Remigio, Juan Ramón; Benot López, Soledad; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaThe term health technologies (HT) it covers not only medical devices, but also medicines, medical and surgical procedures, procedures for the prevention, diagnosis and treatment of health problems, as well as formulas for the organization and management of healthcare. On the other hand, when we talk about health technology assessment (HTA) we refer to a multidisciplinary research process to synthesize the available scientific information. This information concerns the medical, social, economic and ethical consequences of using a health technology. The synthesis must be carried out in a systematic, transparent, unbiased and robust manner.Artículo Implementación y evaluación de un rotatorio formativo en salud bucodental para residentes de medicina de familia y comunitaria. Experiencia piloto(Elsevier, 2024-06) García-Palma, Alfonso; Luque Romero, Luis Gabriel; Gamero-Merino, María Luisa; de-Marco-Pérez, Fernando; Gómez-Salgado, Juan; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaLas enfermedades bucodentales (EBD) se encuentran entre las enfermedades prevenibles más prevalentes a nivel mundial. La consulta de medicina de familia suele ser el primer contacto con las personas que presentan cualquier problema del área oral. En España en el año 2021, se atendieron en Atención Primaria (AP) más de 11 millones de personas por EBD. Según la evidencia disponible, las EBD pueden ser la primera expresión de enfermedades sistémicas y algunas de ellas mantienen una relación bidireccional con ciertas enfermedades crónicas. Dentro del extenso programa de formación de Medicina Familiar y Comunitaria (MFyC) que se desarrolla en cuatro años, no se contempla una formación en los problemas odontológicos de la población4, los cuales son un motivo de consulta frecuente en AP.Artículo Evaluación del manejo y seguimiento de los pacientes diabéticos en la prevención de la retinopatía diabética(Ministerio de Sanidad, 2024-04) Piñas-García, Purificación; Ruiz Romero, M. V.; Luque Romero, Luis Gabriel; Gómez Jiménez, Carlos Alberto; Castillón Torre, L.; Hernández Martínez, Francisco Javier; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaFUNDAMENTOS: La diabetes mellitus es una enfermedad crónica con alta morbimortalidad que afecta a 537 millones de adultos en el mundo. España es el segundo país europeo en prevalencia, con un 14,8% en población de veinte-setenta y nueve años, con 11,6 casos por cada 1.000 personas/año. La retinopatía diabética (RD) es la quinta causa de pérdida de visión a nivel mundial y la séptima causa de ceguera/discapacidad visual entre afiliados a la Organización Nacional de Ciegos de España (ONCE). La detección precoz de RD previene la ceguera en diabéticos y está condicionada por la hemoglobina glicosilada. El objetivo de este trabajo fue analizar el manejo de los pacientes diabéticos en la comarca del Aljarafe (Sevilla) e identificar oportunidades de mejora en la coordinación de su seguimiento entre el médico de Atención Primaria y el médico oftalmólogo. MÉTODOS: Se realizó un estudio observacional retrospectivo (2016-2019) con los pacientes registrados en el censo de diabéticos de los veintiocho municipios del Aljarafe. Se consultó la historia de salud de Atención Primaria y Hospital, así como el programa de Telemedicina. En cuanto al análisis estadístico, para variables cualitativas se calcularon totales y porcentajes; para variables cuantita- tivas, media y distribución estándar (si distribución normal), y la mediana y cuartiles (distribución no normal). RESULTADOS: Se registraron 17.175 diabéticos en el Aljarafe (5,7% de población); 14.440 pacientes (84,1%) tenían alguna determi- nación de hemoglobina durante el periodo, 9.228 (63,9%) las tenían todas en rango adecuado. Tenían control fundoscópico 12.040 diabéticos (70,1%), y de los que no, 346 (10,6%) tenían todas fuera de rango. Hubo 1.878 (10,9%) pacientes sin control fundoscópico ni metabólico, 1.019 (54,3%) eran mujeres, 1.219 (64,9%) menores de sesenta y cinco años, 1.019 (54,3%) con comorbilidad grave. CONCLUSIONES: La mayoría de los pacientes presentan un cribado adecuado y, más de la mitad, determinaciones en rango. Sin embargo, un porcentaje relevante con ninguna hemoglobina glicosilada en rango carecen de control fundoscópico, y otro grupo me- nor está sin control fundoscópico ni metabólico, con variabilidad intermunicipios. Planteamos mejorar los circuitos de comunicación entre niveles.Artículo Emergency and Urgent Care Network: Analysis of the Stroke Care Line According to Care Times and Outcomes(SCIENCEDOMAIN International, 2024) Leite, Karina Fonseca de Souza; Andrade, Rubia Laine de Paula; Faria, Mariana Gaspar Botelho Funari de; Isaac, Igor Simões da Silva; Ferreira, Kamila Santos; Lacalle Remigio, Juan Ramón; Camilo, Millene Rodrigues; Monroe, Aline Aparecida; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS312: Análisis de la Demanda SanitariaBackground: Given the importance of acute stroke care for public health in terms of its burden and consequences like disability and death, evidence-based practice has directed the development of clinical protocols and operational guidelines to care of the populations affected by this pathology. Aim: To evaluate the impact of implementing the stroke care line in the Urgency and Emergency Care Network of a large Brazilian municipality. Methods: This is a retrospective study, conducted between 2014 and 2019 in public health services in Ribeirao Preto, SP, a large municipality of Brazil. Data was collected through secondary sources. A total of 403 patients were included in the study, of which: 172 were treated between 2014 and 2016 and 231 between 2017 and 2019; 118 were served by the mobile pre-hospital care services and 285 by the fixed pre-hospital care services. Data comprise clinical, epidemiological characteristics and severity of cases, as well as stroke care times and outcomes and were analyzed using descriptive techniques, Mann-Whitney and Chi-squared tests. Results: First care provided by a mobile pre-hospital care unit increased from 16.9% to 38.5%. The service times for people undergoing thrombolysis were shorter in the period from 2017 to 2019 compared to 2014 to 2016 in the door-to-needle, stroke onset-to-call, stroke onset-to-ambulance dispatch and regulation-to-door times. Stroke victims treated first by a mobile (ambulance) unit had shorter care times when compared to those who received care in a fixed unit, except in ambulance dispatch-to-door time. No difference was identified in the percentage of outcomes studied in the period from 2017 to 2019 compared to the period from 2014 to 2016. There was a higher craniectomy occurrence in people treated at home than in those attended in health services. The percentage of unfavorable stroke outcomes increased depending on the case severity. Conclusion: The care flow organization with defined responsibilities for each care point through the creation of a care line and the use of pre-established protocols reduced pre- and in-hospital care times; however, they did not have a significative influence on the case outcomes.Artículo Audit of dental reports (II): first phase-II study in a Spanish faculty of dentistry(Medicina oral S L, 2008) Ríos-Santos, J.V.; Martin García, Pilar; Segura Egea, Juan José; Fernández Palacín, Ana; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades MuscularesAs a measure for correction of deficiencies registered through an audit of dental records in the Comprehensive Dentistry Clinic of the Dentistry Faculty of the University of Seville, we elaborated a new format for dental records which was used in 70 patients, carrying out a monitoring audit (Phase V) by applying the same quality criteria and criteria for data collection used in the initial audit (Phase III). We calculated the indices of fulfilment of 46 quality criteria, extending fulfilment percentage to 41 criteria, while statistically significant differences were found in 25 criteria. The standard prefixed as appropriate (75 %) was reached in 29 criteria (against the 12 criteria in which such standard was reached in the first dental audit). It is essential that faculties of dentistry develop systems for dental record revision which may help students achieve the competence of registering dental-care steps appropriately, teachers identify and give response to educational problems, and clinic administration prevent and correct conflicts, at the same time that they all ensure quality in service provision, ease relations with customers and protect users against legal vulnerability.Artículo Dental audit (I): exact criteria of dental records; results of a phase-III study(Medicina oral S L, 2018) Martin García, Pilar; Ríos-Santos, J.V.; Segura Egea, Juan José; Fernández Palacín, Ana; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades MuscularesObjective: Evaluating the quality of dental records in the Faculty of Dentistry of the University of Seville (Spain). We attempted to collect and/or develop identifiable elements of dental care used to evaluate its appropriateness, as well as to measure its level of filling-in between 1999 and 2004 (Phase III of the record audit). Method: The 46 criteria used to evaluate dental care are shown, measuring--in 50 dental records randomly chosen within a 5-year-time period--their level of filling-in (Phase III of a health audit). Results: A low level of filling-in was observed in all quality criteria defined. No record was found to be free from errors. A maximum of 36 criteria out of 46 was fulfilled (mean of 20.8). Conclusions: The standard of appropriate filling-in was only met in 12 criteria (75%), the results being poor, due to the importance which clearly deficient aspects related to diagnosis and treatment plan have in the process of patient care. For such reason, we suggest a remedial action (Phase IV) developing a new model of dental record and its subsequent re-evaluation (Phase V), which will be subject to analysis in the second part of this paper.Artículo Clinical indicators of periodontal disease in patients with coronary heart disease: a 10 years longitudinal study(Medicina oral S L, 2012-06) Machuca-Portillo, Guillermo; Segura Egea, Juan José; Jiménez-Beato, Gema; Lacalle Remigio, Juan Ramón; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; ; Universidad de Sevilla. CTS1000: Odontología en Pacientes Especiales, Médicamente Comprometidos y Hospitalaria; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades MuscularesObjectives: There is evidence about a possible relationship existing between periodontal diseases and coronary heart disease. The aim of the present longitudinal study was to investigate the changes in periodontal evolution after etiological periodontal treatment, comparing a healthy control group with another having coronary heart disease. Study design: The study included initially 55 patients of which 44 finished it. They were placed into two groups: Healthy Control Group (HCG) n =9, and Coronary Heart Disease Group (CHDG) n=35. The gingival level (GL), probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were measured to compare the periodontal status in both groups. The patients were examined and etiological periodontal treatment was performed and they were then examined at the end of 1 and 10 years. Statistical method: A one way-ANOVA and a MR-ANOVA were established; significance p<0.05. Results: No significant differences between both groups were detected on the first visit (p>0.5). However, at the second visit the CHDG presented a significantly higher PD (p<0.05) and PI (p<0.01). CHDG patients gradually increase PD through time and in comparison to the control group (p<0.041). CHDG patients present a significantly higher CAL loss (p<0.0385) and a significant increase in PI (p<0.0041) at the end of one year, while on the third visit no significant differences were detected in any of these indices. Likewise, a similar fact can be observed on evaluating BOP at the end of ten years causal treatment, a smaller decrease in the cardiac group was observed in regards to the initial values (p<0.001). Conclusion: Patients with coronary heart disease showed a worse evolution of periodontal indices than healthy ones, when referring to probing depth, plaque index and bleeding on probing index.Artículo Assessment of a phenotypic algorithm to detect plasmid-mediated quinolone resistance in Enterobacteriaceae(Oxford Academic, 2016-03) Rodríguez Martínez, José Manuel; López Cerero, Lorena; Díaz de Alba, Paula; Chamizo López, Francisco Javier; Díaz de Alba, Paula; Chamizo López, Francisco Javier; Polo Padillo, Juan; Pascual Hernández, Álvaro; Universidad de Sevilla. Departamento de Microbiología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS210: Resistencia a Antimicrobianos; Universidad de Sevilla. CTS312: Análisis de la Demanda SanitariaQuinolone resistance in Gram-negative bacteria is the result of mutations in the quinolone resistance-determining region (QRDR) in chromosomally located genes encoding type II topoisomerases and, to a lesser extent, altered permeability. Plasmid-mediated quinolone resistance (PMQR) has also been reported as encoding different proteins: Qnr proteins, acetyltransferase AAC(6′)-Ib-cr variant and the QepA and OqxAB active efflux pumps.Artículo Loss of efficacy and safety of the switch from infliximab original to infliximab biosimilar (CT-P13) in patients with inflammatory bowel disease(Baishideng Publishing Group Inc, 2018-12-14) Guerra Veloz, María Fernanda; Argüelles Arias, Federico; Laria, Luisa Castro; Maldonado Pérez, Belén; Benítez Roldán, Antonio; Perea Amarillo, Raúl; Merino Bohórquez, Vicente; Calleja, Miguel Ángel; Caunedo Álvarez, Ángel; Vilches Arenas, Ángel; Universidad de Sevilla. Departamento de Medicina; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Farmacología; Universidad de Sevilla. CTS312: Análisis de la Demanda SanitariaBACKGROUND Infliximab original has changed the natural history of inflammatory bowel diseases (IBD) over the past two decades. However, the recent expiration of its patent has allowed the entry of the first Infliximab biosimilar into the European and Spanish markets. Currently switching drugs data in IBD are limited. AIM To compare the efficacy of infliximab biosimilar, CT-P13, against infliximab original, analyzing the loss of response of both at the 12 mo follow-up in patients with IBD. METHODS An observational study of two cohorts has been conducted. One retrospective cohort that included patients with IBD treated with Infliximab original, and a prospective cohort of patients who were switching from infliximab original to infliximab biosimilar (CT-P13). We had analyzed the overall efficacy and loss of efficacy in patients in remission at the end of one year after treatment with the original drug compared to the results of the year of treatment with the biosimilar. RESULTS 98 patients (CD 67, CU 31) were included in both cohorts. The overall efficacy for infliximab original per year of treatment was 71% vs 68.2% for infliximab biosimilar (P = 0.80). The loss of overall efficacy at 12 mo for infliximab original was 6.6% vs 14.5% for infliximab biosimilar (P = 0.806). The loss of efficacy in patients who were in basal remission was 16.3% for infliximab original vs 27.1% for infliximab biosimilar. Adverse events were 9.2% for infliximab original vs 11.2% for infliximab biosimilar. CONCLUSION The overall efficacy and loss of treatment response with infliximab biosimilar (CT-P13) is similar to that observed with infliximab original in patients who were switching at the 12 mo follow-up. There is no difference in the rate of adverse events.
Artículo Systematic review on the use of anticholinergic scales in elderly chronic patients(Elsevier, 2025-03) Díaz Acedo, Rocío; Villalba Moreno, Ángela María; Santos Ramos, Bernardo; Sánchez Fidalgo, Susana; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Instituto de Biomedicina de Sevilla (IBIS)Background: The rising prevalence of chronic conditions and polypharmacy in the elderly increases the risk of anticholinergic burden, the cumulative effect of multiple anticholinergic drugs. However, no standard exists for assessing anticholinergic burden in these patients, resulting in various anticholinergic scales with differing methodologies and outcomes. Objectives: To identify existing anticholinergic scales that are applicable to elderly chronic patients and to compare their main characteristics, included drugs and anticholinergic potential scores. In addition, we aim to analyse the previous validation of these scales. Methods: We conducted a systematic review (MEDLINE, EMBASE and Web of Science; PROSPERO ID CRD42024505226; October 2023) for studies on anticholinergic scales applicable to elderly patients with chronic conditions. We also examined the validation of these tools in predicting anticholinergic-related adverse outcomes. Inclusion criteria targeted studies on anticholinergic scales for patients aged ≥65 with chronic conditions, excluding those hospitalized or with specific diseases. Quality assessments utilized JBI tools and SQUIRE 2.0 standards. Results: From 1399 references, 18 anticholinergic scales development studies were included. Different scales varied in creation methodology, with some based on literature, review of previous scales or experimental data. The included studies are heterogeneous in terms of design and results of their quality analysis. For the second objective, 29 validation studies were considered, with mixed associations found between anticholinergic scales and health outcomes. Conclusions: Current anticholinergic scales and validation studies are diverse and show mixed and controversial results, with evidence often coming from retrospective or low-quality studies; indicating the necessity for future research to focus on developing a clinically applicable tool for accurately assessing anticholinergic burden in the elderly with chronic conditions.Artículo Computerized clinical decision support systems for prescribing in primary care: Characteristics and implementation impact. Scoping review and evidence and gap maps(Elsevier, 2025-01-30) Acosta García, Héctor; Ruano Ruiz, Juan; Gómez García, Francisco José; Sánchez Fidalgo, Susana; Santos Ramos, Bernardo; Molina López, Teresa; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaThis study aimed to conduct a scoping review and evidence and gap maps to characterize Clinical Decision Support Systems (CDSS) in primary care, evaluate their implementation and maintenance levels, and identify evidence gaps. Methods: A literature search covering January 2010 to May 2023 was conducted across various databases. Inclusion criteria encompassed studies involving real patients with detailed descriptions of CDSS, including both comparative and descriptive designs within primary care settings. Two independent reviewers screened the references, while four researchers independently extracted data, which included demographics, main findings, and system descriptions. The results were presented using interactive evidence and gap maps. Results: Among 1,447 initial citations, 75 studies met the selection criteria. The identified types of CDSS included adherence to guidelines/local protocols (45 %), antibiotic prescription (16 %), suitability (15 %), and others. Only one system was classified as "intelligent," while 39 % received a complexity rating of 4 on a scale from 1 to 5. Assessment of various outcomes across the studies revealed health outcomes (20 %), economy/resource use (13 %), potentially inappropriate prescription (61 %), adherence to local guidelines/protocols (12 %), and acceptance/use (40 %). Two maps were created: The first one displayed the type of CDSS linked to the type of results measured. The second one showed the type of CDSS and their most relevant characteristics. Data were represented in a dynamic bubble diagram. Conclusion: Current evidence regarding CDSS in primary care is limited and heterogeneous. The identified systems exhibit relative complexity but are not classified as intelligent, primarily focusing on improving prescribing practices through clinical guidelines or prescription aid tools. The outcomes most frequently assessed included potentially inappropriate prescriptions and acceptance/use. The evidence and gap maps provide a user-friendly format for visualizing existing evidence and identifying research gaps in the implementation of CDSS within primary care.Artículo Características sociodemográficas, clínicas y perfil de riesgo anticolinérgico en una residencia sociosanitaria pública: estudio descriptivo(Fundación Pharmaceutical Care España, 2024) Prado Mel, Elena; Rodríguez Ramallo, Hector; Villalba Moreno, Ángela María; García Cabrera, Emilio; Sánchez Fidalgo, Susana; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaObjetivo: analizar las características demográficas, clínicas y funcionales de personas residentes en un centro sociosanitario público. Caracterizar a la población en función del riesgo anticolinérgico según la escala DBI. Metodología: estudio observacional descriptivo de una cohorte de un centro sociosanitario público de Andalucía. Se llevó a cabo desde septiembre hasta diciembre de 2020.Se recogieron variables sociodemográficas, clínicas y funcionales, de farmacoterapia y carga anticolinérgica asociada según la escala DBI. Se realizó un análisis descriptivo general y un otro diferencial en función de la carga anticolinérgica. Resultados: se incluyeron 148 residentes (mediana 73 años [IQR: 15,25]). El 19,8% de la población era analfabeta. El 43,9% presentaba tabaquismo y el 22,3% consumía alcohol a diario. El 50,3% presentaban polifarmacia excesiva (≥10 medicamentos) y el 73,6%. de los pacientes presentaban riesgo anticolinérgico y/sedante según DBI (definido por presentar una puntuación DBI>0). Los principios activos con actividad anticolinérgica y/o sedante más frecuentemente prescritos fueron lorazepam, tramadol, tamsulosina y trazodona. El delirio y la ansiedad, junto con las infecciones de repetición del tracto urinario, fueron más prevalentes en el grupo de residentes que presentaban carga anticolinérgica (p<0,05). Conclusiones: la población del centro sociosanitario presenta un alto índice de analfabetismo, y elevada prevalencia de consumo de tabaco y alcohol. El índice de polimedicación es elevado, así como el porcentaje de pacientes con riesgo anticolinérgico asociado a la farmacoterapia. La ansiedad, el delirium y las ITUs de repetición fueron más prevalentes en la población con carga anticolinérgica. Estudios multicéntricos con mayor número de residentes serían necesarios para confirmar estos hallazgos.Artículo Medication adherence and persistence in heart failure: A protocol for a systematic review and meta-analysis(Sociedad Española de Farmacia Hospitalaria (SEFH), 2024-08-13) Baéz Gutiérrez, Nerea; Rodríguez Ramallo, Héctor; Sánchez Fidalgo, Susana; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaObjective To study medication adherence and persistence among heart failure patients, assess the methods utilised for estimating medication adherence, and identify optimal adherence thresholds and their impact on clinical outcomes. Methods A systematic search will be conducted in PubMed, Embase, CINAHL, Web of Science, and Scopus databases. Observational studies assessing medication adherence or persistence among heart failure patients via electronic healthcare databases will be included. A narrative synthesis will describe medication adherence and persistence reported and methods used to measure it. A meta-analysis will be attempted to evaluate the impact of secondary medication adherence (multiple and by drug class) on clinical outcomes, including hospitalisation, emergency visits, and mortality. The I2 statistic will be employed to study heterogeneity and the GRADE framework to evaluate evidence certainty. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and is registered with the Prospective Register of Ongoing Systematic Reviews CRD42024509542. Discussion This study aims to evaluate medication adherence and persistence in heart failure management through electronic health databases, intending to explore widely used measurement methods and their limitations, and to identify adherence thresholds associated with improved clinical outcomes. By examining these aspects, we anticipate proposing enhancements for future research and establishing desired adherence goals. This approach highlights the expected significance of our findings in advancing patient care and research methodologies.Artículo ¿Son los factores de riesgo cardiovascular un factor pronóstico desfavorable para los pacientes con covid-19?(Sociedade Galega de Medicina Interna, 2024-04) Luque Linero, Paula; Castilla Guerra, Luis; Arrobas Velilla, Teresa; Fernández Palacín, Ana; Carmona Nimo, Eduardo; Rico Corral, Miguel Ángel; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de MedicinaObjetivo: Valorar si en nuestra población los factores de riesgo cardiovascular (FRCV) se correlacionan con la severidad de la COVID-19 en pacientes hospitalizados. Material y métodos: Estudio de cohortes retrospectivo de pacientes con COVID-19 ingresados en 2020 en un centro terciario del sur de España. Resultados: Se analizaron 608 pacientes con neumonía COVID-19. La mediana de edad fue de 73 años. El 55,8% fueron varones. La hipertensión arterial fue el FRCV más común (83,7%). Un total del 25,8% de los pacientes tuvieron un pronóstico desfavorable. En el análisis multivariante resultaron variables independientes para padecer un COVID severo: ser varón (OR: 1,697; IC 95%: 1,138-2,532), la edad avanzada (OR: 1,697; IC 95%: 1,138-2,532), y la obesidad (OR: 1,634; IC95%: 1,370-1,947). Conclusión: Los FRCV son muy prevalentes en los pacientes ingresados por COVID 19. La obesidad, edad avanzada y el género masculino se asocian con una mayor gravedad y mortalidad hospitalaria en los pacientes ingresados con SARS-CoV-2.Artículo Assessment of Osstell ISQs reliability for implant stability measurement: A cross-sectional clinical study(Medicina Oral S.L., 2013-11) Herrero Climent, Mariano; Santos García, Rocío; Jaramillo Santos, María Reyes; Romero Ruiz, Manuel María; Fernández Palacín, Ana; Lázaro Calvo, Pedro; Bullón Fernández, Pedro; Ríos-Santos, J.V.; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de EstomatologíaResonance frequency analysis (RFA) allows assess implant stability by measuring implant oscillation frequency on the bone. RFA is an objective and non-invasive method for implant stability measurement, although scarce evidence has been provided so far on its reliability. Objectives: Assess the Osstell ISQ system’s reliability (i.e., its measurement reproducibility and repeatability) by means of the intraclass correlation coefficient (ICC) as statistical method. Study Desing: Implants stability registers were completed by means of Osstell ISQ on 85 implants on 23 patients. Six measurements were completed on each implant by means of two different SmartPegs (types I and II); that is, three consecutive measurements with each transducer. Results: Average ISQ was 72.40, 72.22 and 72.79, and 72.06, 72.59 and 72.82 in the first, second, and third measurements with SmartPegs I and II, respectively. Equal values or differences below three ISQ points were observed in 52.9% and 62.4% of the cases with SmartPegs I and II, respectively. The intraclass correlation coefficient was 0.97 for both SmartPegs, and repeatability and reproducibility also reached 0.97 for both SmartPegs. Conclusions: The RFA system Osstell ISQ presents almost perfect repeatability and reproducibility after intraclass correlation coefficient analysis. Osstell ISQ measurements are highly reliable regarding reproducibility. Therefore, one measurement proves enough.Artículo Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure(Wiley, 2013-03-19) Cinca, Juan; Méndez, Ana; Puig, Teresa; Ferrero, Andreu; Roig, Eulalia; Vázquez, Rafael; González Juanatey, José R.; Alonso-Pulpón, Luis; Delgado, Juan; Brugada Terradellas, Josep; Pascual Figal, Domingo; Fernández Palacín, Ana; Miñano Sánchez, Javier; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Farmacología, Pediatría y Radiología; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); Instituto de Salud Carlos IIIAims Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Methods and results Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. Conclusion LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted.Artículo Compliance with voluntary nutritional labelling on alcoholic beverages in Spain(Academic Press Inc Elsevier Science, 2024-12) Padilla-Cruz, Jarileen; Sordo, Luis; Espelt, Albert; Caamaño-Isorna, Francisco; Pastor, Andrea; Donat, Marta; López de Miren, Alda; Valencia Martín, José Lorenzo; Galán, Iñaki; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaAccess to nutritional information is a fundamental consumers right, as it facilitates informed decision-making regarding dietary choices. However, excluding a recent directive concerning wine products, European Union regulations grant exemption to beverages with an alcohol content exceeding 1.2 % from the requirement of disclosing nutritional values. The purpose of this study was to evaluate the industrys compliance with voluntary commitments for nutritional labelling of alcoholic beverages in Spain. A cross-sectional study was conducted in the municipality of Madrid (Spain) during March and April 2023. Data on 627 alcoholic beverages were collected. We considered that a product label displayed complete nutritional data when it showed the energy value per 100 mL as well as the corresponding macronutrients (fats, carbohydrates, and proteins). Only 22.2 % of these products provided any nutritional information, with beers leading at 56.5 %, followed by spirits (26.5 %), vermouths and aperitifs (16.7 %), and wines and sparkling wines significantly fewer at 2.9 %. Only 2.4 % of the sampled beverages provided comprehensive nutritional information including energy and macronutrients. These findings highlight a failure to meet voluntary labelling commitments in Spain, with significant variations observed across sectors. The government should ensure consumersaccess to readily available and accurate information regarding the nutritional composition of alcoholic beverages.Artículo Incorporación de la prescripción electrónica en un distrito de atención primaria: implicaciones en el gasto farmacéutico y factores determinantes de su utilización(Ediciones doyma S A, 2013-03) Silvia Calzón; Juan José Mercader; Juan Carlos Montero; Carmen Sánchez Cantalejo; Valencia, R.; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud PúblicaObjetivo Analizar las implicaciones del uso de receta electrónica sobre el gasto farmacéutico (GF) así como explorar factores determinantes de su utilización. Métodos Construcción de 2 modelos de regresión múltiple, tomando en uno de ellos como variable dependiente el GF y en el otro el porcentaje de prescripción mediante receta electrónica, incluyendo datos referidos a 9 centros de atención primaria de Andalucía. Resultados Cada incremento en un punto de prescripción por principio activo (PPA) se relacionó con una reducción media del GF de 2.079 €/año, mientras que cada incremento porcentual en el uso de receta electrónica se relacionó con un aumento de 1.027 € anuales. También se relacionaron con un mayor GF cada tarjeta ajustada por edad y tipo de farmacia (TAFE) asignada (36,71 €/año), la presión asistencial (2.585 €/año) y la frecuentación (2.17.148 €/año).Los factores que se relacionaron con un mayor uso de receta electrónica fueron un menor índice de ruralidad, una mayor distancia a la capital, una mayor PPA y una menor frecuentación. Conclusiones La prescripción mediante receta electrónica parece ser una variable predictora del gasto farmacéutico, relacionándose cada incremento porcentual con un incremento medio anual de 1.027 euros. Esta variable, junto con la prescripción mediante principio activo, el número de TAFE asignadas, la frecuentación y la presión asistencial media, contribuyen a explicar más del 65% de la variabilidad en el GF entre facultativos. El incremento del gasto relacionado con la receta electrónica parece producirse a expensas del aumento en el número de prescripciones por paciente.Artículo Prevalence and associated factors of depression among adults suffering from migraine in spain(Mdpi, 2023-11-24) Cebrino Cruz, Jesús; Portero de la Cruz, Silvia; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. RNM204: Ecología Reproductiva de PlantasConsidering the significance of migraine and the limited amount of research conducted on its association with depression in population-based studies in Spain, this study aimed to determine the prevalence and change of depression from 2017 to 2020 among adults with migraine in Spain and to analyze the sociodemographic and health-related variables linked to depression in migraine sufferers. A cross-sectional study on 5329 adults with migraine from the Spanish National Health Survey 2017 and the European Health Survey in Spain 2020 was performed. Binary logistic regression was used to examine the factors related to depression. A total of 26.32% of people with migraine suffered from depression. No significant changes in that prevalence between 2017 and 2020 were observed. The risk factors associated with depression included being between the ages of 25 and 44 (p = 0.018), being separated or divorced (p = 0.033), being unemployed (p < 0.001), not engaging in recreational physical activity (p = 0.016), perceiving one’s health as average, poor, or very poor (p < 0.001), experiencing moderate to severe pain in daily activities (p = 0.011, p = 0.004, p < 0.001, respectively), and having 1–2 or 3 chronic conditions (p = 0.003, p < 0.001, respectively). Conversely, being married (p = 0.001) and alcohol consumption (p = 0.007) were identified as protective factors.Artículo Factors related to depression in adults with oral health problems in Spain (2017 to 2020)(Frontiers Media S A, 2024-02-27) Cebrino Cruz, Jesús; Portero de la Cruz, Silvia; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. RNM204: Ecología Reproductiva de PlantasBackground: The need to study the link between gender, depression, and oral health is becoming increasingly evident. This study therefore aimed to determine the prevalence and evolution over time of depression among women and men with oral health problems and to evaluate the association between depression status, lifestyle-related variables health-related variables and use of dental health services in those people. Methods: We performed a nationwide cross-sectional study on 25,631 adults with oral health problems residing in Spain from the Spanish National Health Survey 2017 and the European Health Survey of Spain 2020, including as the main variable self-reported diagnosis of depression. We analysed independent variables such as lifestyle-related variables, health-related variables, and variables related to dental health services. Sociodemographic characteristics were considered as control variables. Results: The prevalence of depression among adults with oral health problems in Spain was 7.81% (10.14% for women, 5.39% for men), with a notable decrease from 2017 to 2020 in women. Depressed women had a slightly higher percentage of filled or capped teeth, and had more covers (crowns), bridges or other types of prostheses or dentures, while men had more caries. Women also made more frequent, regular dental visits for check-ups and mouth cleaning, whereas men often needed extractions. Unfavourable associated factors in both genders were: perceiving their health as good, average, poor, or very poor, and having 1–2 and ≥ 3 comorbidities. Conversely, not being a current smoker was related to less likelihood of depression. In women only, not engaging in leisure time physical activity produced more unfavourable associated factors. Conclusion: The prevalence of depression among adults with oral health problems in Spain from 2017 to 2020 was 7.81%, but this figure has been steadily decreasing over time. In addition, the favourable and unfavourable associated factors could help us inform health professionals and authorities in order to prevent depression and enhance the care of this population according to gender.