Artículos (Medicina Preventiva y Salud Pública)

URI permanente para esta colecciónhttps://hdl.handle.net/11441/11050

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Biomonitoring of DAPs levels in urine and amniotic fluid of pregnant women in Seville (Spain): evaluation of prenatal exposure
(Elsevier, 2025-12-19) Sánchez Ruiz, Rocío; Hinojosa Hidalgo, María Gracia; Aranda Merino, Noemí; Fernández Torres, Rut; Cerrillos, Lucas; Ostos, Rosa; Fernández Palacín, Ana; Moreno Navarro, Isabel María; Nutrición y Bromatología, Toxicología y Medicina Legal; Química Analítica; Medicina Preventiva y Salud Pública; Ministerio de Ciencia, Innovación y Universidades (MICIU). España; European Union (UE); Junta de Andalucía
Among all population groups, pregnant women are one of the most vulnerable due to increasing concern about prenatal exposure to environmental pollutants, including pesticides such as organophosphates (OPs). In this regard, dialkyl phosphates (DAPs) are nonspecific metabolites excreted in urine and widely used to assess OP exposure. Thus, this study aimed to assess the risk of indirect OP exposure by determining six DAPs (dimethyl phosphate (DMP), O,O-dimethyl thiophosphate (DMTP), O,O-dimethyl dithiophosphate (DMDTP), diethyl phosphate (DEP), O,O-diethyl thiophosphate (DETP), and O,O-diethyl dithiophosphate (DEDTP)) in urine and amniotic fluid (AF) from a 74-pregnant-women cohort in Seville (Southern Spain). Sample preparation was based on electromembrane extraction (EME), a microextraction technique using an electric potential to selectively extract analytes across a supported liquid membrane (SLM). The analysis was performed using ion-pair ultrahigh-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (UHPLC-ESI-MS/MS). Results showed that DAPs can cross the placental barrier, as most AF samples showed between 80 and 99 % positive levels, depending on the compound, however, the studies in this regard are very scarce. Nonetheless, these levels were slight, and both mean and maximum concentrations detected in AF were lower than urine levels in every case. Moreover, the percentage of positive samples in urine was lower (44–92 %). Thus, this research highlights the importance of studying the presence of these metabolites, both in urine and in AF, and the physiological outcomes that their presence may cause both in the mothers and infants.
Improving Diagnostic Accuracy for Surgical Pelvic Organ Prolapse: A Sequential Protocol Combining POP-Q Examination and Transperineal Ultrasound
(MDPI, 2026-01-26) García Mejido, José Antonio; Hurtado-Guijosa, Ana; Fernández Palacín, Ana; Fernández Palacín, Fernando; Bugatto, Fernando; Sáinz Bueno, José Antonio; Cirugía; Medicina Preventiva y Salud Pública; CTS312: Análisis de la Demanda Sanitaria
Background/Objectives: The POP-Q system is conventionally used to evaluate pelvic organ prolapse (POP). Nevertheless, differences between clinical examination and intraoperative findings can hinder appropriate surgical planning. We aimed to assess the accuracy of a sequential protocol involving clinical POP-Q assessment and, in cases of uncertain diagnosis, transperineal ultrasound. Methods: We conducted a prospective observational study with 314 women scheduled for POP surgery from January 2021 to December 2024. A pelvic floor specialist assessed all patients using the POP-Q system. Transperineal ultrasound was carried out only when the clinical diagnosis remained uncertain. We compared the accuracy of this sequential approach (POP-Q ± ultrasound) versus POP-Q alone, using intraoperative findings as the gold standard. Sensitivity and specificity were determined for each type of prolapse. Results: Of the 314 patients, 181 (57.6%) had a definitive diagnosis with POP-Q alone, whereas 133 (42.4%) required additional ultrasound. In these uncertain cases, the addition of ultrasound significantly increased sensitivity for cystocele (by 0.5–11.3%), uterine prolapse (45.5–63.7%), cervical elongation (5.2–21.4%), rectocele (5.7–16.4%), and enterocele (58.7–74.7%) (all p < 0.05). Specificity also improved for uterine prolapse, cervical elongation, and rectocele. The sequential protocol’s performance in uncertain cases was comparable to clinical examination in straightforward cases. Conclusions: Applying a sequential protocol that adds transperineal ultrasound for unclear cases significantly increases diagnostic precision for surgical POP, potentially optimizing surgical planning.
Compliance with voluntary nutritional labelling on alcoholic beverages in Spain
(Elsevier, 2024-12) Padilla Cruz, Jarileen; Sordo, Luis; Espelt, Albert; Caamaño Isorna, Francisco; Pastor, Andrea; Donat, Marta; López de Alda, Miren; Valencia Martín, José Lorenzo; Galán, Iñaki; Medicina Preventiva y Salud Pública; Gobierno de España
Access to nutritional information is a fundamental consumer´s 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 industry´s 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 consumers´ access to readily available and accurate information regarding the nutritional composition of alcoholic beverages.
Qualitative analysis of the literature on distraction-based techniques for early-onset scoliosis
(Cureus INC; Springernature; Springer Science and Business media LLC, 2025-12-13) Molina-Linde, Juan Máximo; Carlos-Gil, Ana María; Rosario-Lozano, Maria Piedad; Lacalle Remigio, Juan Ramón; Medicina Preventiva y Salud Pública; CTS312: Análisis de la Demanda Sanitaria
Early-onset scoliosis (EOS) presents significant clinical challenges due to its impact on growth and pulmonary development. Because the available evidence is heterogeneous and high-quality comparative trials are scarce, we incorporated an exploratory qualitative content analysis to complement the systematic review. Fifty documents, including comparative studies, systematic reviews, a health technology assessment report, and economic evaluations, were analyzed by using NVivo qualitative analysis software (QSR International, Melbourne, Australia) and categorized into six thematic groups. These included studies evaluating the three main distraction-based techniques, traditional growing rods, magnetically controlled growing rods, and Vertical Expandable Prosthetic Titanium Rib (VEPTR). Word-cloud visualizations showed that most studies consistently emphasized patients, surgical techniques, deformity correction, and growth-related aspects, represented by concepts associated with curve correction and spinal height gain, such as Cobb angle and T1-S1 height. Follow-up and procedural aspects also appeared frequently, whereas economic evaluations focused on costs and resource use. In contrast, clinically important areas such as pulmonary function, health-related quality of life, and long-term outcomes were infrequently addressed across categories, revealing major evidence gaps. This qualitative approach highlights the dimensions most commonly explored in the literature, identifies underrepresented outcomes relevant to clinical decision-making, and underscores the need for future research that integrates functional and patient-centered measures to support comprehensive care planning in EOS.
Recomendaciones SER sobre la gestión de riesgo del tratamiento con FAME biológicos o sintéticos dirigidos en pacientes con artritis reumatoide
(Elsevier, 2023-12) Balsa, Alejandro; Díaz del Campo Fontecha, Petra; Silva Fernández, Lucía; Valencia Martín, José Lorenzo; Nistal Martínez, Virginia; León Vázquez, Fernando; Villaverde García, Virginia; Medicina Preventiva y Salud Pública
Objetivo Elaborar recomendaciones basadas en la evidencia disponible y el consenso de expertos, para la gestión del riesgo del tratamiento biológico y los inhibidores de las JAK en pacientes con artritis reumatoide. Métodos Se identificaron preguntas clínicas de investigación relevantes para el objetivo del documento. Estas preguntas fueron reformuladas en formato PICO (paciente, intervención, comparación, outcome o desenlace) por un panel de expertos, seleccionados en base a su experiencia en el área. Se realizó una revisión sistemática de la evidencia, graduándose de acuerdo a los criterios GRADE (Grading of Recommendations Assessment, Development, and Evaluation). A continuación, se formularon las recomendaciones específicas. Resultados Se propusieron por el panel de expertos 6 preguntas PICO en base a su relevancia clínica y a la existencia de información reciente referentes al riesgo de aparición de infecciones graves, el riesgo de reactivación del virus de la hepatitis B, el riesgo de reactivación del virus varicela-zoster, el riesgo de aparición de cáncer de piel (melanoma y no melanoma) o hematológico, el riesgo de aparición de enfermedad tromboembólica y el riesgo de progresión del virus del papiloma humano. Se formularon un total de 29 recomendaciones, estructuradas por pregunta, basadas en la evidencia encontrada y el consenso de los expertos. Conclusiones Se presentan las recomendaciones SER sobre la gestión del riesgo del tratamiento con terapias biológicas e inhibidores de las JAK en la artritis reumatoide.
Artificial intelligence in Brazilian Primary Health Care: scoping review
(BEn - Associação Brasileira de Enfermagem, 2025) Morales Botero, Dany Alexandra; Bonfim, Rafaele; Fonseca, Karina; Andrade-Gonçalves, Rubia Laine de Paula; Aparecida Monroe, Aline; Morales, Fátima; Medicina Preventiva y Salud Pública; CTS1162: Investigación Clínica y Experimental en Salud Pública
Objectives: to provide evidence on the usage of artificial intelligence in Brazilian Primary Health Care. Methods: scoping review, conducted on February 2025. Searches were accomplished in six databases. Selection process was conducted by three reviewers. Data were extracted using a form by two reviewers. Results were synthetized in a narrative way. Results: 27 studies were included out of 981 retrieved. Machine Learning and Deep Learning were used in the studies to: make estimates and predictions, track and diagnose health conditions and complications and analyze determinants of universal health coverage. The main strengths found for using them were: to optimize resources; to provide early diagnosis; to allow risk stratification; to facilitates access. The main challenges for using them were: poor access to treatment and data availability. Conclusions: although the strengths of AI applications in Brazilian healthcare system were highlighted, its implementation should address the guarantee of the effective right to health.
Ageism and the feminization of old age: A Systematic review
(Elsevier Science Bv; Elsevier, 2025-11-14) Robles Costa, Juan; Quintero Flórez, Angélica; García Cabrera, Emilio; Romero Barranca, Julia; Vilches Arenas, Ángel; Medicina Preventiva y Salud Pública; CTS312: Análisis de la Demanda Sanitaria; CTS1162: Investigación Clínica y Experimental en Salud Pública
Background: Increases in life expectancy and declining birth rates have intensified the demographic weight of older adults, particularly women. This population frequently faces intersecting age and gender-based discrimi nation, resulting in greater health burdens and lower quality of life compared to men. Objective: To examine gender-based disparities affecting older adults, particularly older women, intending to uncover underlying mechanisms and contribute to the formulation of more equitable, gender-responsive, and age-sensitive public health policies. Study design: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251104219). Methods: Six databases were searched (2014–2024) for studies in English or Spanish on gender- and age-based health inequalities in older adults. Eligible systematic reviews, observational, and experimental studies were quality-assessed (PRISMA, STROBE, CONSORT), and findings were synthesized qualitatively. Results: Fourteen studies met the inclusion criteria. Across contexts, older women consistently exhibited higher prevalence of disability, frailty, depression, and poorer self-rated health, frequently linked to lower educational attainment and income. In contrast, older men showed lower prevalence of these conditions but faced higher mortality risks from frailty and suicide. Men also tended to report better subjective quality of life. Conclusions: While women live longer, they often experience greater illness and functional limitations. Socio economic disadvantages explain part of these gaps, but a considerable proportion remains unexplained. These f indings highlight the urgent need for gender- and age-sensitive public health strategies to reduce inequities in later life.
Video game player profiles among university students: Impact of game preferences and academic background
(Elsevier, 2025) García Cabrera, Emilio; Luna Perejón, Francisco; Pertegal Vega, Miguel Ángel; Muñoz Saavedra, Luis; Sevillano Ramos, José Luis; Miró Amarante, María Lourdes; Psicología Evolutiva y de la Educación; Medicina Preventiva y Salud Pública; Arquitectura y Tecnología de Computadores; Ministerio de Ciencia e Innovación (MICIN). España; Agencia Estatal de Investigación. España
Video games have become a widespread cultural and economic phenomenon, with Spain ranking among the top European countries in gaming consumption. This study examines the gaming habits and preferences of 440 university students at the University of Seville, classifying player profiles based on game preferences and academic background. A cross-sectional study was conducted using an anonymous online survey, and principal component analysis identified three distinct player profiles: Competitive, Explorer, and Socializer. Findings indicate that gaming frequency varies significantly by academic discipline, with students in technical fields playing more frequently and preferring PC gaming, while those in social and health sciences favor mobile gaming. Moreover, the Explorer profile is associated with higher gaming frequency, whereas the Socializer profile is linked to lower engagement. Contrary to common concerns, gaming time does impact academic performance, particularly when exceeding five hours per day. Findings suggest that gamification in higher education should align with students’ gaming profiles to boost engagement and learning performance. While offering useful insights, the study’s cross-sectional design and selfreported data limit its scope. Longitudinal research is needed to assess long-term academic and well-being impacts.
A community-based strategy for the prevention of gender-based violence with people who live in vulnerable conditions in Seville, Spain
(Frontiers Media SA, 2025-10-06) Deldar-Abad-Paskeh, Mahshid; Morales, Fátima; Pedraza-Romero, Isabel María; Salimi-Leisner, Nina; Sánchez Fidalgo, Susana; García Gil, Carmen; Ávalos-Torres, Antonia; Medicina Preventiva y Salud Pública; SEJ066: Mujeres, Bienestar y Ciudadanía
Introduction: Gender-based violence is a global problem, present in various spheres: economic, political, social, health-related, and cultural. According to official data, in 2021, there were 87,307 calls to the 016 helpline, 120,813 reports of gender-based violence, and 44 women were murdered due to gender-based violence in Spain. The prevalence and differences in the probability of experiencing gender-based violence in Spain show an unequal distribution between Spanish and migrant women, with the latter being in a more vulnerable situation. This study evaluates a community intervention strategy for the prevention of gender-based violence in people who live in vulnerable conditions. Methods: A mixed-method study was conducted, using an adapted questionnaire as well as personal open-ended interviews with each participant. The participants were adults attending the Casa Pumarejo soup kitchen in Seville, including both Spanish and migrant women aged between 20 and 50 years. Additionally, their prior training in gender equality and their knowledge of violence detection were assessed. In personal interviews, an in-depth exploration of each woman’s lived experience and their understanding of how to act or prevent gender-based violence was carried out. Results: Before the intervention, the participants did not perceive gender-based violence, as they had not received training on the subject, except for those whose studies were related to gender equality. During the intervention, it was discovered that the association Mujeres Supervivientes had developed a successful methodology for assisting people who live in vulnerable conditions and had experienced gender-based violence. Notably, most participants did not know where to seek help when experiencing violence, nor were they aware of the 016 helpline. Discussion: Although this is a small-scale local initiative, we can conclude that, thanks to this intervention, the women have improved their ability to detect and prevent gender-based violence.
Cervical Cancer Screening in Refugee and Migrant Populations: Results of Systematic Review and Meta-Analysis in Cross-Sectional and Cohort Studies
(MDPI, 2025-09-10) Restivo, Vincenzo; Graci, Davide; Immordino, Angelo; Mancuso, Daniele Giacomo; Morales, Fátima; Pace, Chiara; Immordino, Palmira; Medicina Preventiva y Salud Pública; SEJ066: Mujeres, Bienestar y Ciudadanía
Background/Objectives: Cervical cancer is currently the fourth leading cause of cancer in women. It is primarily caused by Human Papilloma Virus (HPV) infections. Primary prevention methods, such as vaccines, and secondary prevention strategies, such as screening, have significantly reduced the burden of these diseases. The screening could be a crucial factor in the early diagnosis. This study aims to estimate the access of migrant and refugee populations to cervical cancer screening (CCS). Methods: A meta-analysis of scientific literature present in Pubmed and Scopus databases was conducted according to the PRISMA 2020 guidelines. Eighty-seven cross-sectional and five cohort unique studies were examined, to evaluate the participation of migrant and refugee populations to CCS programs in different world regions. Results: Statistical analysis was performed using STATA 14.2 software. Among cross-sectional studies, mean regular adherence to CCS for migrant and refugees resulted being 56% (95% CI 53–60), while participation at least once is 60% (95% CI 54–65). In cohort studies, regular adherence and participation at least once are, respectively, 55% (95% CI 50–59) and 56% (95% CI 52–61). Conclusions: The results of this review show how migrant and refugee populations have limited access to prevention interventions due to several socio-cultural factors. Our work calls for public health professionals’ efforts in order to promote more inclusive policies and prevention strategies towards those populations, aiming to reduce disparities and public health expenditures.
Cardiac rehabilitation for workers with ischemic heart disease: Benefits for cardiovascular health and quality of life
(Wolters Kluwer Health, 2025) Delgado-Calderón, Manuel; Jiménez-Ortega, Lara Estefanía; Ladisa, María; Camacho Vega, Juan Carlos; Vilches Arenas, Ángel; Luque Romero, Luis Gabriel; Palomo-Gómez, Rocío; Martín-Pereira, Jorge; Gómez Salgado, Juan; Construcciones Arquitectónicas II; Medicina Preventiva y Salud Pública
Cardiac rehabilitation programs (CRPs) are multifactorial interventions defined by the World Health Organization as essential strategies to improve patients’ health-related quality of life (HRQoL) by enhancing their physical, psychological, social, and occupational well-being. These programs are a cornerstone in the comprehensive treatment of heart disease, facilitating the recovery of functional capacity and reintegration into the workforce through a multidisciplinary approach. The objective of this study was to assess the efficacy of CRPs in enhancing functional capacity (cardiac and psychological) and HRQoL in workers with ischemic heart disease. An observational pre-post study without a control group was conducted, focusing on actively employed individuals with ischemic heart disease. A total of 214 patients were included, selected according to specific inclusion criteria after excluding those not suitable for longitudinal follow-up. Participants were active workers aged 18 to 65 years who were prescribed a CRP between January 2020 and December 2021. Sociodemographic, occupational, cardiovascular risk, and clinical-therapeutic data were collected to evaluate changes following completion of the program. Health-related quality of life (HRQoL) was also assessed. A total of 214 patients were included, 83.9% male, with a mean age of 54.21 years. Most had a history of hypertension, dyslipidemia, smoking, low physical activity, overweight or obesity, and a family history of ischemic heart disease. Among those who started the program (94.4%), the most common diagnosis was acute myocardial infarction involving a single coronary vessel. Additionally, 77.1% underwent stent angioplasty, and 47.2% participated in a moderate-risk CRP. After completion, the SF-36 score improved significantly (46.92 vs 70.21), and depressive symptoms decreased (55.10% vs 38.22%). Significant benefits were observed in most modifiable cardiovascular risk factors, along with an increase in the proportion of patients with preserved left ventricular ejection fraction (65.4% vs 72%) and in metabolic equivalent (MET) levels. In 157 participants (73.4%), MET gain was quantified, with a mean increase of 2.67 ± 1.64 METs. These findings suggest that cardiac rehabilitation, as a secondary prevention strategy, effectively improves cardiac function and HRQoL in working-age patients with ischemic heart disease.
GeoHealth: geographic information system for health management and clinical, epidemiological and translational research
(IOS Press, 2022) Moreno, Alberto; Moreno, Jesus; González, Victor; Salas, Samuel; Segura, Carmen; Luque, Virginia de; Cuadri, Pastora; Guardia, Pedro; Luque Romero, Luis Gabriel; Vilches Arenas, Ángel; Medicina Preventiva y Salud Pública
This project aims to develop a system for clinical, epidemiological and translational research capable of associating contextual variables and geospatial data with clinical patient information. The GeoHealth system will include a section to perform exploratory analysis that will help identify risk factors to optimize clinical decision making.
Cronicare: platform for the design and implementation of follow-up, control and self-management interventions for chronic and multimorbidity patients based on mobile technologies
(IOS Press, 2022) Moreno, Alberto; Moreno, Jesús; Salas, Samuel; González, Víctor; Valido, Agustín; Guardia, Pedro; Luque Romero, Luis Gabriel; Vega, Juan Antonio de la; Medicina Preventiva y Salud Pública
The project proposes to facilitate the design and evaluation of interventions based on mobile technologies and information systems in order to improve the capacity for self-management, empowerment and control of chronic and multimorbidity pa tients. The system allows to create customizable apps according to the needs of primary care and specialized care. The project includes an evaluation of the impact of the care model, as well as the effectiveness and efficiency of the intervention through a study with 124 multimorbidity patients
Adherence and persistence to heart failure guideline-directed medical therapy: A systematic review of studies based on electronic healthcare data
(Elsevier, 2025-07-17) Báez-Gutiérrez, Nerea; Galindo-García, Cristina; Rodríguez Ramallo, Hector; Sánchez Fidalgo, Susana; Medicina Preventiva y Salud Pública
Background Heart failure (HF) significantly impacts global morbidity, mortality, and healthcare costs. Effective treatment involves multiple guideline-directed medical therapies, such as beta-blockers, angiotensin-converting enzyme inhibitors, mineralocorticoid receptor antagonists, angiotensin receptor–neprilysin inhibitor and sodium-glucose cotransporter 2 inhibitors. However, medication adherence and persistence in HF patients are often suboptimal, negatively influencing clinical outcomes. This systematic review assesses medication adherence and persistence among HF patients and their relationship to clinical outcomes. Methods A systematic review following PRISMA guidelines was conducted, evaluating observational studies utilizing electronic healthcare databases published between 1990 and 2024. Studies reporting adherence or persistence to HF pharmacological treatments, measured by pharmacy claims or electronic health records, were included. Primary adherence (initial dispensing), secondary adherence (continued refilling), and persistence (duration until medication discontinuation) were analyzed. Results Fifty-two studies involving 2,001,178 HF patients were reviewed. No studies adequately assessed primary adherence. Secondary adherence was predominantly evaluated using Proportion of Days Covered or Medication Possession Ratio, with adherence generally below optimal levels (<80%). Medication adherence declined significantly with increased regimen complexity and over extended periods. Persistence rates were notably lower in long-term follow-ups, especially with mineralocorticoid receptor antagonists. Higher medication adherence and persistence consistently correlated with reduced hospitalizations, emergency department visits, and mortality rates. Methodological heterogeneity across studies precluded the feasibility of a meta-analysis. Conclusions Medication adherence and persistence among HF patients remain suboptimal, particularly with complex, multi-drug regimens and prolonged treatments. Improved adherence was correlated with better clinical outcomes, underscoring the need for standardized adherence measures and targeted interventions to enhance patient outcomes.
Serum cystatin C levels in preterm newborns in our setting: Correlation with serum creatinine and preterm pathologies
(Elsevier, 2015) Bardallo Cruzado, Leonor; Pérez González, Elena; Martínez Martos, Zoraima; Bermudo Guitarte, Carmen; Granero Asencio, Mercedes; Luna Lagares, Salud; Marín Patón, Mariano; Polo Padillo, Juan; Medicina Preventiva y Salud Pública; CTS312: Análisis de la Demanda Sanitaria
Background: Cystatin C (CysC) is a renal function marker that is not as influenced as creatinine (Cr) by endogenous or exogenous agents, so it is proposed as a marker in preterm infants. Objectives: To determine serum CysC values in preterm infants during the first week of life, compared to Cr. To analyse alterations caused by prematurity diseases. Method: The design involved a longitudinal, observational study of prospective cohorts. Groups were based on gestational age (GA): Group A (24–27 weeks), Group B (28–33 weeks), Group C (34–36 weeks). Blood samples were collected at birth, within 48–72 h and after 7 days of life. Statistics: SPSS v.20 software was used. The statistical methods applied included chi-squared test and ANOVA. Results: A total of 109 preterm infants were included in the study. CysC levels were 1.54 mg/l (±0.28) at birth, 1.38 mg/l (±0.36) within 48–72 h of life, and 1.50 mg/l (± 0.31) after 7 days (p < 0.05). Cr levels were 0.64 mg/dl (±0.17) at birth, 0.64 mg/dl (± 0.28) within 48–72 h, and 0.56 mg/dl (± 0.19) after 7 days (P < .05). CysC values were lower in hypotensive patients and in those with a respiratory disease (P < .05), and no alterations associated with other diseases were observed. There were no differences in Cr levels associated with any disease. Creatinine levels were higher in patients ≤1.500 g (P < .05). Conclusions: Serum CysC decreased within 48–72 h of life, and this decline showed significance (P < .05). The levels increased after 7 days in all 3 GA groups, and there was no difference in CysC levels among the groups. More studies in preterm infants with hypotension and respiratory disease are required. CysC is a better glomerular filtration rate (GFR) marker in ≤1.500 g preterm infants.
Una concepción topológica del “bootstrap” permite la demostración del sesgo de Berkson en epidemiología nutricional
(Sociedad Española de Dietética y Ciencias de la Alimentación, 2016) Gómez González, Carmen; Peña Rodríguez, Amelia; Salas Díaz, Inmaculada; Praena Fernández, Juan Manuel; Gálvez Acebal, Juan; Lozano Rodríguez, Jesús Manuel; Vilches Arenas, Ángel; Ortega Calvo, Manuel; Medicina Preventiva y Salud Pública; Instituto de Biomedicina de Sevilla (IBIS); CTS312: Análisis de la Demanda Sanitaria
Antecedentes: La prevalencia de la desnutrición entre los pacientes quirúrgicos es elevada y se ha relacionado con el aumento de la morbimortalidad. La fuga de anastomosis es una de las complicaciones quirúrgicas más importantes y se ha relacionado con desnutrición, mala técnica quirúrgica, contaminación abdominal entre otras. Objetivo: Demostrar que la relación de la desnutrición y la incidencia de dehiscencia de anastomosis en pacientes post operados. Material y Métodos: Se evaluara por medio del cuestionario de Valoración Global Subjetiva el estado nutricional de pacientes sometidos a intervenciones quirúrgicas abdominales que requieran resección y anastomosis. Se incluyeron 34 pacientes en este estudio de investigación, dividiendo los grupos en bien nutridos y malnutridos. Resultados: Se concluyó que Existe una mayor prevalencia en el grupo malnutrido de dehiscencia de anastomosis 11.8% en comparación al grupo bien nutrido 5.9% sin embargo no fue estadísticamente significativo (p=>0.05). Discusión: El grupo mal nutrido presentaba una media en edad mayor que el grupo bien nutrido, el IMC, la albumina y la cuenta linfocitaria eran menores en el grupo mal nutrido en comparación al bien nutrido. Conclusiones: Se realizo el análisis de las variables con la prueba Chi cuadrada en la cual no se encontró asociación entre las variables estudiadas.
Tendencia de la mortalidad por edad y sexo en España (1981-2016). Cambios asociados a la crisis económica
(Elsevier, 2020) Márquez Calderón, Soledad; Pérez Velasco, Laura; Viciana Fernández, Francisco José; Fernández Merino, Juan Carlos; Medicina Preventiva y Salud Pública; CTS140: Análisis Epidemiológico de las Desigualdades en Salud
Objetivo: Analizar la tendencia de las tasas de mortalidad por edad y sexo en España e identificar si se han producido cambios tras el comienzo de la crisis económica. Método: Estudio de tendencias de las tasas de mortalidad por grupos quinquenales de edad y sexo en el periodo 1981-2016, mediante regresión joint-point. Se detallan los resultados de los dos últimos periodos identificados en las regresiones, que permiten identificar cambios ocurridos después del inicio de la crisis. En caso de ralentización o estancamiento de la tendencia de mortalidad en varios grupos de edad sucesivos, se realizó un análisis de tendencias por causas. Resultados: La mortalidad se redujo de forma significativa entre 1981 y 2016. Tras el inicio de la crisis económica, la tendencia de la mortalidad total estandarizada no cambió en los hombres, y sufrió un estancamiento en las mujeres entre 2013 y 2016. En el análisis por grupos quinquenales de edad, la tendencia descendente de la mortalidad sufrió un estancamiento en los hombres en todos los grupos entre los 15 y 39 años, que se inició entre 2011 y 2014 y duró hasta 2016. En ambos sexos, en los cuatro grupos de edad entre 60 y 79 años, la reducción previa de la mortalidad sufrió una ralentización o estancamiento, que se inició entre 2009 y 2014, y continuó hasta 2016. Las causas que más contribuyeron al cambio de tendencia fueron las causas externas en hombres de 15-39 años, y las enfermedades del sistema circulatorio y respiratorio en las personas de 60-79 años. Conclusión: La tendencia descendente de la mortalidad ha sufrido una ralentización o un estancamiento después del inicio de la crisis económica, principalmente en hombres jóvenes, y en hombres y mujeres de 60-79 años.
Dificultades y barreras encontradas por los profesionales sanitarios en la atención de pacientes paliativos en un distrito sanitario
(Sociedad Española de Cuidados Paliativos, 2021) Vidal Serrano, Sofía; Fernández Ojeda, María del Rocío; Romeo López Alonso, Sergio; Lacalle Remigio, Juan Ramón; Medicina Preventiva y Salud Pública; CTS312: Análisis de la Demanda Sanitaria
Objetivo: Conocer las dificultades y barreras encontradas por distintos profesionales sanitarios para la asistencia a personas en cuidados paliativos. Diseño: Diseño observacional descriptivo transversal. Emplazamiento: Hospital San Juan de Dios y centros de atención primaria circundantes pertenecientes al distrito sanitario Aljarafe, Sevilla. Participantes: 118 profesionales sanitarios de estos centros: internistas, médicos de urgencias y médicos de familia, así como profesionales de enfermería de las mismas áreas asistenciales. Mediciones principales: Mediante una encuesta se recogieron variables sociodemográficas y profesionales sobre la formación y experiencia en cuidados paliativos, así como los ítems de la Escala de Dificultades en Cuidados Paliativos (PCDS, Palliative Care Difficulties Scale). Resultados: Se incluyeron un total de 118 profesionales con una edad media de 42,2 años, de los cuales el 57,6 % eran mujeres. Las mayores barreras encontradas por los profesionales fueron la escasa formación en cuidados paliativos y la dificultad de acceso a la información en el domicilio, con un rango observado de entre 2,27 y 3,26. No se encuentran diferencias estadísticamente significativas al estudiar las dificultades percibidas en función de la categoría profesional. En la comparación de ámbitos asistenciales sí hay diferencias (p = 0,03): se detectan mayores dificultades en urgencias, siendo el médico de urgencias el que presenta mayor dificultad frente al internista (p < 0,01). Entre los profesionales de enfermería de los tres ámbitos asistenciales no se identifican diferencias. Conclusión: Los médicos y el personal de enfermería de urgencias son los profesionales que mayores dificultades encuentran en la prestación de cuidados paliativos en su práctica asistencial, principalmente en la coordinación interniveles y en la formación, mientras que los internistas son los que menos las perciben.
Trastornos psiquiátricos y tabaquismo. Análisis de mortalidad
(Neumosur. Asociación de Neumología y Cirugía Torácica del Sur, 2023) Ignacio Expósito, María del Mar; Almadana Pacheco, Virginia; Benito Bernáldez, Cristina; Montserrat García, S.; Vilches Arenas, Ángel; Valido Morales, Agustín S.; Medicina Preventiva y Salud Pública; Medicina; Instituto de Biomedicina de Sevilla (IBIS); CTS312: Análisis de la Demanda Sanitaria
La prevalencia de consumo de tabaco entre aquellos que padecen algún tipo de patología psiquiátrica es significativamente superior a la de la población general. Como consecuencia está descrita en la bibliografía una tasa de mortalidad asociada al tabaco de casi el doble con respecto al resto de la población. Objetivo: identificar factores clínicos, psicológicos o sociales que puedan influir en la probabilidad de éxitus a corto plazo en pacientes que realizan el programa de deshabituación tabáquica.
Tabaquismo y mortalidad. Análisis de los posibles factores relacionados
(Neumosur. Asociación de Neumología y Cirugía Torácica del Sur, 2023) Ignacio Expósito, María del Mar; Hurtado Gañán, M. G.; Perera Louvier, Rafael; Montserrat García, S.; Vilches Arenas, Ángel; Valido Morales, Agustín S.; Medicina Preventiva y Salud Pública; Medicina; CTS312: Análisis de la Demanda Sanitaria
El consumo de tabaco continúa siendo a día de hoy el primer factor de riesgo de mortalidad prevenible relacionado con las principales causas de muerte en el mundo. A pesar de que la mayoría de los pacientes que acuden a la consulta especializada de tabaquismo no se consideran enfermos por este motivo. Objetivo principal: conocer las principales características clínicas y psicológicas de aquellos pacientes que acuden a un programa de deshabituación tabáquica en una unidad especializada. Objetivo secundario: analizar posibles diferencias entre aquellos que fallecen en un plazo de 10 años.

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