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1.
Acta Ortop Mex ; 36(6): 333-334, 2022.
Article in Spanish | MEDLINE | ID: mdl-37669650

ABSTRACT

No Abstract available.

2.
Acta Ortop Mex ; 36(4): 201, 2022.
Article in Spanish | MEDLINE | ID: mdl-36977637

ABSTRACT

No Abstract available.


Subject(s)
Authorship , Editorial Policies , Humans
3.
J Healthc Qual Res ; 33(6): 360-369, 2018.
Article in Spanish | MEDLINE | ID: mdl-30497970

ABSTRACT

OBJECTIVE: To analyse barriers limiting an integral approach in the care process of patients with actinic keratosis, and to validate a questionnaire of their perception in order to assess this approach. METHOD: A qualitative study (Focus Group) was conducted to assess the perception of the healthcare process of professionals (dermatologists, family doctors, nurses, pharmacists and managers), and patients. A validation study of a new tool was conducted, defining the scope and contents of a questionnaire of perceived quality. Reliability, consistency and validity were analysed after inviting a convenience sample of 225 patients to respond. RESULTS: Underdiagnosis in primary care, a higher variability in resources, and access to the health care circuit, together with gaps in patient information about actinic keratosis, are relevant barriers to achieve comprehensive care in this disease condition. The result of the focus groups advised to elaborate 14 reactive items. A total of 224 patients responded (mean age 71.6, SD 11.1), of which 153 (68%) were men. Two factors were isolated including 12 items (explained variance of 58%). The consistency of this factorial solution was .87, the split-half reliability being .76, with the scores in the factors showing an adequate predictive capacity. CONCLUSIONS: The coordination between levels and to reduce to variability in equipment and clinical decision making in Primary Care are the most prominent barriers. The questionnaire has appropriate metric properties and it explores the information and care by the medical staff and the information and advice provided by the pharmacist.


Subject(s)
Health Care Surveys , Keratosis, Actinic/diagnosis , Keratosis, Actinic/therapy , Quality of Health Care , Aged , Clinical Decision-Making , Dermatologists , Female , Focus Groups , Humans , Male , Middle Aged , Nurses , Pharmacists , Physicians, Family , Qualitative Research , Reproducibility of Results
4.
5.
Br J Biomed Sci ; 72(3): 120-7, 2015.
Article in English | MEDLINE | ID: mdl-26510268

ABSTRACT

Pulsed-field gel electrophoresis (PFGE) is the 'gold standard' for genotyping of methicillin-resistant Staphylococcus aureus (MRSA); however, the DiversiLab (DL) system, based on rep-PCR, is faster, simpler and could be better adapted to daily routine hospital work. We genotyped 100 MRSA isolates using PFGE, DL, and spa typing, and evaluated the discriminatory power of each technique and the correlation between them by Simpson's index(SI) and adjusted Rand coefficient (ARI), respectively. The isolates were from clinical samples from eight hospitals in Extremadura (Spain) during 2010. DL separated the 100 MRSA into 18 patterns, with 69% of the isolates grouped into four predominant patterns. spa typing reported 17 spa types, classifying 69% of MRSA into two major types (t067 and t002). PFGE revealed the existence of 27 patterns, gathering 54% of MRSA into three pulse types (E8a, E7a and E7b). SI values were 0.819, 0.726, 0.887 and 0.460 for DL, spa typing, PFGE and CC-BURP, respectively. ARI values of DL over PFGE, spa typing and CC-BURP were 0.151, 0.321 and 0.071, respectively. DL has less discriminatory power than PFGE but more than spa typing. The concordance of DL with PFGE is low, primarily because DL does not discriminate between the three predominant MRSA pulse types in our environment.


Subject(s)
Antigens, Bacterial/genetics , Bacterial Typing Techniques/standards , Genotype , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/genetics , Bacterial Typing Techniques/methods , Electrophoresis, Gel, Pulsed-Field/methods , Humans , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microsatellite Repeats , Phylogeny , Polymerase Chain Reaction/methods , Staphylococcal Infections/microbiology
6.
Rev Esp Quimioter ; 28(2): 79-85, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25904514

ABSTRACT

Genotyping methods are useful resources for the surveillance, detection, prevention and control of multidrug-resistant nosocomial agents, such as methicillin-resistant Staphylococcus aureus (MRSA). An understanding of the association between genotype and antibiotic susceptibility in MRSA clones may be useful in the surveillance of MRSA and to avoid inappropriate treatment future resistance. We genotyped MRSA clinical isolates from the Extremadura region of Spain using pulsed field electrophoresis (PFGE) and analyzed the spectrum of antibiotic susceptibility for each isolate to determine whether resistance is associated with specific genotypes. PFGE revealed six major genotypes: E8a (25%), E7b (17%), E7a (12%), E8B (8%), E10 (6%), and E20 (4%). Isolates with the genotypes E8a and E10 exhibit higher resistance ratios for levofloxacin than isolates with the other major pulsotypes. Similar results were obtained for isolates with the E20 pulsotype with respect to mupirocin. Although we identified no vancomycin-, tigecycline-, linezolid- or daptomycin-resistant strains, we observed significant differences in the mean MIC values obtained for some of these drugs among the major genotypes. Specifically, isolates with the E7b, E8b, and E20 genotypes have signif-icantly higher MICs of tigecycline, vancomycin and linezolid, respectively, than the most sensitive pulsotypes. Isolates with the E8b profile also exhibit a significantly higher rate of re-duced vancomycin susceptibility (RVS) (i.e., MIC between 1 and 2 mg/L) than clones with the E10 and E8a profiles. In conclusion, we report associations between genotype and antibiotic sensitivity that should be considered in programs for monitor-ing and controlling MRSA in health care settings.


Subject(s)
Drug Resistance, Bacterial/genetics , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Staphylococcal Infections/microbiology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Culture Media , Electrophoresis, Gel, Pulsed-Field , Genotype , Humans , Microbial Sensitivity Tests
7.
Article in Spanish | IBECS | ID: ibc-127636

ABSTRACT

Introducción. El incumplimiento farmacológico supone un importante problema que afecta el éxito terapéutico de los pacientes. El objetivo principal de esta investigación consistió en validar la llamada telefónica al domicilio del paciente como método de automedición del recuento de comprimidos simple como método alternativo al patrón oro del recuento simple en consulta sanitaria. Pacientes y métodos. Estudio de investigación observacional, multicéntrico, prospectivo, longitudinal, desarrollado por 25 investigadores en diferentes centros de salud de Extremadura que incluyeron 125 pacientes diagnosticados de hipertensión arterial no controlada de los cuales finalizaron 121. La inclusión de pacientes se realizó de forma consecutiva y a medida que el investigador detectaba un hipertenso no controlado. Se efectuaron 3 visitas, que incluían visita de inclusión, visita de seguimiento a las 4 semanas y visita final a las 8 semanas. Previamente a las visitas primera y final, se realizó la llamada telefónica al paciente para recordarle la visita correspondiente y recopilar en ese mismo momento información sobre el número de comprimidos que le quedaban. Resultados. Fueron incluidos 121 pacientes. En la visita final, el test de la llamada telefónica como método de medida del cumplimiento obtuvo: sensibilidad: 100%; especificidad: 86%; exactitud global: 86,8%; VPP: 30,4%; VPN: 100%; CP+: 7,13; CP−: 0,0 e índice kappa: 0,415 (p < 0,0001). El área bajo la curva ROC fue de 0,995 (IC95%: 0,985-1). Conclusiones. Concluimos que la llamada telefónica como método de medida del cumplimiento terapéutico puede ser una buena alternativa por su casi universalidad, coste reducido y sin la necesidad de desplazamiento de los pacientes a los centros sanitarios (AU)


Introduction. Pharmacological non-compliance is a significant problem that can affect patient health. The main aim of this investigation is to validate the telephone call to the patient’ home as a self-report method of counting the amount of tablets taken by the patient, as an alternative method to a simple tablet count in the clinic (gold standard). Patients and methods. An observational, multicentre, prospective, and longitudinal study was conducted by 25 researchers in different health centres in Extremadura, and which included 125 consecutively enrolled patients with uncontrolled arterial hypertension, 121 ended the study. Three visits were made, including enrollment visit, follow-up visit at 4 weeks, and final visit at 8 weeks. A telephone call was made prior to the enrollment and final visit to remind the patients of the next visit, and to ask at the same time about the number of tablets remaining. Results. A total of 121 patients completed the study. In the final visit, the phone-call method of compliance showed: 100% sensitivity, 86% specificity, 86.8% of overall accuracy, 30.4% PPV, 100% NPV, CP+ 7.13, CP− 0.0, and a kappa index of 0.415 (P < .0001). The area under the ROC curve was 0.995 (95% CI, 0.985-1). Conclusions. It was concluded that the telephone phone call, as a therapeutic compliance method, can be a good alternative due to being almost universal, easy to use, its reduced cost, and without the need of patients to go to the medical centres (AU)


Subject(s)
Humans , Male , Female , Interviews as Topic/methods , Interviews as Topic , Patient Compliance/statistics & numerical data , Medication Adherence/statistics & numerical data , Hypertension/epidemiology , Hypertension/prevention & control , Pharmacovigilance , Self Medication/methods , Self Medication/statistics & numerical data , Drug Monitoring/methods , Drug Monitoring/statistics & numerical data , Drug Monitoring/trends
8.
Rev Esp Quimioter ; 27(3): 180-9, 2014 Sep.
Article in Spanish | MEDLINE | ID: mdl-25229373

ABSTRACT

The correct surveillance and control of infection caused by methicillin-resistant Staphylococcus aureus (MRSA) needs of update knowledge of its specific properties in each place. Our study aims to describe the current characteristics of infection due to MRSA in Extremadura. During 2010, 309 MRSA were collected from clinical samples in our region. A susceptibility test that included 17 antibiotics tested by AST -588 card Vitek 2 ® and E -test method was performed on all isolates. A sample of 100 strains, selected by stratified random sampling, were genotyped by pulsed field electrophoresis (PFGE). The prevalence of MRSA in Extremadura was 20.2%. Don Benito-Villanueva area showed the most prevalence and a higher incidence. Merida reported the most favourable situation, with a relatively low ratios of prevalence and incidence. The community acquired reached 44 % in the region, showing predominantly in less populated areas (Navalmoral and Coria). The most common multiresistant pattern was tobramycin-levofloxacin-erythromycin (44%), followed tobramycin-erythromycin-clindamycin (20%). No linezolid, daptomycin and tigecycline resistant strains were observed, but 42 % of the MRSA strains showed decreased susceptibility vancomycin (DSV). PFGE analysis reported 27 genotypes, with 3 major genotypes: E8a (25%), E7b (17%) and E7a (12%). The post-hoc statistical analysis did not reveal significant differences in the distribution of genotypes between different areas. However it revealed some trends that should be considered.


Subject(s)
Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Methicillin-Resistant Staphylococcus aureus , Staphylococcal Infections/epidemiology , Staphylococcal Infections/microbiology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cross Infection/epidemiology , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Health Surveys , Humans , Incidence , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Microbial Sensitivity Tests , Spain/epidemiology , Vancomycin Resistance
9.
Semergen ; 40(7): 366-73, 2014 Oct.
Article in Spanish | MEDLINE | ID: mdl-24838054

ABSTRACT

INTRODUCTION: Pharmacological non-compliance is a significant problem that can affect patient health. The main aim of this investigation is to validate the telephone call to the patient' home as a self-report method of counting the amount of tablets taken by the patient, as an alternative method to a simple tablet count in the clinic (gold standard). PATIENTS AND METHODS: An observational, multicentre, prospective, and longitudinal study was conducted by 25 researchers in different health centres in Extremadura, and which included 125 consecutively enrolled patients with uncontrolled arterial hypertension, 121 ended the study. Three visits were made, including enrollment visit, follow-up visit at 4 weeks, and final visit at 8 weeks. A telephone call was made prior to the enrollment and final visit to remind the patients of the next visit, and to ask at the same time about the number of tablets remaining. RESULTS: A total of 121 patients completed the study. In the final visit, the phone-call method of compliance showed: 100% sensitivity, 86% specificity, 86.8% of overall accuracy, 30.4% PPV, 100% NPV, CP+ 7.13, CP- 0.0, and a kappa index of 0.415 (P<.0001). The area under the ROC curve was 0.995 (95% CI, 0.985-1). CONCLUSIONS: It was concluded that the telephone phone call, as a therapeutic compliance method, can be a good alternative due to being almost universal, easy to use, its reduced cost, and without the need of patients to go to the medical centres.


Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Medication Adherence , Telephone , Aged , Antihypertensive Agents/administration & dosage , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Self Report , Sensitivity and Specificity , Spain
10.
Int J Tuberc Lung Dis ; 16(10): 1400-4, 2012 Oct.
Article in English | MEDLINE | ID: mdl-23107638

ABSTRACT

BACKGROUND: Mycobacterium africanum is a cause of tuberculosis (TB) that has mainly been described in Africa, but immigration and travel patterns have contributed to the spread of the disease to other countries. METHODS: We retrospectively reviewed TB cases due to M. africanum during 2000-2010 in seven Spanish hospitals. Selected clinical charts were reviewed using a predefined protocol that included demographical, clinical and microbiological data and outcome. RESULTS: Although 57 cases were diagnosed, only 36 clinical charts were available for review: 82.8% were men and the mean age was 31.6 years (range 12-81). Forty-four cases were from Africa, 1 from the Philippines, 1 from India, and 4 from Spain, while the country of origin was unknown in 7 cases. The most frequent site of infection was the lung (58.3%). Four cases (6.9%) were resistant to at least one first-line anti-tuberculosis drug. CONCLUSIONS: Disease due to M. africanum in industrialised countries is mainly associated with immigration from endemic areas, although some cases also occur among native-born populations.


Subject(s)
Developed Countries , Mycobacterium Infections/epidemiology , Mycobacterium/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Morbidity/trends , Mycobacterium Infections/microbiology , Retrospective Studies , Spain/epidemiology , Young Adult
11.
Cir Pediatr ; 24(2): 84-9, 2011 Apr.
Article in Spanish | MEDLINE | ID: mdl-22097654

ABSTRACT

INTRODUCTION: Anterior ectopic anus (AEA), continues to be a controversial issue. The objective is to determine the normal position of the anus or anal ano-genital index (AGI) in newborns (NB) and in a group of infants with chronic constipation, know the incidence of AEA in both groups, and its relationship with constipation. METHODS: A prospective aleatory study is performed in where the AGI is determined in 529 NB and 64 older patients with chronic constipation. The AGI is obtained by dividing the distances (cm): vulvar fornix-anus/fornix-coccyx in females and scrotum-anus/scrotum-coccyx in males. The NB group is further studied for gestational age, weight, number of meconium discharges and anal calibration. The newborns with AEA are then controlled to exclude constipation. In patients with chronic constipation, their age, sex and AGI are evaluated. The statistical comparisons are made by a Student's t test and Welch's t test for independent samples. RESULTS: 49.5% of NB are male. The average gestational age is 38.95 +/- 2.08/w in NB females and 38.54 +/- 2.26/w in NB males. The average weight is 3101.91 +/- 511.41/g in newborn females and 3145.14 +/- 573.36/g in newborn males. The average AGI of NB females is 0.40 +/- 0.05 and NB males 0.53 +/- 0.06. AEA is considered with AGI < 0.30 in females and < 0.41 in males. 2.2% of NB females (6/267) and 1.1% of NB males (3/262) have AEA. There is a significant difference between the AGI of NB females and NB males (p < 0.0001). 98% of NB discharge meconium in the first 24 hours. 2 NB females with AGI 0,21 and 0,26 had severe constipation in the first months of life. In group with chronic constipation (64 pacients), 59.4% are female. The AGI is 0.36 +/- 0.1 in females and 0.47 +/- 0.1 in males (p < 0.0001). Concerning of AEA in the NB group (AGI < 0.30 in females and 0.41 in males) incidence of AEA in group with chronic constipation is 35% in males and 47% in females. CONCLUSIONS: The position of the anus in the perineal floor is anterior in females, with significant differences (p < 0.0001) to the AGI in males. AEA has more incidence in females (2.2%). In the constipated group 47% of females had AEA and it is considered the probable reason for this disorder in these patients. To conclude, each NB evaluation protocol should include determination of the AGI in the neonatal period to exclude AEA and to prevent clinical consequences.


Subject(s)
Anal Canal/abnormalities , Constipation/etiology , Chronic Disease , Congenital Abnormalities/diagnosis , Congenital Abnormalities/epidemiology , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Prospective Studies
12.
Pediatr Surg Int ; 27(10): 1111-5, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21553273

ABSTRACT

INTRODUCTION: The objective of this study was to determine the normal anal position index (API) in neonates and in a group of older children with chronic constipation, and to identify the incidence of anterior ectopic anus (AEA) in the two groups. MATERIALS AND METHODS: A prospective random study was carried out in two European hospitals determining the API in 1,012 neonates (529 in Group A, and 483 in Group B) and in 64 children suffering chronic constipation of ages between 3 months and 12 years (Group C). The API is defined as the ratio between the fourchette-anal and fourchette-coccygeal distances in girls and the scroto-anal and scroto-coccygeal distances in boys. The gestational age, weight, meconium evacuation and anal calibre were recorded in Groups A and B, and age, sex, and API in Group C. Statistical comparisons were made using Student's t test and Welch's t test for independent sample groups. RESULTS: The mean API in Group A was 0.53 ± 0.06 in males and 0.40 ± 0.05 in females, and in Group B 0.51 ± 0.06 in males and 0.39 ± 0.08 in females, with significant differences between the sexes (p < 0.0001) in both groups; 1.7% of the neonates in Group A and 2.4% of Group B presented AEA. 4/13 newborns females with AEA presented with severe constipation during their first months of life. For the 64 patients in Group C: 59.3% were female; the mean API was 0.47 ± 0.1 in males and 0.36 ± 0.1 in females (p < 0.0001). The incidence of AEA was 47% in females and 35% in males. CONCLUSIONS: In the neonates (Groups A and B), the position of the anus in the perineum was more anterior in females than in males (p < 0.0001); 31% of the newborns females with AEA presented with constipation in their first months of life. In the Group C patients, there was a high incidence of AEA, especially in the females, and we consider it to be the probable cause of this defecation disorder.


Subject(s)
Anal Canal/abnormalities , Constipation/etiology , Child , Child, Preschool , Chronic Disease , Constipation/epidemiology , Female , Humans , Incidence , Infant , Infant, Newborn , Italy/epidemiology , Male , Prospective Studies , Sex Distribution , Spain/epidemiology
13.
Cir. pediátr ; 24(2): 84-89, abr. 2011. ilus, tab
Article in Spanish | IBECS | ID: ibc-107303

ABSTRACT

Introducción. El ano anterior ectópico (AAE) continúa siendo una entidad controvertida. El objeto es determinar la posición normal del ano o índice anogenital (IAG) en recién nacidos (RN) y en un grupo de niños con estreñimiento crónico, conocer la incidencia del AAE en ambos grupos, y la relación de éste con el estreñimiento. Material y métodos. Se realiza un estudio prospectivo y aleatorio en el que se determina el IAG en 529 RN y en 64 pacientes de más edad con estreñimiento crónico. El IAG se obtiene dividiendo las distancias(cm): horquilla vulvar-ano/horquilla-coxis en niñas y escrotoano/escroto-coxis en niños. En el grupo de RN se estudian, además, la edad gestacional, peso, evacuación meconial y calibre anal. Los RN con AAE son controlados para el despistaje de estreñimiento. En los paciente scon constipación crónica se valora la edad, sexo e IAG. Las comparaciones estadísticas se efectúan mediante los tests de t-Student y elde Welch para muestras independientes .Resultados. De los 529 RN, el 49,5% son hombres. La edad gestacional media en RN niñas es 38,95 ± 2,08/s y 38,54 ± 2,26/s en RN niños. El peso es 3.101,91 ± 511,41/g en RN niñas y 3.145,14 ± 573,36/gen RN niños. El IAG medio en RN niñas es 0,40 ± 0,05 y en niños 0,53± 0,06. Se considera AAE los IAG de menos 2 DS por debajo de la (..) (AU)


Introduction. Anterior ectopic anus (AEA), continues to be a controversial issue. The objective is to determine the normal position of theanus or anal ano-genital index (AGI) in newborns (NB) and in a group of infants with chronic constipation, know the incidence of AEA in both groups, and its relationship with constipation. Methods. A prospective aleatory study is performed in where the AGI is determined in 529 NB and 64 older patients with chronic constipation. The AGI is obtained by dividing the distances (cm): vulvarfornix-anus/fornix-coccyx in females and scrotum-anus/scrotum-coccyx in males. The NB group is further studied for gestational age, weight, number of meconium discharges and anal calibration. The newborns with AEA are then controlled to exclude constipation. In patients with chronic constipation, their age, sex and AGI are evaluated. The statistical comparisons are made by a Student’s t test and Welch’s t test for independent samples. Results. 49.5% of NB are male. The average gestational age is38.95 ± 2.08/w in NB females and 38.54 ± 2.26/w in NB males. The average weight is 3101.91 ± 511.41/g in newborn females and 3145.14± 573.36/g in newborn males. The average AGI of NB females is 0.40± 0.05 and NB males 0.53 ± 0.06. AEA is considered with AGI < 0.30in females and < 0.41 in males. 2.2% of NB females (6/267) and 1.1%of NB males (3/262) have AEA. There is a significant difference between (..) (AU)


Subject(s)
Humans , Anal Canal/anatomy & histology , Constipation/physiopathology , Digestive System Abnormalities/diagnosis , Mass Screening , Prospective Studies
14.
J Hazard Mater ; 174(1-3): 9-16, 2010 Feb 15.
Article in English | MEDLINE | ID: mdl-19782466

ABSTRACT

Natural tannin-based adsorbent has been prepared on the basis of the gelification of Quebracho bark extract. The resulting product, Quebracho Tannin Gel (QTG) was tested as cationic dye adsorbent with Methylene Blue (MB). Kinetics of adsorption process were studied out and a period of 15 days was determined for reaching equilibrium. The influences of pH and temperature were evaluated. As pH or temperature raise q capacity of QTG increases. Theoretical modelization of dye-QTG adsorption was carried out by multiparametric adjustment according to Langmuir's hypothesis. Values of the k(l1), k(l2) and activation energies were calculated.


Subject(s)
Methylene Blue/chemistry , Tannins/chemistry , Adsorption , Hydrogen-Ion Concentration , Kinetics , Models, Theoretical , Solutions , Temperature , Water
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