Determinación de antígeno carcinoembrionario en los exámenes rutinarios de salud realizados desde Atención Primaria / Carcinoembryonic antigen as a cancer screening marker by primary care physicians

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Are the characteristics of the patient with a spinal cord injury changing?

STUDY DESIGN: A retrospective analytical study. OBJECTIVE: To determine the epidemiologic pattern of spinal cord injury (SCI) over the last decade. SETTING: Patients admitted in the spinal cord injury unit at a university hospital between 1 January 2001 and 31 December 2013. METHODS: A review of the clinical history of the patients was conducted. Patients were allocated according to traumatic (traffic and non-traffic accidents) or non-traumatic origin (tumour and non-tumour disease). Information about gender, age, admission and discharge date and cause, level and grade of spinal cord injury was collected. An analysis using the time-trend series was performed. RESULTS: The average length of stay decreases 1.5 days quarterly, and the average patient's age increases 0.25 year quarterly. No trend was observed with respect to the number of cases. CONCLUSION: Although the number of patients with an SCI caused by an accident has decreased and the average age of patients with an SCI has increased, it cannot be said that there has been a paradigm shift in patients with SCI.

[Factors associated with a significant functional gain and new institutionalisation in rehabilitated patients admitted to a long term care unit]. / Factores asociados a mejoría funcional y nueva institucionalización en enfermos con intervención rehabilitadora en una unidad de media-larga estancia.

BACKGROUND AND OBJECTIVES: To determine which factors are associated with a functional gain above 19 on Barthel's index (CSFG) and also factors associated with a new post-discharge institutionalisation (NPDI) in patients who a underwent rehabilitation intervention whilst admitted to a medium long term care unit. PATIENTS AND METHODS: Prospective study of patients admitted between 2000 and 2005 who underwent a rehabilitation intervention. Demographic, mind-body and laboratory data were collected. RESULTS: 153 patients were selected for the first aim and 148 for the second. 53.3% of the patients achieved a CSFG. The incidence of NPDI was of 23.7%. The following factors were associated with a CSFG in the multivariate analysis: age (OR: 0.95), female gender (OR: 0.35), rehabilitation objective at admission (OR: 7.43), infectious disease as primary diagnosis (OR: 10.35), mild dependence at admission (OR: 0.09), absence of malnutrition (OR: 3.12), high comorbidity (OR: 0.31), need of wound care (OR: 0.36) and ansiolitic intake at admission (OR: 9.11). Likewise, the following factors were associated with the occurrence of a NPDI: age (OR: 1.12), long-term care objective at admission (OR: 7.84), chronic lung disease (OR: 0.29), number of drug prescriptions at admission (OR: 0.82), neuroleptic intake at admission (OR: 7.42), living with relatives (OR: 0.29) and nosocomial infection during the hospital stay (OR: 2.99). CONCLUSIONS: Several factors have been associated to CSFG and NPDI and they would be useful to optimise rehabilitation resources and to plan post-discharge institutional transfer.

Factores asociados a mejoría funcional y nueva institucionalización en enfermos con intervención rehabilitadora en una unidad de media-larga estancia / Factors associated with a significant functional gain and new institutionalisation in rehabilitated patients admitted to a long term care unit

Fundamento y objetivoDeterminar qué factores se asocian con una ganancia funcional clínicamente relevante (GFCR) superior a 19 en el índice de Barthel y con nueva institucionalización al alta (NIA) en pacientes con intervención rehabilitadora.Pacientes y métodoEstudio prospectivo en pacientes con intervención rehabilitadora ingresados entre 2000 y 2005 en una unidad de media-larga estancia. Se recogieron datos demográficos, biopsicosociales y de laboratorio.ResultadosParticiparon en el estudio 153 pacientes para el primer objetivo y 148 para el segundo. Alcanzó una GFCR el 53,3% de los pacientes. La incidencia de NIA fue del 23,7%. En el análisis multivariante se relacionaron con una GFCR los siguientes factores: edad (OR: 0,95), sexo femenino (OR: 0,35), objetivo de remisión rehabilitador (OR: 7,43), diagnóstico principal infeccioso (OR: 10,35), dependencia moderada al ingreso (OR: 0,09), ausencia de desnutrición (OR: 3,12), alta comorbilidad (OR: 0,31), necesidad de curas al ingreso (OR: 0,36) y uso de ansiolíticos al ingreso (OR: 9,11). Asimismo, se relacionaron con NIA: edad (OR: 1,12), remisión para larga estancia (OR: 7,84), enfermedad pulmonar crónica (OR: 0,29), número de fármacos al ingreso (OR: 0,82), neurolépticos al ingreso (OR: 7,42), vivir con familiares (OR: 0,29) e infección nosocomial (OR: 2,99).ConclusionesSe ha detectado un conjunto de variables asociadas a una GFCR y al riesgo de NIA, que podrían ser utilizadas tanto para optimizar los recursos rehabilitadores como para planificar la necesidad de un recurso residencial al alta(AU)

Background and objectivesTo determine which factors are associated with a functional gain above 19 on Barthel's index (CSFG) and also factors associated with a new post-discharge institutionalisation (NPDI) in patients who a underwent rehabilitation intervention whilst admitted to a medium long term care unit.Patients and methodsProspective study of patients admitted between 2000 and 2005 who underwent a rehabilitation intervention. Demographic, mind-body and laboratory data were collected.Results153 patients were selected for the first aim and 148 for the second. 53.3% of the patients achieved a CSFG. The incidence of NPDI was of 23.7%. The following factors were associated with a CSFG in the multivariate analysis: age (OR: 0.95), female gender (OR: 0.35), rehabilitation objective at admission (OR: 7.43), infectious disease as primary diagnosis (OR: 10.35), mild dependence at admission (OR: 0.09), absence of malnutrition (OR: 3.12), high comorbidity (OR: 0.31), need of wound care (OR: 0.36) and ansiolitic intake at admission (OR: 9.11). Likewise, the following factors were associated with the occurrence of a NPDI: age (OR: 1.12), long-term care objective at admission (OR: 7.84), chronic lung disease (OR: 0.29), number of drug prescriptions at admission (OR: 0.82), neuroleptic intake at admission (OR: 7.42), living with relatives (OR: 0.29) and nosocomial infection during the hospital stay (OR: 2.99).ConclusionsSeveral factors have been associated to CSFG and NPDI and they would be useful to optimise rehabilitation resources and to plan post-discharge institutional transfer(AU)

Prevalence of hepatitis A virus antibodies in patients with chronic liver diseases.

OBJECTIVE: The age of persons with hepatitis A virus (HAV) infection in the general population has risen; these persons are at increased risk of clinically severe disease, especially patients with chronic liver disease. The aim of the present study was to analyze the prevalence of total antibodies against HAV in patients with chronic liver disease. METHODS: In a prospective study carried out between September 1998 and June 1999, 180 patients seen in the chronic liver disease outpatient department were studied. The prevalence of total anti-HAV antibodies was determined by age group, etiology and degree of histological damage, and according to the antecedents of risk for parenteral infection. A nonconditional logistic regression model was fitted with anti-HAV positivity as the dependent variable. RESULTS: Mean age was 44.1 years, with an anti-HAV prevalence of 77.2% (varying from 42.9% in the 21-25-year-old group to more than 83% in patients > 56-years old). Differences across groups regarding other categories (histological damage, etiology and history of parenteral or drug use) were not statistically significant, but the probability of anti-HAV positivity increased with age and a history of drug addiction. CONCLUSIONS: The prevalence of total anti-HAV antibodies is high among patients with chronic liver disease. We therefore recommend this test before vaccination against HAV, until current recommendations on universal childhood vaccination are implemented, in order to prevent hepatitis A epidemics in the general population.

Prevalencia de anticuerpos antivirus de la hepatitis A en pacientes con hepatopatías crónicas / Prevalence of hepatitis A virus antibodies in patients with chronic liver diseases

OBJETIVO: la edad de infección por el virus de la hepatitis A (VHA) ha aumentado en la población, con un mayor riesgo de gravedad clínica, sobre todo en pacientes con hepatopatía crónica. Se pretende conocer la prevalencia de anticuerpos totales frente al VHA en pacientes con hepatopatía crónica. PACIENTES Y MÉTODOS: se estudió de forma prospectiva a 180 pacientes atendidos consecutivamente en nuestra consulta de Hepatopatías Crónicas desde septiembre de 1998 hasta junio de 1999. Se determinó la prevalencia de anticuerpos totales anti-VHA por grupos de edad, etiologías, grado de afectación histológica y antecedentes de riesgo de infección por vía parenteral. Finalmente se ajustó un modelo de regresión logística no condicional con variable dependiente la presencia de anti-VHA. RESULTADOS: la edad media fue de 44,1 años, con una prevalencia de anti-VHA del 77,2 por ciento (desde el 42,9 por ciento entre 21-25 años hasta más del 83 por ciento a partir de 56 años). No existieron diferencias estadísticamente significativas según la afectación histológica, etiología o antecedentes de riesgo parenteral o de drogadicción, pero la probabilidad de tener anti-VHA aumentaba con la edad y con el antecedente UDVP. CONCLUSIONES: los pacientes con hepatopatía crónica presentan una alta prevalencia de anticuerpos totales anti-VHA, En consecuencia, en estos pacientes recomendamos su determinación previamente a la vacunación frente al VHA hasta que se introduzcan las recomendaciones actuales de vacunación generalizada de la población infantil para evitar epidemias de hepatitis A en la población general (AU)