Science.gov

Sample records for estructuras primarias secundarias

  1. Alfabetización en Astronomía de docentes de Educación Primaria y de Educación Secundaria en La Plata

    NASA Astrophysics Data System (ADS)

    De Biasi, M. S.; Orellana, R. B.

    2014-10-01

    La educación de este siglo tiene como uno de sus retos alcanzar la alfabetización cientfica de todos los ciudadanos para que comprendan y tomen decisiones sobre el mundo natural y sus cambios originados por la actividad humana utilizando el conocimiento científico. En esta misión los docentes de los niveles obligatorios de enseñanza juegan un papel clave por su rol de agentes multiplicadores del conocimiento. Se requiere, entonces de una adecuada alfabetización en ciencias de los docentes o, como mínimo, que dominen los temas científicos a enseñar. En el campo de la Astronomía, numerosas investigaciones han señalado que maestros de primaria y estudiantes de profesorados poseen una escasa formación en estos temas (Camino 1995 y 1999, Gangui 2010), que frecuentemente presentan a los alumnos concepciones alternativas o no científicas de los fenómenos astronómicos cotidianos (Kriner 2004, Vega Navarro 2007, Gangui et al 2010); a lo que se suma la presentación confusa o errónea de algunos temas astronómicos en los textos escolares (Kriner 2004). Desde 2011, la Facultad de Ciencias Astronómicas y Geofísicas, UNLP, ofrece un curso de capacitación destinado a fortalecer y actualizar los contenidos académicos y didácticos de los docentes del distrito La Plata utilizando diversas estrategias didácticas. Los contenidos comprenden los temas astronómicos de los diseños curriculares vigentes. La evaluación diagnóstica de los conocimientos previos de los docentes cursantes sobre los contenidos de mayor presencia en los diseños curriculares mostró resultados similares a las investigaciones arriba mencionadas. Referente a los movimientos de la Tierra, en promedio, el 54% poseía conceptos erróneos y el 16% no los sabía; con referencia a la Luna el 56% poseía conceptos erróneos y un 4% no los sabía. Los resultados del curso mostraron que el 95% de los docentes revirtió sus conceptos previos erróneos, que adquirió criterios para la búsqueda de

  2. [Analysis of information sources in the journal, Atencion Primaria].

    PubMed

    Aleixandre, R; Giménez Sánchez, J V; Terrada Ferrandis, M L; López Piñero, J M

    1996-03-31

    To contribute to improving the understanding of the information bases of Spanish scientific production in the primary care field; to aid international contacts and the diffusion of information among doctors in our country. A bibliometric analysis of the bibliographic references of the studies published in the journal Atención Primaria during 1991. A data base, managed by dBASE IV, was created. The Unit of Documental Analysis and Bibliometry of the Institute of Documental and Historical Studies in Science (University of Valencia-CSIC). 2,615 bibliographic references in 205 studies contained in volume 8 of Atención Primaria. References from journal articles (68%) and books (26%) predominated. There were a large number of references from Spanish publications (45%) as against Northamerican (27%) and British (15%). There were few references from other European countries or Latin America. Information was quickly out of date (4 year semiperiod; Price index 50%). High proportion of self-quotations from the journal. The major role of the journal Atención Primaria in communicating information in the primary care field was underlined. The small amount of information from Latin America and E.U. countries (except Great Britain) highlights the isolation of Spain from these countries, which can be explained by the limits of the primary care field itself. There was also little use of information to which access was more difficult for primary care doctors, such as doctoral theses, congress papers or reports. Moreover this is a field with a high percentage of recent literature and rapidly out-of-date information.

  3. A Case Study of Schooling Practices at an "Escuela Secundaria" in Mexico

    ERIC Educational Resources Information Center

    de Souza, Marcela

    2013-01-01

    This article reports results of a qualitative study conducted at a public "escuela secundaria" (U.S. grades 7, 8, and 9) in Guadalajara, Mexico, during the spring of 2010. As the second phase of an ongoing project, the main goal was to learn from direct classroom observation about the most prevalent teaching and institutional practices…

  4. A Case Study of Schooling Practices at an "Escuela Secundaria" in Mexico

    ERIC Educational Resources Information Center

    de Souza, Marcela

    2013-01-01

    This article reports results of a qualitative study conducted at a public "escuela secundaria" (U.S. grades 7, 8, and 9) in Guadalajara, Mexico, during the spring of 2010. As the second phase of an ongoing project, the main goal was to learn from direct classroom observation about the most prevalent teaching and institutional practices…

  5. Criptococosis cutánea primaria en paciente inmunocompetente.

    PubMed

    Vázquez-Osorio, Igor; García-Rodiño, Sara; Rodríguez-Rodríguez, Marta; Labandeira, Javier; Suárez-Peñaranda, José Manuel; Sánchez-Aguilar, MDolores; Vázquez-Veiga, Hugo

    2016-05-15

    La criptococosis cutánea es una micosis propia de pacientes inmunodeprimidos, sobre todo aquellos con infección por el virusde la inmunodeficiencia humana (VIH). Sin embargo, existen casos infrecuentes de criptococosis cutánea en pacientes inmunocompetentes, que suelen simular otras dermatosis, lo que retrasa su diagnóstico y tratamiento. Presentamos el caso de un varón pluripatológico de 79 años, con úlceras dolorosas en dorso de mano derecha que no respondían a tratamientos tópicos. A través del estudio histopatológico y micológico se alcanzó el diagnóstico de criptococosis cutánea primaria, lográndose la remisión de las lesiones tras 6 meses de tratamiento con fluconazol.

  6. Early membrane depressions in hepatocytes cultured on Primaria supports.

    PubMed

    Griffiths, B J; Evans, P J

    2001-01-01

    The topography of spreading hepatocytes on positively charged Primaria plates was examined using scanning electron microscopy. The cells acquired a uniform morphology within 2 h. The spreading was rapid and the surface of the cells showed early prominent depressions or dips. The hepatocytes had either one or two of these structures which corresponded to the frequency of mononuclear and binuclear cells, respectively. The nuclear origin of the dips was strengthened after 6 h. They contained solid structures, whose number, size and shape were the same as nucleoli. The membrane dipping was independent of cell density and took place under conditions where phenotypic changes can occur. Kidney proximal tubule cells had no dips. Co-cultures of hepatocytes and kidney proximal tubule cells showed that the cell types behave differently.

  7. Primera aproximación a la estructura interna de Plutón

    NASA Astrophysics Data System (ADS)

    Steren, G. A.; Carranza, G. J.; Hubbard, W. B.

    En el presente trabajo se propuso estudiar la estructura interna actual del planeta Plutón. El modelo que se planteó es del tipo de estructura no-diferenciada. Se incluyó como fuente de calor interna la radioactividad y como único mecanismo de transporte de la energía a la conducción. Se encontró que el planeta estaría compuesto por una mezcla de roca (65% en masa) y hielo de agua (35%). Este simple modelo permite inferir que una estructura más realista para Plutón debería incluir también a la convección como mecanismo de transporte. Ello además permitiría avanzar de modo más firme en el estado de diferenciación del planeta, que casi seguramente sea más complejo que el adoptado.

  8. Adsorption of fibronectin and vitronectin onto Primaria and tissue culture polystyrene and relationship to the mechanism of initial attachment of human vein endothelial cells and BHK-21 fibroblasts.

    PubMed

    Steele, J G; Dalton, B A; Johnson, G; Underwood, P A

    1995-09-01

    The two cell culture substrata, tissue culture polystyrene (TCPS) and Primaria, were compared in order to determine whether a nitrogen-containing surface such as Primaria attracts cells by a different mechanism to an oxygen-containing surface (TCPS). The amounts of vitronectin (Vn) and fibronectin (Fn) which adsorb from the fetal bovine serum (FBS) component of the culture medium onto Primaria and TCPS were determined. Primaria adsorbed two- to threefold more Fn than TCPS, but adsorbed similar amounts of Vn from medium containing FBS. The Fn and Vn binding sites on Primaria were distinct, as adsorption was non-competitive between these two proteins. The amounts of Fn and Vn that adsorbed onto the two surfaces were compared to the concentration dependence of the cell attachment activities of Fn and Vn. Whereas the amounts of Fn which adsorbed onto TCPS were suboptimal for cell attachment, Primaria adsorbed an Fn surface density that was supraoptimal for attachment of human vein endothelial cells and BHK-21 fibroblasts. We conclude that Primaria differs from TCPS in that both Fn and Vn mediate initial cell attachment to Primaria when the culture medium contains FBS, whereas cell attachment to TCPS is dependent upon Vn.

  9. Como Ayudarle a su Hijo con la Tarea Escolar: Una guia para padres de alumnos de escuela primaria y secundaria (Helping Your Child with Homework: For Parents of Elementary and Junior High School-Aged Children).

    ERIC Educational Resources Information Center

    Paulu, Nancy, Ed.; Perkinson, Kathryn, Ed.

    This Spanish-language booklet is designed to provide parents of elementary and junior high school students with an understanding of the purpose and nature of homework along with suggestions for helping their children complete homework assignments successfully. Following a discussion of why teachers assign homework, how homework can help children…

  10. Como ayudar a su hijo con la tarea escolar: Para los padres con ninos en la primaria y la secundaria (Helping Your Child with Homework: For Parents of Children in Elementary through Middle School).

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Office of Intergovernmental and Interagency Affairs.

    Homework is an opportunity for children to learn and for families to be involved with their children's education, but helping children with homework is not always easy. This Spanish-language booklet is designed to provide parents of elementary and middle grades students with an understanding of the purpose and nature of homework and offers…

  11. [Duration of the editorial process of the Atención Primaria journal].

    PubMed

    Jiménez Villa, J

    1999-05-01

    To quantify how long the different steps in the process of editing the manuscripts received by the journal Atención Primaria took. Retrospective, descriptive study. The journal Atención Primaria. Manuscripts submitted for publication in the sections Original articles, Short articles and Letters to the Editor between January 1 and June 30 1997 (6 months). Retrospectively, information was collected on the dates of receipt, of sending out to referees, receipt of their views and comments, sending back to the authors, receipt of their modified text or reply, of final decision on acceptance or rejection, and of publication if accepted. Of the 132 original and short articles received, 22 (16.7%) were awaiting a final decision. Of the remaining 110, 53 (48.2%) had been rejected and 57 (51.8%) accepted. The length of each step in the editorial process was less than 30 days for half the manuscripts. The time elapsed from receipt to editorial decision was less than 45 days in half the cases and 60 days on average. The time from acceptance to publication was 137 days on average. How long each step in the editorial process took can be considered acceptable, although the wide variability in the times taken by authors to modify their manuscripts is striking. Mechanisms must be sought to avoid the excessive delay in the publication of research, by increasing the speed of the referees' reviews and of authors' modifications.

  12. [Types of studies published in the journal Atencion Primaria between 1984-1990].

    PubMed

    Jiménez Villa, J; Carré Llopis, M C; Argimon Pallás, J M

    1993-06-15

    To determine the frequency and the main methodological characteristics of the epidemiological designs used in the research studies published in the journal Atencion Primaria between 1984 and 1990. A descriptive study. Included are all the articles presenting data produced by the authors themselves in the context of a research study and published in the sections of original articles, special contributions or clinical notes in the issues of the journal Atencion Primaria between 1984 and 1990. A data-gathering questionnaire was used, whose concordance was previously assessed blindly by two observers. There were 324 articles included. Of these, 93% were descriptive studies, out of which 27% were prevalence studies. Of these prevalence studies, 15.7% were conducted among the population as a whole. A questionnaire, which had been previously validated in 47.7% of cases, was used in 13.5% of the studies. Experimental research accounted for 21 studies (6.5%), of which 85% had an explicit control group. Only a small proportion are analytical studies. The majority of descriptive studies are carried out among the population attending for treatment.

  13. La Enseñanza/Aprendizaje del Modelo Sol-Tierra Análisis de la Situación Actual y Propuesta de Mejora Para la Formación de los Futuros Profesores de Primaria

    NASA Astrophysics Data System (ADS)

    Martínez Sebastià, Bernat

    2004-12-01

    This work is an extened summary of the autor's PhD thesis. It deals with the teaching of astronomy (day/night, seasons) in primary school. At first, students teachers' undestanding of astronomical concepts related to Sun-Earth system have been analysed. Taking into account the results of the previous analysis and using a socio-constructivist approach a teaching sequence has been designed. This sequence has been tested with different groups of students teachers showing an improvement in their undestanding of elementary astronomical concepts. El trabajo que presentamos es un resumen extenso de la tesis doctoral del autor. El enfoque utilizado ha sido tratar de ligar la investigación sobre las ideas, razonamientos y obstáculos de los profesores de primaria con la planificación de la enseñanza del modelo Sol-Tierra que permite explicar el ciclo día/noche y las estaciones. En primer lugar, se ha procedido a realizar un análisis crítico de los resultados que se obtienen en el aprendizaje de los contenidos astronómicos en la enseñanza habitual. En segundo lugar se ha diseñado un curriculum potencialmente superador de esta situación desde una orientación que concibe la enseñanza y el aprendizaje como un proceso de construcción de conocimientos en una estructura problematizada. Finalmente, esta secuencia didáctica ha sido experimentada con diferentes grupos de estudiantes de magisterio, mostrando una mejora relevante en la comprensión de los conceptos astronómicos fundamentales.

  14. Trombosis venosa esplácnica como manifestación inicial de mielofibrosis primaria.

    PubMed

    Campos-Cabrera, Gregorio; Campos-Cabrera, Virginia; Campos-Cabrera, Salvador; Campos-Villagómez, José-Luis; Romero-González, Alejandra

    2017-01-01

    Las neoplasias mieloproliferativas (NMP) son alteraciones crónicas de las células madre hematopoyéticas clonales caracterizadas por una mayor producción de granulocitos, glóbulos rojos o plaquetas. Una de las principales complicaciones de las NMP es la aparición de problemas trombóticos venosos y arteriales causados por un aumento en la agregación plaquetaria y la generación de trombina. Se evaluaron 11 casos de mielofibrosis primaria (MP), de los cuales dos debutaron con trombosis venosa esplácnica (TVE). Tras observar los resultados de este estudio y de la literatura mundial, se sugiere que al evaluar pacientes con TVE se incluyan métodos diagnósticos para MP, como la mutación JAK2V617F. Myeloproliferative neoplasms are chronic disorders of clonal hematopoietic stem cells, characterized by an overproduction of functional granulocytes, red blood cells and / or platelets, and one of the major complications is the occurrence of venous and arterial thrombotic problems caused by increased platelet aggregation and thrombin generation. In this study 11 cases of primary myelofibrosis (PM) were evaluated and 2 debuted with splanchnic venous thrombosis (SVT); so after seeing the results of this study and of world literature, it is suggested that in patients with SVT, diagnostic methods for PM like the JAK2V617F mutation should be included.

  15. Origen y evolución de la estructura del Universo

    NASA Astrophysics Data System (ADS)

    García Lambas, D.

    Se presenta una revisión de diversos tópicos vinculados a la evolución de estructuras en el Universo y se discuten los escenarios más aceptados para la comprensión de las irregularidades primigenias y de su evolución temporal. Se analizan evidencias observacionales de la naturaleza jerárquica en los mecanismos de formación de sistemas, tales como las indicaciones provenientes de las correlaciones espaciales y de velocidades, la naturaleza del Universo a alto redshift, y la habilidad de los modelos jerárquicos en predecir diversas propiedades dinámicas, fotométricas y químicas de las galaxias.

  16. [The authors and the bibliographic references of the original articles published in the journal Atención Primaria (1984-1990)].

    PubMed

    del Burgo, J L; Gérvas, J J

    1992-05-15

    The main aim of the study is to assess the developing situation of the articles published in the journal Atención Primaria in relation to the original articles included in the same journal. There are secondary aims of describing the amount of self-quotation, the profession of the authors, their geographical distribution and their use of bibliographic references. A descriptive analysis of the authors and bibliographic references in the original articles. SITE. Publications and research in Primary Care. All the original articles published in the journal Atención Primaria during its first seven years (1984-1990). Gathering of data from the original articles (the number of authors, province of their place of work, titles, total number of references, references from Atención Primaria, the number of self-quotations, etc.) In the seven years studied, 295 original articles have been published by 1467 authors, 44% of whom are family doctors. The average number of authors per article was 5. There are twelve Spanish provinces from which no-one has published. Altogether 4,908 bibliographic references, an average of 16.6 per article, have been used. The number of references from the journal itself rose steadily from 1% in 1984 to 11.7% in 1988, but went down to 10.3% in 1990. 52% of the bibliographic references were in Castilian and 42.6% in English. The journal Atención Primaria is often quoted in original articles published in the same journal. The number of authors and references per original article is high but stable.

  17. Trombosis primaria de la descendente anterior en un paciente con síndrome de anticuerpos antifosfolípidos.

    PubMed

    Acuña-Valerio, Jorge; Peña-Duque, Marco Antonio; Contreras-Villaseñor, Álvaro

    2017-01-01

    El síndrome de anticuerpos antifosfolípidos es una situación clínica y bioquímica heterogénea. Presentamos el caso de un varón joven con antecedente de tromboembolia venosa que se presentó en esta ocasión por dolor precordial, con elevación del ST en el electrocardiograma. Fue llevado a sala de angiografía para realizar angioplastia primaria y se observó una oclusión total ostial de la descendente anterior. Se realizó aspiración manual del trombo. No se realizó angioplastia con balón ni stent. En la angiografía de control a las 48 horas se observó ausencia de trombo y de placas aterosclerosas, lo cual se corroboró mediante ultrasonido intracoronario. Antiphospholipid antibody syndrome is a heterogeneous clinical and biochemical entity. We present the case of a young male with history of venous thromboembolism. This time he presents because of chest ischemic pain associated with ST segment elevation. He was taken to the cath lab to perform a primary percutaneous coronary intervention and a total occlusion of the left anterior descending artery was noted. Successful thrombus aspiration was performed. No stent was deployed. He was taken to the cath lab for a second look angiography and no atherosclerotic lesions were observed, which was confirmed by intravascular ultrasound.

  18. [Atención Primaria journal in MEDLINE: an analysis of the first 7 years of indexing (1989-1995)].

    PubMed

    Simó Miñana, J; Gaztambide Ganuza, M; Latour Pérez, J

    1999-05-01

    To evaluate the validity of the information of bibliometric interest retrieved from MEDLINE and referred to the articles published by Atención Primaria journal from 1989 to 1995. To describe the presence of this journal and its evolution among the journals of its own thematic group (Family Practice) during the same period. Retrospective descriptive study. MEDLINE database on SilverPlatter, 1997 edition. In a first step, all the documents published by the spanish journal during this period have been revised. Secondly, with a sample of 385 documents that comes from 24 issues selected at random, it has been analysed the indexing of the following fields: title in english (TI), original title (TO), authors (AU), bibliographic citation (SO), year of publication (PY), country of publication (CP) and type of publication (PT). The field institutional address of primary author (AD) will be studied exhaustively. The number of articles indexed coming from the different journals of the Family Practice group, and their evolution during the studied period were analysed, as the countries and languages of publication of these journals. The spanish journal has been compared with the rest of its thematic group in type of publications and type of studies (PT field). MEDLINE hasn't indexed 158 out of 1865 (8.47%) of the documents published by the journal from 1985 to 1995. This percentage becomes 4.04% when reply letters, that MEDLINE doesn't indexed, are not considered. MEDLINE offers the field AD for the papers published by the Spanish journal from 1990. From this moment on the field AD appears in 95% of the indexed documents. The 30% of the registers without the AD field, don't have institutional address in the original document. The institution or centre that MEDLINE cites firstly in the AD field, coincide with the one of the first author, in 99% of the cases. The number of authors is correct in all cases, even if in 3.37 +/- 1.8% there are typographical mistakes. TO, SO, PY and

  19. Estructura espacial de las órbitas caóticas en un modelo autoconsistente de galaxia elíptica

    NASA Astrophysics Data System (ADS)

    Muzzio, J. C.

    Hemos logrado construir modelos autoconsistentes de sistemas estelares utilizando una aproximación cuadrupolar para el potencial. Esto nos permite determinar órbitas y exponentes de Lyapunov de objetos que tienen posiciones y velocidades equivalentes a las que se obtienen de la funcón de distribución del sistema. La distribución espacial de las órbitas caóticas exhibe considerable estructura y, lo que es más importante aún, los valores de los exponentes de Lyapunov calculados sobre intervalos finitos de tiempo, muestran una fuerte correlación con el comportamiento de la órbita en esos mismos intervalos, por lo que permiten reconocer distintos subsistemas con diferentes distribuciones espaciales.

  20. La estructura dinámica del cinturón de Kuiper interior y la formación de Urano y Neptuno

    NASA Astrophysics Data System (ADS)

    Melita, M. D.; Brunini, A.

    De acuerdo a los más recientes estudios sobre la formación de Urano y Neptuno, éstos podrían haber sufrido una importante migración radial hacia el exterior, debido al intercambio de momento angular con los planetesimales presentes en esa región durante las últimas etapas de la formación del Sistema Solar. Esta migración radial habría tenido importantes consecuencias sobre la presente estructura dinámica del cinturón cometario de Kuiper. Tal como lo reflejan las observaciones, la mayoría de los cuerpos observados en el cinturón de Kuiper se encuentran en resonancia de movimientos medios exteriores con Neptuno, hecho que también se refleja en la presente órbita de Plutón. En el presente trabajo se estudia tanto numérica como analíticamente la influencia de la variación de las masas de Urano y Neptuno durante el proceso de migración sobre las probabilidades de captura en algunas de las resonancias exteriores de Neptuno. Se estudia también la influencia de encuentros gravitacionales mutuos sobre la estabilidad de las órbitas resonantes. Este estudio ofrece argumentos de plausibilidad para explicar por qué ninguno de los objetos descubiertos en el cinturón de Kuiper se encontraría en la resonancia 2:1.

  1. Efectos combinados de la ampliación de la atención primaria de salud y de las transferencias condicionadas de dinero en efectivo sobre la mortalidad infantil en Brasil, 1998–2010*

    PubMed Central

    Guanais, Frederico C.

    2015-01-01

    Objetivos. Examiné los efectos combinados del acceso a la atención primaria mediante el Programa de Salud Familiar (PSF) y las transferencias condicionadas de dinero en efectivo del Programa Bolsa Familia (PBF) sobre la mortalidad infantil posneonatal (MIPN) en Brasil. Métodos. Empleé un análisis ecológico longitudinal usando datos en panel de 4 583 municipios brasileños de 1998 al 2010, con 54 253 observaciones en total. Estimé modelos de regresión de efectos fijos por mínimos cuadrados ordinarios, con la tasa de MIPN como la variable dependiente y el PSF, el PBF y sus interacciones como las principales variables independientes de interés. Resultados. La asociación de una mayor cobertura del PSF con una menor tasa de MIPN se volvió más fuerte conforme aumentaba la cobertura del PBF. En los promedios de todas las demás variables, cuando la cobertura de PBF era 25%, la MIPN predicha fue 5,24 (intervalo de confianza [IC] de 95% = 4,95, 5,53) para una cobertura del PSF de 0%, y de 3,54 (IC de 95% = 2,77, 4,31) para una cobertura del PSF de 100%. Cuando la cobertura del PBF era de 60%, la MIPN predicha fue 4,65 (IC de 95% = 4,36, 4,94) para una cobertura del PSF de 0%, y de 1,38 (IC de 95% = 0,88, 1,89) para una cobertura del PSF de 100%. Conclusiones. El efecto del PSF depende de la ampliación del PBF. Para las poblaciones empobrecidas y subatendidas, la combinación de intervenciones tanto del lado de la oferta como del lado de la demanda podría ser necesaria para mejorar los resultados en salud.

  2. Estudio de la estructura logica utilizada en la ensenanza y el aprendizaje de los conceptos sobre el comportamiento de gases en el curso introductorio de quimica a nivel universitario

    NASA Astrophysics Data System (ADS)

    Costa Diaz, Agnes

    El estudio que se presenta es de caracter cualitativo, un estudio multicasos donde se estudia la estructura logica utilizada por cuatro (4) profesores universitarios que ensenan el curso introductorio de quimica, en la planificacion, presentacion y evaluacion del tema sobre el comportamiento de los gases. Se utilizaron varias fuentes de informacion como: cuestionarios de profesores y estudiantes, entrevistas, grabaciones videomagnetofonicas, materiales didacticos y una prueba conceptual, entre otros. La informacion recopilada fue analizada de acuerdo al orden logico del contenido presentado, el estilo de ensenanza del profesor, las tecnicas y estrategias utilizadas para el desarrollo de destrezas de pensamiento, el ambiente fisico en el salon de clase y los instrumentos de evaluacion y avaluo. El estudio demuestra que lo que los profesores piensan y planifican para hacer sus presentaciones no necesariamente es lo que ocurre en el salon de clases. El desarrollo de destrezas de pensamiento, que constituye una prioridad de los profesores, no se elaboran efectivamente. El uso de las estrategias de resolucion de problemas numericos predomino. La participacion del estudiante en el salon de clases fue limitada y no se logro demostrar el desarrollo de las destrezas de pensamiento deseadas. Aunque los profesores tienen su propio estilo de ensenanza, el orden logico del contenido presentado en clase fue el mismo o siguio muy de cerca el orden establecido por el libro de texto. Los profesores utilizaron preferentemente la tiza y la pizarra para sus presentaciones y la dinamica en el salon de clases fue esencialmente tradicional. Los profesores hicieron su presentacion y los estudiantes copiaron pasivamente la informacion. Las evaluaciones de los estudiantes fueron esencialmente, pruebas escritas de seleccion multiple de acuerdo con el estilo en que se les enseno. El avaluo fue casi inexistente. La prueba conceptual administrada revela un aprendizaje pobre en los conceptos mas

  3. High School Students' Previous Knowledge about the Stars. (Spanish Title: Conocimientos Previos de Estudiantes de Secundaria Acerca de Las Estrellas.) O Conhecimento Prévio de Alunos do Ensino Médio sobre as Estrelas

    NASA Astrophysics Data System (ADS)

    Iachel, Gustavo

    2011-12-01

    Based on the readings of articles related to Astronomy Education published in Brazil, it was noticed a lack of research on previous knowledge of students about the physical characteristics of stars, a fact that motivated us to develop this study. Previous knowledge of 125 students (approximated 15 years old) constituted the study sample; data was collected through written questionnaires (Appendix A) for analysis. From the content analysis of these responses it was possible to achieve some inferences as, for example, many students have some difficult to develop an explanatory model on the functioning of a star; there are few who say that the stars have a certain length of existence; some students have said that stars have tips; few recognize that a star is formed by a mass of gas; some previous knowledge come from purely visual aspects; furthermore, some students do not have the habit of observing nature in detail. We see this research as a reference in which science teachers can recognize the importance of previous knowledge for practice teaching and acquire resources for planning their lessons. De la lectura de artículos relacionados con la Educación en Astronomía publicados en el Brasil, se encuentra una falta de investigaciones acerca del conocimiento previo de los estudiantes sobre las características físicas de las estrellas, hecho que nos motivó a desarrollar este estudio. Los datos analizados se obtuvieron al aplicar un cuestionario a 125 estudiantes de secundaria, para posteriormente realizar un análisis de contenido, tal cuestionario se presenta en el Anexo A. Al realizar el análisis de contenido de las respuestas obtenidas, fue posible hacer algunas inferencias, como por ejemplo; muchos estudiantes tienen dificultades para desarrollar un modelo explicativo acerca del funcionamiento de una estrella; pocos estudiantes dicen que las estrellas tienen un cierto tiempo de vida; algunos estudiantes imaginan que las estrellas tienen puntas; pocos

  4. Sexual health after breast cancer: Recommendations from the Spanish Menopause Society, Federación Española de Sociedades de Sexología, Sociedad Española de Médicos de Atención Primaria and Sociedad Española de Oncología Médica.

    PubMed

    Mendoza, Nicolás; Molero, Francisca; Criado, Fermín; Cornellana, Mª Jesús; González, Encarna

    2017-02-20

    Breast cancer is the most common cancer in women. As survival rates are increasing, the long-term health problems of survivors now need attention. Many survivors develop sexual disorders as a consequence of either the side-effects of treatment or induced menopause. A panel of experts from various Spanish scientific societies (Spanish Menopause Society, SMS; Federación Española de Sociedades de Sexología, FESS; Sociedad Española de Médicos de Atención Primaria, SEMERGEN; and Sociedad Española de Oncología Médica) met to develop recommendations for the management of sexual health in breast cancer survivors based on the best evidence available. The main recommendation is that sexuality must be considered by a multidisciplinary team as an integral part of treatment, to improve the quality of life of breast cancer survivors.

  5. El paradigma jerarquico de formacion de estructuras

    NASA Astrophysics Data System (ADS)

    Lambas, D. G.

    This contribution aims at showing our current understanding of the hierarchical clustering scenario for structure formation, its main success in terms of agreement of theoretical predictions and observations, and the most direct tests that provide confidence on the validity of the paradigm. FULL TEXT IN SPANISH

  6. Determining the Shape of the Orbit of Mars in the High School. (Spanish Title: Determinación de la Forma de la Órbita de Marte en la Escuela Secundaria.) Determinando a Forma da Órbita de Marte no Ensino Médio

    NASA Astrophysics Data System (ADS)

    Dutra, Carlos Maximiliano; Rossini Goulart, Andressa

    2014-12-01

    In the present work, in order to supply the lacks of practical activities related to the content of Kepler's Laws in high school physics textbooks, we present a practical activity to determine the shape of the orbit of Mars. In this activity the student can experience the discovery the shape of the orbit of Mars in a way similar to that realized by Johannes Kepler combining the physical concepts with geometry. We applied the activity to eighteen high school teachers participating in a Postgraduate Course in Science Education. After two hours of work the group obtained the shape of the orbit of Mars and estimated its orbital parameters with a relative error less than 14%. En el presente trabajo y con el objetivo de reducir la escasez de actividades prácticas relacionadas con el contenido de las leyes de Kepler en libros de texto de física de la escuela secundaria, se presenta una actividad práctica para determinar la forma de la órbita de Marte. En esta actividad el estudiante puede vivir la experiencia de descubrir la forma de la órbita de Marte de una manera similar a la realizada por Johannes Kepler combinando los conceptos físicos con la geometría. Aplicamos la actividad a dieciocho maestros de escuelas secundarias en un Curso de Especialización en Enseñanza de las Ciencias. Después de dos horas de trabajo el grupo obtuvo la forma de la órbita de Marte com error inferior al 14% en los parámetros orbitales. No presente trabalho, visando suprir a deficiência de atividades práticas relacionadas ao conteúdo de Leis de Kepler nos livros-textos de Física do 1º ano do Ensino Médio, apresentamos uma atividade prática de determinação da órbita de Marte. O aluno, combinando conceitos físicos com a geometria poderá vivenciar a experiência da descoberta da forma da órbita de Marte de modo similar ao realizado por Johannes Kepler. Aplicamos a metodologia proposta junto a dezoito professores do Curso de Especialização em Educação em Ciências e

  7. Strengths of primary healthcare regarding care provided for chronic kidney disease.

    PubMed

    Paula, Elaine Amaral de; Costa, Mônica Barros; Colugnati, Fernando Antonio Basile; Bastos, Rita Maria Rodrigues; Vanelli, Chislene Pereira; Leite, Christiane Chaves Augusto; Caminhas, Márcio Santos; Paula, Rogério Baumgratz de

    2016-09-09

    municipio brasileño. estudio epidemiológico, transversal, realizado en 14 unidades de atención primaria y en un centro de atención secundario, en el período de 2010 a 2013. Se utilizó el referencial metodológico de Donabedian. Para evaluación de estructura y proceso; fueron entrevistados 14 médicos, 13 supervisores y 11 agentes comunitarios de salud de la atención primaria. Para evaluación del resultado, fueron utilizadas 1.534 fichas médicas en la atención primaria y 282 en la atención secundaria. en la mayoría de las unidades faltaban consultorios para la atención médica y de enfermería, los equipos estaban incompletos y la mayoría de los profesionales no participó de capacitaciones sobre la atención a la enfermedad renal crónica. Los médicos de las unidades primarias, clasificados como capacitados, encaminaron usuarios para la atención secundaria en etapas más precoces de la enfermedad renal crónica (etapa 3B) cuando comparados a los médicos de las unidades no capacitadas (58% vs 36%) (p=0,049). Las unidades de atención primaria, clasificadas como capacitadas, presentaron mejores tasas de estabilización de la filtración glomerular (51%) cuando comparadas a las unidades parcialmente capacitadas (36%) y no capacitadas (44%) (p=0,046). los usuarios atendidos en las unidades de atención primaria, con puntuación más elevada en criterios de estructura y proceso, presentaron mejores resultados clínicos.

  8. Solar Physics Topics in High School: Analysis of a Course with Practical Activities at Dietrich Schiel Observatory. (Spanish Title: Temas de Física Solar Para Estudiantes de Escuelas Secundarias: un Análisis de un Curso con Enfoque Práctico en el Observatorio Dietrich Schiel.) Tópicos de Física Solar no Ensino Médio: Análise de um Curso com Atividades Práticas no Observatório Dietrich Schiel

    NASA Astrophysics Data System (ADS)

    Calbo Aroca, Silvia; Donizete Colombo, Pedro, Jr.; Celestino Silva, Cibelle

    2012-12-01

    This work analyses results obtained in a solar physics course for high school students promoted at the Dietrich Schiel Observatory of the University of São Paulo (USP). The course was elaborated by the authors with the intention of investigating student's concepts about the Sun, teaching topics of modern physics related to the Sun and providing students with knowledge about our star as well. The methodology of data gathering consisted of audio and video records of classes and of semi-structured interviews, and analysis of answers to written questionnaires. The results showed that most high school students conceived the Sun as made of fire, while sunspots were thought to be holes in the Sun. Even though some students did know that a spectrum is formed using a prism or diffraction grating, most of them ignored the nature of the observed spectral lines. Through the course, this topic was developed by means of a practical approach with solar and lamp spectra observations. The results obtained in the course point to the importance of science centers as partners in formal education. In this specific case, the Solar Room at the Dietrich Schiel Observatory is as a favorable environment for teaching modern physics in high school. Este artículo analiza los resultados obtenidos en un curso sobre la física solar, auspiciado por el Observatorio Dietrich Schiel de la USP para estudiantes de las escuelas secundarias. El curso fue diseñado por los autores con la intención de investigar las concepciones sobre el sol, enseñar temas relacionados con la física moderna del Sol y conocimientos generales sobre el astro rey. La metodología utilizada para la recolección de datos consistió en grabar, en audio y video, las clases, las entrevistas semi-estructuradas y las respuestas a los cuestionarios escritos. Los resultados mostraron que la mayoría de los participantes conciben el Sol como constituido por fuego y las manchas solares en la superficie solar como agujeros. Aunque

  9. Ruprecht 44 y la estructura espiral externa de la Galaxia

    NASA Astrophysics Data System (ADS)

    Giorgi, E. E.; Solivella, G. R.; Vázquez, R. A.; De Laurenti, M. A.

    We present first results of a photometric study UBVI CCD; complemented with MK spectral classification and 2MASS data; focusing on the region of the open cluster Ruprecht 44. This cluster is in an area of very low interstellar absorption; through which it is possible examine in the optical range the spiral structure outside the solar circle. Precise distances determination of blue stars in the field of this cluster enable analyze; with other data recently obtained; the structure of great design in the third galactic quadrant. FULL TEXT IN SPANISH

  10. Estructuras circumnucleares en la galaxia Seyfert interactuante NGC 1241

    NASA Astrophysics Data System (ADS)

    Díaz, R. J.; Carranza, G.; Dottori, H.

    We have studied the rotation curve and morphology of the central 10 kiloparsecs (~40'') of NGC 1241 obtaining 50 radial velocity measurements in three different position angles. These observations indicate a large velocity gradient of 70 km/sec/('') in the central 5''. The fitting of different density distribution laws to the derived rotation curve indicates a mass of ~ 9 E9 Msolar in the inner kpc. HST-NICMOS images show the presence of a circumnuclear star formation ring at radius ~ 2.8'' (720 pc). This ring is more defined than most of the known cases and harbours a mini-bar and nuclear spiral arms with a sense of rotation opposite than the main spiral arms. This morphological evidence suggest the presence of a dynamically decoupled system inside the circumnuclear ring. As in other cases studied by us, the ring seems to be inside an Inner Lindblad Resonance and the Lindblad curve ω-κ/2 for this object begins to drop for Rmax = 400 pc (~1.5''), but the limited spatial resolution does not allow us to find out a definitive evidence for the existence of a second ILR inside at inner radii. Up to date there is no published morphological or kinematical evidence for the presence of a second ILR at such small radii, a necessary ingredient for the presence of circumnuclear ring of star formation, considering the results of recent hydrodynamic simulations. We have proposed the observation of NGC 1241 with better instruments in order to extend the rotation curve to the central 2'', unveil the presence of a second inner resonance, study in detail the structural properties of the nuclear counterrotating arms and establish accurate models of mass distribution in galaxies with circumnuclear rings. This program has been awarded with Band 1 observing time at the Gemini North Telescope Quick Start Stage (Brasil and Argentina).

  11. Las Estructuras centrales de la galaxia Seyfert NGC 7582

    NASA Astrophysics Data System (ADS)

    Celiz, D.; Gaspar, G.; Díaz, R.; D'Ambra, A.

    2017-10-01

    We present the first stage of the study of the Seyfert Galaxy NGC 7582 through high spatial resolution NIR images obtained with the instrument Flamingos-2 of Gemini South. NGC 7582 harbours a Seyfert 2 nucleus that in 1998 experienced an unusual change in its optical emission line spectrum, remaining as a Seyfert 1 nucleus for some months. Moreover, variations in its X-ray spectrum have been interpreted as evidence of the clumpy nature of the circumnuclear absorbing material, conceived as a torus in the Unified Model. These peculiarities plus the high inclination of the galaxy make it a suitable candidate for deep infrared observations. In this work we present high resolution images of the galaxy, from which we caracterized the most central regions, specially the circumnuclear ring and a "box-type" structure, little studied to date. We performed aperture photometry of the nucleus for different radii. We find that the measured magnitudes are consistent with those reported in the literature for previous epochs, indicating that the nucleus has not suffered dramatic variations during this observation epoch.

  12. [Pathogenesis of spinal cord injuries and mechanisms of repair induced by olfactory ensheathing cells].

    PubMed

    Botero, Lucía; Gomez, Rosa Margarita; Chaparro, Orlando

    2013-05-16

    Introduccion. La lesion medular es un evento catastrofico, cuyas consecuencias persisten durante toda la vida del paciente. La investigacion en tratamiento se ha basado principalmente en el desarrollo de terapias que reduzcan la discapacidad, pero desde los anos noventa hay un avance significativo y se han probado varios trasplantes celulares en modelos animales de lesion medular, celulas de Schwann, astrocitos y celulas de la glia envolvente olfatoria (CGEO). Objetivo. Hacer un recuento detallado de la patogenia de la lesion medular primaria y secundaria y de los mecanismos por los cuales las CGEO inducirian sus posibles efectos regenerativos descritos en la bibliografia. Desarrollo. Despues del traumatismo, la lesion se desarrolla en dos fases, la primaria se caracteriza por las lesiones de compresion y la secundaria se produce por una serie de factores que se dan en paralelo y que incluyen factores vasculares, celulares, moleculares y formacion de cicatriz glial. La mayoria de los modelos de lesion medular y trasplante con CGEO han comunicado recuperacion funcional, remielinizacion y regeneracion axonal. Estas celulas ejercen su accion de manera indirecta a traves de la produccion de factores de crecimiento y de manera directa induciendo regeneracion neuronal, axonal y remielinizacion. Conclusiones. Las CGEO son una opcion terapeutica en pacientes con lesion medular debido a que inducen de modo directo o indirecto regeneracion neuronal, axonal, remielinizacion de axones, disminucion de cicatriz glial y otros efectos que conducen a la recuperacion funcional.

  13. Implementation of an e-Interconsultation system between a Hospital Pharmacy Service and Primary Care Pharmacy Units in a health area.

    PubMed

    García-Queiruga, Marta; Margusino-Framiñán, Luis; Martín-Herranz, Isabel; Gutiérrez-Estoa, Miguel; Güeto-Rial, Xosé; Capitán-Guarnizo, Judith; Silva-Tojo, Alfredo

    2017-03-01

    Objetivo: Presentar los requisitos, desarrollo, estructura y resultados de una plataforma de e-Interconsulta de comunicación entre farmacéuticos de atención primaria y hospitalaria. Método: Se creó un grupo de trabajo y se definieron los objetivos, el cronograma de trabajo, los requisitos del programa informático, la estructura de la plataforma electrónica, la validación de la misma y la implantación. Tras su desarrollo informático y su validación, se realizaron sesiones formativas y se puso en marcha en junio de 2015.Resultados: Tras un año de funcionamiento, el número total de e-interconsultas realizadas fue de 321, de las cuales 110 fueron derivaciones de atención hospitalaria hacia atención primaria y 211 en el sentido inverso. La homologación sanitaria de recetas y la necesidad de seguimiento farmacoterapéutico en atención primaria, destacan entre las causas motivadas de consulta.Conclusiones: La plataforma e-Interconsulta, es un sistema válido, eficaz y de sencillo manejo para la derivación de consultas o pacientes entre ambos niveles asistenciales.

  14. [Not Available].

    PubMed

    Díaz, Toni; Ficapal-Cusí, Pilar; Aguilar-Martínez, Alicia

    2016-07-19

    Introducción: a pesar de la relevancia nutricional del desayuno para el desarrollo y su asociación a un mejor aprendizaje y rendimiento escolar, numerosos estudios ponen en evidencia que en muchos casos se omite o se hace mal.Objetivo: determinar la calidad del desayuno de estudiantes de entre 10 y 16 años con intención de determinar en qué momento sería conveniente realizar programas educativos sobre la importancia de esta comida y cómo mejorar su calidad.Método: estudio observacional, descriptivo y transversal a partir de un cuestionario con preguntas cerradas acerca de los hábitos de alimentación en el desayuno en estudiantes de educación primaria y secundaria.Resultados y conclusión: solo el 18,5% de los estudiantes realiza un desayuno de buena calidad y su mala calidad va aumentando progresivamente con los cursos y se asocia al hecho de desayunar solo. En ambos niveles educativos los alimentos más consumidos en casa pertenecen al grupo de los lácteos y los cereales, mientras que en el centro escolar, el bocadillo resulta el desayuno más habitual; no obstante se observan diferencias entre primaria y secundaria en cuanto al consumo de fruta y bebidas azucaradas, entre otros.Conclusión: sería interesante valorar la instauración de programas de desayuno escolar incluyendo en ellos no solo a estudiantes de primaria, sino también, y especialmente, a adolescentes pues son estos quienes omiten esta comida en mayor proporción. Las intervenciones deberían orientarse a corregir las desviaciones más habituales observadas en cada uno de los niveles educativos.

  15. La Celebracion de Navaidad. Para la Secundaria. (The Celebration of Christmas, Secondary Level.)

    ERIC Educational Resources Information Center

    Herrera, Gloria; Lizcano, Jeanette

    The celebration of Navidad (Christmas) by various cultures is the topic of this secondary level unit. Unit objectives are that the student will be able to differentiate between his culture's Christmas customs and those of the dominant culture, and be able to relate their origin. The customs of Mexico, Panama, and south Texas are discussed. Also…

  16. La Celebracion de Navaidad. Para la Secundaria. (The Celebration of Christmas, Secondary Level.)

    ERIC Educational Resources Information Center

    Herrera, Gloria; Lizcano, Jeanette

    The celebration of Navidad (Christmas) by various cultures is the topic of this secondary level unit. Unit objectives are that the student will be able to differentiate between his culture's Christmas customs and those of the dominant culture, and be able to relate their origin. The customs of Mexico, Panama, and south Texas are discussed. Also…

  17. Motivacion y estudiantes de secundaria (Motivation and Middle School Students). ERIC Digest.

    ERIC Educational Resources Information Center

    Anderman, Lynley Hicks; Midgley, Carol

    Research has shown a decline in motivation and performance for many children as they move from elementary school into middle school; however, research has also shown that the nature of motivational change on entry to middle school depends on characteristics of the learning environment in which students find themselves. This Digest outlines some…

  18. Modelo Pedagogico de Educacion Primaria para Adultos: Guia General de Apoyo para el Estudiante de Primaria (Pedagogical Model for Adult Primary Education: General Guide for the Student).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This book, part of a Mexican series of instructional materials, is directed toward people over the age of 15 who are interested in beginning, continuing or finishing their basic education. It explains the pedagogical model developed for adult education in Mexico based on the following features: (1) the content of the textbooks must be useful for…

  19. Las ayudas educativas en la educacion primaria (Teaching Aids in Elementary Education).

    ERIC Educational Resources Information Center

    Ministerio de Educacion Nacional, Bogota (Colombia). Centro Nacional de Documentacion e Informacion Pedagogica.

    The Colombian Institute of Pedagogy (ICOLPE) has undertaken a study of the availability and use of teaching aids and instructional materials in that country on the primary level. This report contains the results of that study. The document provides a listing of companies producing teaching aids. Questionnaires (included) were sent to educational…

  20. Estructura de las burbujas en la region sureste de la Nube Mayor de Magallanes

    NASA Astrophysics Data System (ADS)

    Oddone, M. A.; Ambrocio-Cruz, S. P.; LeCoarer, E.; Goldes, G. V.

    In this work we present preliminary results obtained from the analysis carried out on the medium-size bubble structures located in the southeast region of the Large Magellanic Cloud (LMC). We determine the characteristic parameters of these structures (surface brightness; electronic density; emission measure; mass; luminosity; ambient density; age; energy; among others). This will allow us to discriminate which is the origin (stellar wind; supernova explosion; or other mechanisms) of the different bubbles that form the LMC9 supershell. Thus; we will try to determine whether the analyzed objects have kinematically some identity as a group; or they are relatively isolated objects on the diffuse background they belong to. FULL TEXT IN SPANISH

  1. Vinculación entre varios cúmulos estelares y estructuras del medio interestelar

    NASA Astrophysics Data System (ADS)

    Corti, M. A.; Baume, G. L.; Panei, J. A.; Suad, L. A.; Testori, J. C.; Borissova, J.; Kurtev, R.; Chené, A. N.; Ramirez Alegría, S.

    2015-08-01

    We study the embedded clusters DBS77, 78, 102, 160, and 161 located in the Galactic plane in the fourth quadrant of the Milky Way and the surrounding interstellar medium (ISM). We analyzed UBVIc photometry (SOAR) and infrared spectroscopy (NTT, ESO). We complemented these data with JHK (VVV2MASS), HI 21 cm bands (SGPS), 1.4 GHz (ATCA), and 4.85 GHz (PMN). We did multiband analysis and spectral classification of the brightest stars in each area. We also identified the ISM structures possibly related to the clusters. Finally, we obtained the main parameters of the studied clusters, the structures of the ISM and the link between them.

  2. Estructura de disco en galaxias ``elípticas'' enanas: evidencias fotométricas

    NASA Astrophysics Data System (ADS)

    Cellone, S. A.; Buzzoni, A.

    We present evidences for the presence of disk structure in faint galaxies (MB ≤ -15) in the NGC 5044 Group, which were originally classified as dwarf ellipticals (dE). These evidences, obtained from multicolour surface photometry, are: External isophotes with a ``warped disk'' morphology. Surface brightness profiles with a two component (bulge + disk) structure. Situation of the galaxies in a surface-brightness vs. magnitude plot. Situation of the galaxies in a colour - magnitude plot. These indicators are not simultaneously present in every object, hence it is probable that dwarf ``elliptical'' galaxies with disk structure are an heterogeneous set. In some of these objects, the presence of a disk component is evident both from their morphology and from their stellar populations. ``Disky'' dEs seem to show a more extended projected spatial distribution on the Group field than the rest of the dEs.

  3. Estructura orbital en el Problema Restringido Rectilíneo Isósceles

    NASA Astrophysics Data System (ADS)

    Orellana, R. B.

    Para definir problemas en Mecánica Celeste se utilizan diferentes parámetros. El conocimiento de la dinámica del problema para valores particulares de estos parámetros nos permite entender el comportamiento en casos más generales. El Problema Restringido Rectilíneo Isósceles puede ser considerado como el caso límite del Problema de Sitnikov cuando la excentricidad tiende a uno o como el Problema Isósceles cuando la masa central tiende a cero. Se ha compactificado el espacio de fases y analizado la dinámica en el límite. Esto ha permitido separar el espacio de fases en diferentes regiones dependiendo de las clases de órbitas.

  4. Nuestro Trabajo: Primaria para Adultos. Segunda Parte. Edicion Experimental (Our Work: Primer for Adults. Part Two. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This workbook is part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. This workbook is designed to orient people who are only recently literate to the world of work and business. Topics covered include worker…

  5. El lenador, el nino, y el burro. Serie Primaria. (The Woodcutter, the Little Boy, and the Donkey. Primary Series.)

    ERIC Educational Resources Information Center

    Marquez, Jerry

    The illustrated book tells the story of a woodcutter, his son, and their donkey. Written in Spanish, the story tells how one day after cutting and selling the wood, the woodcutter, who was very tired, decided to ride the donkey back home. On the way, they met some young girls who thought the woodcutter was very mean for making his son walk while…

  6. Nuestra Comunidad: Primaria para Adultos. Segunda Parte. Edicion Experimental (Our Community: Primer for Adults. Part Two. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This textbook is part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. It is designed to teach people with developing literacy skills to participate in a meaningful way in the life of their community. Topics…

  7. La Formacion Docente y la Educacion Primaria en Una Propuesta de Cambio (Teacher Training on Education: A Proposal for Change).

    ERIC Educational Resources Information Center

    Fernandez, Enrique Alonso, Ed.

    In order to raise the quality of teaching and teacher education in Uruguay, a program of innovation and change was considered at a 1986 educational conference. Conference goals included identifying ways to: (1) increase opportunities to promote innovation and change; (2) search for strategies to encourage creative problem solving; (3) increase…

  8. Nuestra Familia: Primaria para Adultos. Segunda Parte. Edicion Experimental (Our Family: Primer for Adults. Part Two. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This textbook is part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. It is designed to orient people with little education or developing literacy skills to a sense of responsibility toward their families.…

  9. El lenador, el nino, y el burro. Serie Primaria. (The Woodcutter, the Little Boy, and the Donkey. Primary Series.)

    ERIC Educational Resources Information Center

    Marquez, Jerry

    The illustrated book tells the story of a woodcutter, his son, and their donkey. Written in Spanish, the story tells how one day after cutting and selling the wood, the woodcutter, who was very tired, decided to ride the donkey back home. On the way, they met some young girls who thought the woodcutter was very mean for making his son walk while…

  10. La Formacion Docente y la Educacion Primaria en Una Propuesta de Cambio (Teacher Training on Education: A Proposal for Change).

    ERIC Educational Resources Information Center

    Fernandez, Enrique Alonso, Ed.

    In order to raise the quality of teaching and teacher education in Uruguay, a program of innovation and change was considered at a 1986 educational conference. Conference goals included identifying ways to: (1) increase opportunities to promote innovation and change; (2) search for strategies to encourage creative problem solving; (3) increase…

  11. Effects of dietary supplementation with lemon verbena extracts on serum inflammatory markers of multiple sclerosis patients.

    PubMed

    Mauriz, Elba; Vallejo, Daniela; Tuñón, María Jesús; Rodriguez-López, Jesús María; Rodríguez-Pérez, Roberto; Sanz-Gómez, Javier; García-Fernández, María del Camino

    2014-11-04

    Introducción: La inflamación es uno de los principales factores que contribuyen en la etiopatogénesis de la esclerosis múltiple (EM). Se ha demostrado que las intervenciones en la dieta con extractos de Lipia citriadora (hierbaluisa) son efectivas en la prevención de las enfermedades inflamatorias. Objectivos: El objetivo de este estudio es evaluar el efecto de la suplementación con extractos de hierbaluisa en los biomarcadores de inflamación en suero de pacientes con diferentes subtipos clínicos de esclerosis múltiple. Métodos: El efecto de la suplementación con hierbaluisa (10 % p/p verbascósido) se evaluó mediante un estudio aleatorizado de doble ciego controlado con grupo placebo, constituido por 30 participantes clasificados según la forma de presentación de EM en: remitentes-recaídas (n=10), primaria progresiva (n=5) y secundaria progresiva (n=15). Los niveles de citoquinas y proteína C reactiva en suero se valoraron en los grupos intervención y control de cada uno de los subtipos clínicos de EM después de 28 días de suplementación en la dieta. Resultados: Se estudiaron los niveles en suero de proteína C reactiva y de 8 citoquinas como biomarcadores de inflamación (IFN-, IL-12, IL-23, IL-6, TNF-, TGF-, IL-4 e IL-10). Los pacientes del grupo de intervención con EM secundaria progresiva presentaron concentraciones de proteína C reactiva significativamente más bajos comparados con el grupo placebo (p.

  12. [Prevalence of asthma and its symptoms in schoolchildren from Cuernavaca, Morelos, Mexico].

    PubMed

    Mancilla-Hernández, Eleazar; González-Solórzano, Evaristo Víctor Manuel; Medina-Ávalos, Miguel Ángel; Barnica-Alvarado, Raúl Humberto

    2016-01-01

    Antecedentes: El asma es una enfermedad crónica que se ha incrementado en las 2 últimas décadas. Objetivo: Determinar la prevalencia de asma y sus síntomas en la ciudad de Cuernavaca, Morelos, México. Métodos: Estudio descriptivo de prevalencia en escuelas oficiales de la ciudad de Cuernavaca, Morelos, de nivel preescolar, primaria y secundaria, mediante el “Cuestionario diagnóstico de asma para estudios epidemiológicos”. Resultados: Se obtuvieron 7947 encuestas en escolares de 3 a 15 años, encontrándose una prevalencia de asma de 11.9%, 49% en niños y 51 % en niñas. En cuanto a los síntomas de asma, la mayor prevalencia la obtuvo la tos que aumenta con el frío (63%), sin embargo, en los pacientes con asma este síntoma solo se presentó en 17%; la opresión torácica tuvo la prevalencia más baja entre los síntomas (10%), sin embargo, en pacientes con asma fue de 49%. Conclusiones: Con el cuestionario diagnóstico de asma para estudios epidemiológicos se encontró una prevalencia promedio de asma de 11.9% en preescolares, escolares y alumnos de secundaria, discretamente inferior a la diagnosticada en otras ciudades del centro de México. La prevalencia de los síntomas de asma resultó más elevada que la del diagnóstico de asma.

  13. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    PubMed Central

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  14. [Prevalence of rhinitis allergic in populations of several states of Mexico].

    PubMed

    Mancilla-Hernández, Eleazar; Medina-Ávalos, Miguel Alejandro; Barnica-Alvarado, Raúl Humberto; Soto-Candia, Diego; Guerrero-Venegas, Rosario; Zecua-Nájera, Yahvéh

    2015-01-01

    Antecedentes: la rinitis alérgica es una enfermedad inflamatoria de la mucosa nasal, caracterizada por síntomas de prurito, rinorrea, congestión nasal y estornudos, inducidos por una respuesta mediada por IgE. En México tenemos reportes de prevalencia de rinitis alérgica con variaciones de 5 a 48% cuando se pregunta si hubo síntomas de rinitis los últimos 12 meses. Objetivo: determinar la prevalencia de rinitis alérgica en población escolar de varios estados de México. Material y método: estudio descriptivo de prevalencia en el que se aplicó un cuestionario a población preescolar, primaria, secundaria y preparatoria. Se realizó en cuatro ciudades de cuatro estados: Puebla, Puebla, Tulancingo, Hidalgo, Tlaxcala, Tlaxcala y Cancún, Quintana Roo. Los padres contestaron los cuestionarios de preescolar y primaria y los alumnos de secundaria y preparatoria contestaron sus cuestionarios. El estudio se realizó de junio de 2014 a enero de 2015. El instrumento utilizado fue el Cuestionario diagnóstico de rinitis alérgica para estudios epidemiológicos. Resultados: de las encuestas aplicadas se obtuvieron 8,159 cuestionarios contestados; en la ciudad de Puebla: 2,267; Tulancingo, Hidalgo: 2,478; Tlaxcala, Tlaxcala: 2,574; Cancún, Quintana Roo: 840; 4,190 (51%) correspondieron al sexo masculino. El porcentaje promedio general de prevalencia de rinitis alérgica entre los cuatro estados, incluidas todas las edades, fue de 15%. Conclusiones: con la aplicación del cuestionario diagnóstico de rinitis alérgica para estudios epidemiológicos en las cuatro ciudades de cuatro estados diferentes encontramos una prevalencia de rinitis alérgica de 15% en mayores de 13 años y de 13% en niños de 12 años o menos.

  15. Composición de especies y estructura del bosque kárstico de San Patricio, Guaynabo, Puerto Rico

    Treesearch

    A. Suárez; I. Vicéns; A.E. Lugo

    2005-01-01

    Five permanent plots were established along an elevational gradient in the San Patricio urban forest. At the time of the study (August, 2004) we found 29 forest species in a 0.19 ha area. Of these, seven were introduced and dominated the mogote valley where there had previously been a military base. The slopes and top of the mogote were dominated by native species,...

  16. Propiedades estadísticas de galaxias en las futuras estructuras más grandes del universo

    NASA Astrophysics Data System (ADS)

    Lares, M.; Yaryura, Y.; García Lambas, D.

    Superclusters of galaxies are the largest isolated structures in the universe. We study statistical properties of clustering of galaxies within superclus- ters, using a catalogue calibrated to identify future bound superstructures. We use a volume limited sample (z < 0.1) of spectroscopic galaxies from SDSS-DR7 to select luminous galaxies as centers, and fainter galaxies as tracers, to compute the cross­correlation function of galaxies. We find that this function depends on the chosen centers: luminous galaxies in super- clusters show a higher cross­correlation with tracers. We define subsamples to obtain an unbiased estimation of the clustering, independent of luminos- ity and mass. The influence of large scale environment is seen for galaxies in SCG only for distances greater than ~ 1Mpc. FULL TEXT IN SPANISH

  17. "Tras de un Amoroso Lance" como Estructura Expresiva (The Poem, "Behind the Amorous Cast" as an Expressive Structure).

    ERIC Educational Resources Information Center

    Bratosevich, Nicolas

    1967-01-01

    An analysis of a poem by San Juan de la Cruz (St. John of the Cross), the sixteenth century Spanish mystic, identifies symbols and images, explains themes, and offers a synthesis of his structural patterns. The poem, "Tras de amoroso lance", deals with the theme of the search of the beloved (i.e., the soul) for the lover, and…

  18. Composición y estructura de un bosque tropical urbano en el karso norteno de Puerto Rico

    Treesearch

    E. López Machado; K. Soto Hidalgo; T. Heartsill-Scalley

    2012-01-01

    Tropical secondary forests provide many products, environmental services, and recreation. These forests have a set of biological features, such as their high productivity and a uniform composition of dominant tree species. To understand the composition and structure of a secondary forest in the northern karst zone, we selected the Santa Ana Environmental Center (CASA...

  19. El origen de las galaxias en modelos jerárquicos de formación de la estructura

    NASA Astrophysics Data System (ADS)

    Navarro, J. F.

    En esta charla presentaré una revisión de los modelos corrientes de formación de galaxias. En particular, haré énfasis en el origen de la gran variedad de morfologías galácticas y de las correlaciones entre las propiedades estructurales de discos y esferoides, todo dentro del contexto cosmológico jerárquico provisto por teorías como la de materia oscura fría. En este tipo de teorías las correlaciones observadas entre la luminosidad, velocidad de rotación, momento angular, y tamaño de galaxias son el resultado de la falta de escalas naturales en el proceso de formación de los halos de materia oscura que dichas galaxias habitan. Simulaciones numéricas que incorporan efectos gravitacionales, hidrodinámicos y de formación estelar ilustran estas ideas y demuestran las dificultades que aquejan a modelos donde tanto discos como esferoides son el resultado final de una secuencia de fusiones de sistemas protogalácticos.

  20. Estructura física del Glóbulo 2 del Saco de Carbón

    NASA Astrophysics Data System (ADS)

    Racca, G.; Gómez, M.; Kenyon, S.

    We apply H-band (1.65 μm) star counts to derive the density profile of the Coalsack Globule 2 and use a polytropic model to describe the internal structure of this small cloud. For a gas temperature T ˜ 15 K, this globule is moderately unstable.

  1. [Validity and factorial invariance of the social ecological model in explaining fruit intake in Mexican schoolchildren].

    PubMed

    Ochoa-Meza, Gerardo; Sierra, Juan Carlos; Pérez-Rodrigo, Carmen; Aranceta Bartrina, Javier; Esparza-Del Villar, Óscar A

    2014-11-24

    Objetivo: Estimar la bondad de ajuste del modelo Motivación- Habilidad-Oportunidad (MHO), a fin de evaluar la varianza observada en las preferencias para comer fruta y el consumo actual de fruta en niños escolares mexicanos; así como la invarianza factorial a través del género y tipo de población (urbana y semi-urbana) en la que residen los niños. Métodos: Se diseñó un modelo con siete constructos de un cuestionario validado que mide preferencias, habilidades cognitivas, actitudes, modelamiento, percepción de barreras, accesibilidad en la casa, accesibilidad en la escuela y la frecuencia de consumo de fruta. El cuestionario se aplicó en una muestra representativa de 1434 niños escolares de 10 a 12 años, de quinto y sexto grado de educación primaria, en un estudio transversal y ex post facto realizado en 2013 en seis ciudades del Estado de Chihuahua, México. Resultados: El modelo MHO mostró índices de ajuste adecuados y explicó el 39% de la varianza en las preferencias para comer fruta. La estructura del modelo muestra muy buena estabilidad en la estructura factorial y las dimensiones de la escala fueron equivalentes en las muestras analizadas. Conclusión: La modelización mediante ecuaciones estructurales muestra un modelo parsimonioso que, puede ser utilizado para explicar las variaciones en el consumo de fruta en niños escolares mexicanos de 10 a 12 años. La estructura del modelo fue estrictamente invariante y muestra evidencias de validación cruzada. Finalmente, se discuten las modificaciones requeridas para obtener un mejor ajuste de los datos en contextos escolares y las directrices a seguir en futras investigaciones.

  2. Milk and dairy products intake in child-juvenile population in Navarre, Spain.

    PubMed

    Durá-Travé, Teodoro; Gallinas-Victoriano, Fidel

    2014-10-01

    Objetivo: Realizar un estudio descriptivo del consumo de leche y derivados lácteos en una población de escolares y adolescentes y analizar su contribución nutricional en la dieta de estos jóvenes. Material y Métodos: Registro de consumo de alimentos de tres días lectivos consecutivos en una muestra de 353 alumnos que cursaban Educación Primaria, entre 9 y 12 años de edad; y a 406 alumnos que cursaban Educación Secundaria Obligatoria, entre 13 y 16 años, en la ciudad de Pamplona (Navarra, España). Resultados: El 94% de los encuestados referían haber tomado lácteos en el desayuno y, en menor proporción, en la cena (69,3%), comida del mediodía (42,1%), merienda (23,3%) y almuerzo (16,4%). No existían diferencias estadísticamente significativas entre los grupos de edad. El valor medio del número de raciones de lácteos consumidas por la totalidad de los encuestados era de 2 diarias, siendo significativamente superior (p.

  3. [Autism: the importance of dysmorphology in the identification of associated medical conditions].

    PubMed

    Ruggieri, V L; Arberas, C L

    2017-02-24

    Introduccion. Los trastornos del espectro autista (TEA) se caracterizan por deficits en la comunicacion e interaccion social asociados a intereses restringidos y conductas estereotipadas. Considerados trastornos del neurodesarrollo, presentan una base neurobiologica reconocida. Las causas geneticas, las anomalias cromosomicas o los defectos genicos son las etiologias mas frecuentemente reconocidas, seguidas por factores toxicos y ambientales (epigeneticos). Desarrollo. Las dismorfias son alteraciones congenitas de la forma de una parte de un ser vivo, producidas durante su desarrollo, y su reconocimiento es esencial en la delineacion de un sindrome o una entidad especifica. En el caso de los TEA permiten diferenciar las formas primarias o idiopaticas de las secundarias o sindromicas. En este trabajo describimos los aspectos dismorfologicos vinculados a los TEA que permitiran definir una presuncion diagnostica y orientar los estudios complementarios de acuerdo con ellos. Conclusiones. La identificacion de estas entidades medicas especificas, asociadas a los TEA, es fundamental, ya que permite inferir la posible evolucion, prevenir eventuales complicaciones y otorgar un asesoramiento genetico adecuado.

  4. Violencia de Pareja en Mujeres Hispanas: Implicaciones para la Investigación y la Práctica

    PubMed Central

    Gonzalez-Guarda, Rosa Maria; Becerra, Maria Mercedes

    2012-01-01

    Las investigaciones sobre la violencia entre parejas sugieren que las mujeres hispanas están siendo afectadas desproporcionadamente por la ocurrencia y consecuencias de este problema de salud pública. El objetivo del presente artículo es dar a conocer el estado del arte en relación a la epidemiologia, consecuencias y factores de riesgo para VP entre mujeres Hispanas, discutiendo las implicaciones para la investigación y la práctica. Investigaciones han demostrado una fuerte asociación del status socioeconómico, abuso de droga y el alcohol, la salud mental, aculturación, inmigración, comportamientos sexuales riesgosos e historia de abuso con la violencia entre parejas. Sin embargo, más estudios se deben llevar a cabo para identificar otros factores de riesgos y de protección a poblaciones hispanas no clínicas. Mientras que el conocimiento sobre la etiología de la VP entre mujeres Hispanas se expanda, enfermeras y otros profesionales de la salud deben desarrollar, implementar y evaluar estrategias culturalmente adecuadas para la prevención primaria y secundaria de la violencia entre pareja. PMID:26166938

  5. All Seem to Need Immediate Attention--What Should I Do First? A Successful Principal in a New School Assignment at Secundaria Revolucion

    ERIC Educational Resources Information Center

    Torres-Arcadia, Celina; Flores-Kastanis, Eduardo

    2012-01-01

    This case provides emerging school administrators the opportunity to learn about the school system in Mexico. The case relates to a successful principal in her new school assignment. Martha Miramontes is an experienced and successful principal who quickly identified a number of challenges in her new campus. Even though each problem can be solved…

  6. "Educación Bilingüe a Nivel De Escuela Secundaria": Dual-Language Education at the High School Level

    ERIC Educational Resources Information Center

    Vazquez, Dania

    2013-01-01

    The Summer 2013 issue of "Voices in Urban Education" presents an interview with Dania Vazquez, founding principal of the Margarita Muñiz Academy, a Boston public high school offering dual-language education in Spanish and English. The first dual-language high school in Massachusetts, this Innovation School opened in the fall of 2012 with…

  7. Preparing the High School Classroom for Migrant English Language Learners (Preparación del aula de secundaria para estudiantes migrantes que aprenden inglés)

    ERIC Educational Resources Information Center

    Rouse, Megan Elizabeth

    2014-01-01

    In United States schools, the rate of immigrant English language learners is rapidly rising, affecting the lives of both students and teachers. This article will discuss the best ways to facilitate the students' language learning in a school setting; the type of structure, goals, and standards that can be expected; as well as ways to change the…

  8. Presentaciones poco comunes y peligros de la sífilis secundaria: periosteitis, tenosinovitis y anomalías hepáticas.

    PubMed

    Rosa-Gonçalves, Diana; Bernardes, Miguel; Costa, Lúcia

    2017-06-02

    We herein describe two cases of secondary syphilis in patients with human immunodeficiency virus (HIV) infection with an unusual presentation, a diffuse polyostotic periosteitis. Patients referred mainly intense bone pain. Other relevant aspects of the clinical pictures were flexor tenosynovitis and hepatic abnormalities. Given the persistence of symptoms, the treatment duration performed was different from most described in literature. However, although more slowly than expected, both obtained a favorable clinical response after treatment with benzathine penicillin G. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  9. Steppin' On Up: A Post-Secondary Guide for Migrant Students = Tomando Accion: Una Guia para los Estudiantes Migrantes Sobre Que Hacer Despues de la Escuela Secundaria.

    ERIC Educational Resources Information Center

    Western Stream Migrant Education Program Coordination Center, Portland, OR.

    This bilingual guide (English and Spanish) provides information for migrant students on postsecondary education. The guide includes information on: (1) career planning, involving self-exploration, occupational exploration, and strategies for reaching career objectives; (2) planning for postsecondary education during high school, including a…

  10. What's in a Word? Elementary Students Learn a Lesson in the Language of Respect. Los Estudiantes de Primaria Aprenden una Leccion en el Lenguaje del Respeto.

    ERIC Educational Resources Information Center

    Maddalozzo, Rebecca

    2001-01-01

    Describes how one elementary teacher helped students in her class and in the entire school see through ethnic biases and feel proud of being bilingual or having bilingual friends. Her efforts taught the children that bilingual students are very much like their non-bilingual classmates in being unique people with talents that should be respected.…

  11. Insegnamento della lingua seconda (italiano) nella scuola primaria: l'esperienza altoatesina (Teaching Italian as a Second Language in Elementary School: The Upper Adige Experience).

    ERIC Educational Resources Information Center

    Bertocchi, Daniela

    1979-01-01

    Provides an evaluation of a 30-year experience in teaching Italian to German-speaking elementary school children in an upper northeast region of Italy. Analyzes degrees of bilingualism and sociocultural contact, emphasizing the need for culturally oriented, carefully structured materials and instruction by specially trained teachers. (MES)

  12. El recreo en la escuela primaria: Que indica la investigacion? (Recess in Elementary School: What Does the Research Say?) ERIC Digest.

    ERIC Educational Resources Information Center

    Jarrett, Olga S.

    Compared to the rest of the school day, recess is a time when children have more freedom to choose what they want to do and with whom. In light of the current climate of school accountability, this Spanish-language Digest discusses research on recess and its relationship to learning, social development, and child health, as well as research on…

  13. Insegnamento della lingua seconda (italiano) nella scuola primaria: l'esperienza altoatesina (Teaching Italian as a Second Language in Elementary School: The Upper Adige Experience).

    ERIC Educational Resources Information Center

    Bertocchi, Daniela

    1979-01-01

    Provides an evaluation of a 30-year experience in teaching Italian to German-speaking elementary school children in an upper northeast region of Italy. Analyzes degrees of bilingualism and sociocultural contact, emphasizing the need for culturally oriented, carefully structured materials and instruction by specially trained teachers. (MES)

  14. Curriculum Guide for Spanish Language Arts, Primary Level B = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel B.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section on preparing instructional material for this group and a section defining the areas to be emphasized in the program: word attack, comprehension skills, study…

  15. Curriculum Guide for Spanish Language Arts, Primary Level A = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel A.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section on preparing instructional material for this group and a section defining the areas to be emphasized in the program: word attack, comprehension skills, study…

  16. Curriculum Guide for Spanish Language Arts, Primary Level C = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel C. (Grade 1).

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section defining the areas to be emphasized in the program: word attack, comprehension skills, study skills, literature appreciation, and writing skills. Sections…

  17. Curriculum Guide for Spanish Language Arts, Primary Level C = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel C. (Grade 1).

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section defining the areas to be emphasized in the program: word attack, comprehension skills, study skills, literature appreciation, and writing skills. Sections…

  18. Curriculum Guide for Spanish Language Arts, Primary Level B = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel B.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section on preparing instructional material for this group and a section defining the areas to be emphasized in the program: word attack, comprehension skills, study…

  19. What's in a Word? Elementary Students Learn a Lesson in the Language of Respect. Los Estudiantes de Primaria Aprenden una Leccion en el Lenguaje del Respeto.

    ERIC Educational Resources Information Center

    Maddalozzo, Rebecca

    2001-01-01

    Describes how one elementary teacher helped students in her class and in the entire school see through ethnic biases and feel proud of being bilingual or having bilingual friends. Her efforts taught the children that bilingual students are very much like their non-bilingual classmates in being unique people with talents that should be respected.…

  20. Curriculum Guide for Spanish Language Arts, Primary Level A = Guia para la ensenanza de las artes del lenguaje espanol, primaria, nivel A.

    ERIC Educational Resources Information Center

    Chicago Board of Education, IL. Dept. of Curriculum.

    The curriculum guide for teachers of Spanish language arts for native Spanish-speaking primary students in the Chicago public schools' bilingual education program is introduced by a section on preparing instructional material for this group and a section defining the areas to be emphasized in the program: word attack, comprehension skills, study…

  1. Nuevo enfoque de la ensenanza de las matematicas en el nivel de primaria (A New Approach to the Teaching of Mathematics at the Primary School Level).

    ERIC Educational Resources Information Center

    Jimenez Lozano, Blanca; And Others

    This document is an English-language abstract (approximately 1500 words) of a new approach to the teaching of mathematics in Mexican elementary schools. Three aspects of mathematical reform are discussed: (1) syllabus content; (2) teaching methods; and (3) the question of introducing the pupil to modern mathematics at the earliest possible stage…

  2. Nuevo enfoque de la ensenanza de las matematicas en el nivel de primaria (A New Approach to the Teaching of Mathematics at the Primary School Level).

    ERIC Educational Resources Information Center

    Jimenez Lozano, Blanca; And Others

    This document is an English-language abstract (approximately 1500 words) of a new approach to the teaching of mathematics in Mexican elementary schools. Three aspects of mathematical reform are discussed: (1) syllabus content; (2) teaching methods; and (3) the question of introducing the pupil to modern mathematics at the earliest possible stage…

  3. Estructura y química del suelo en un bosque de Castilla elastica en el carso del norte de Puerto Rico: resultados de una calicata

    Treesearch

    Christian A. Viera Martinez; Oscar Abelleira; Ariel E. Lugo

    2008-01-01

    We dug a soil pit of 1m x 1m x 1m in a forest dominated by Castilla elastica, a tree for shade coffee introduced in the karst of northern Puerto Rico. We found four soil horizons (designation notes in parenthesis) (A) organic soil matter (E) mineral soil leachate (B) aerobic mineral soil, and (C) saturated soil. The total storage of soil organic matter was 143 Mg/ha....

  4. El Impacto de Textos en Contextos Familiares en Comunidades de Practica para la Adquisicion de Vocabulario y Estructuras Gramaticales de Español Inicial Acelerado

    ERIC Educational Resources Information Center

    Burgos, Francisco

    2014-01-01

    This study, which involved classroom-based experimental research conducted during the Fall semester of 2013 in a Spanish class at Oakwood University, aimed at extending the findings of previous studies on the use of familiar texts in reading and writing (Brown 2007, Vygotsky 1978, Kern 2000, Rollins & Villamil 2001, McCourt 2006, Morris, Beck…

  5. Estructura y Funcionamiento del Cuerpo Humano. Prontuario. Guia del Maestro. Documento de Trabajo (Structure and Function of the Human Body. Handbook and Teacher's Guide. Working Document).

    ERIC Educational Resources Information Center

    Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

    This handbook and teacher's guide are for a 37-week course on the human body, intended for secondary or postsecondary students in allied health occupations. The syllabus lists general objectives and the number of hours and weeks devoted to each unit. A course outline is provided for five units: anatomy and physiology terminology; general…

  6. El Impacto de Textos en Contextos Familiares en Comunidades de Practica para la Adquisicion de Vocabulario y Estructuras Gramaticales de Español Inicial Acelerado

    ERIC Educational Resources Information Center

    Burgos, Francisco

    2014-01-01

    This study, which involved classroom-based experimental research conducted during the Fall semester of 2013 in a Spanish class at Oakwood University, aimed at extending the findings of previous studies on the use of familiar texts in reading and writing (Brown 2007, Vygotsky 1978, Kern 2000, Rollins & Villamil 2001, McCourt 2006, Morris, Beck…

  7. La region en los procesos de planificacion Latinos Americanos. Estructura institucional y bases juridicas. (The Region in the Planning Processes in Latin America: Institutional Structures and Juridical Basis)

    ERIC Educational Resources Information Center

    Basaldua, Raul Oscar; Moreno, Oscar Alberto

    1971-01-01

    This paper is part of a larger research project on the decisional structure of regionalized countries, which the authors are conducting at the Instituto Torcuato Di Tella with the Arq. Jorge Hardoy. (Editor)

  8. Efectos del huracán Georges en la composición de especies y estructura de un bosque secundario en el interior de Puerto Rico

    Treesearch

    A.E. Lugo; C.M. Domínguez Cristóbal; N. Méndez Irizarry

    2005-01-01

    From 1995 to 2003 we studied species composition and structure in a secondary subtropical wet forest in Utuado Puerto Rico. During September 21-22, 1998, hurricane Georges passed through the stand with maximum sustained winds of 184 km/h and gusts of 240 km/h. Species richness increased after the hurricane. While native species Miconia prasina reduced its Importance...

  9. Installation of devices in water tanks to prevent drowning of wild animals (Instalacion de Estructuras Dentro de Tanques de Agua Para Evitar El Ahogamiento de Animales Silvestres)

    Treesearch

    Alberto Lafon

    2006-01-01

    Domestic farm and ranch properties use a variety of water retention structures and water supply infrastructures that benefit wildlife. Some water supply systems, however, are harmful to wild birds, small mammals, and reptiles. Water supply systems include metal water tanks, cemented reservoirs, or excavated earthen retention ponds (or tanques as they are known in...

  10. La region en los procesos de planificacion Latinos Americanos. Estructura institucional y bases juridicas. (The Region in the Planning Processes in Latin America: Institutional Structures and Juridical Basis)

    ERIC Educational Resources Information Center

    Basaldua, Raul Oscar; Moreno, Oscar Alberto

    1971-01-01

    This paper is part of a larger research project on the decisional structure of regionalized countries, which the authors are conducting at the Instituto Torcuato Di Tella with the Arq. Jorge Hardoy. (Editor)

  11. Estructura y Funcionamiento del Cuerpo Humano. Prontuario. Guia del Maestro. Documento de Trabajo (Structure and Function of the Human Body. Handbook and Teacher's Guide. Working Document).

    ERIC Educational Resources Information Center

    Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

    This handbook and teacher's guide are for a 37-week course on the human body, intended for secondary or postsecondary students in allied health occupations. The syllabus lists general objectives and the number of hours and weeks devoted to each unit. A course outline is provided for five units: anatomy and physiology terminology; general…

  12. [Prevalence, type of epilepsy and use of antiepileptic drugs in primary care].

    PubMed

    Fernández-Suárez, Elena; Villa-Estébanez, Rubén; Garcia-Martinez, Alberto; Fidalgo-González, José A; Zanabili Al-Sibbai, Ahmad A; Salas-Puig, Javier

    2015-06-16

    Introduccion. La epilepsia es una enfermedad con gran repercusion social y economica. La prevalencia deberia ser usada como la base mas importante para planificar la prevencion secundaria y terciaria. Objetivos. Identificar los pacientes con diagnostico de epilepsia en un centro de atencion primaria y determinar la prevalencia, las caracteristicas demograficas, el tipo de sindrome epileptico y el uso de los farmacos antiepilepticos. Pacientes y metodos. Estudio descriptivo transversal retrospectivo. Incluyo 196 pacientes con diagnostico de epilepsia pertenecientes a un centro de salud y revision de la historia clinica hospitalaria, con el estudio de las variables sociodemograficas y clinicofarmacologicas. Resultados. Prevalencia de epilepsia: 8,4/1.000 habitantes. Edad media: 50,3 años. Sexo: 52,6%, hombres. Ambito: 79,6%, urbano. Antecedentes familiares de epilepsia: 14,8%. Tipo de epilepsia: focal sintomatica por ictus (14,3%), generalizada idiopatica (13,8%), focal criptogenica (8,7%), no clasificada (31,1%). Edad media al inicio de la crisis: 31,6 años. Comorbilidad neurologica o psiquiatrica: 62,8%. Ultima revision: el 18,9% sin tratamiento antiepileptico, el 56,6% en monoterapia y el 24,5% en politerapia. Libres de crisis: 76,5%. Farmacos mas prescritos: acido valproico, carbamacepina, fenitoina, lamotrigina y levetiracetam. Un 78,6% sin efectos secundarios. Fallecimiento: 4,1%. Conclusiones. La prevalencia de pacientes con epilepsia fue de 8,4/1.000 habitantes y predomina la focal sintomatica por ictus. Casi un tercio de los pacientes referia algun factor desencadenante de crisis, principalmente consumo de alcohol o fiebre. Predomina la monoterapia, los efectos secundarios son escasos y, en la ultima revision, la mayoria se hallaba libre de crisis.

  13. [Intracranial tumor behavior of plasma cell neoplasms. Report of 2 cases and literature review].

    PubMed

    López-Elizalde, Ramiro; Lemus-Rodríguez, Yazmín; Godínez-Rubí, Marisol; Madrigal-Saray, Arturo; Muñoz-Serrano, José Antonio; Velásquez-Santana, Héctor

    2013-01-01

    Antecedentes: el mieloma múltiple es una neoplasia de células plasmáticas caracterizada por destrucción ósea, insuficiencia renal, anemia e hipercalcemia. Los plasmacitomas de los huesos del cráneo representan menos de 1% de los tumores de cabeza y cuello. Se manifiestan como lesión primaria o secundaria a mieloma múltiple en 20-30%, incluso pueden aparecer varios años después del diagnóstico. Los autores comunicamos dos casos de pacientes mexicanas con lesiones plasmocíticas intracraneales, asociadas con mieloma múltiple.Casos clínicos: el primer caso es el de una paciente de 24 años de edad, con diagnóstico de mieloma múltiple e infiltración ósea que fue extirpado en 90%. Experimentó una recidiva local que requirió otra intervención para su remoción. El segundo caso es el de una mujer de 62 años de edad con un tumor intracraneal de células plasmáticas que se resecó en su totalidad. Ambas recibieron terapia adyuvante con quimio y radioterapia con resultados favorables. Las pacientes fallecieron a los 5 y 1.5 años, respectivamente, por insuficiencia renal como consecuencia de la enfermedad sistémica. Conclusiones: se propone a la quimioterapia y radioterapia como parte esencial del tratamiento de este tumor porque su comportamiento natural agresivo puede complicar la evolución, a pesar de ser accesibles quirúrgicamente.

  14. Desarrollo de la Escala sobre el Estigma Relacionado con el VIH/SIDA para Profesionales de la Salud mediante el uso de métodos mixtos123

    PubMed Central

    Varas-Díaz, Nelson; Neilands, Torsten B.; Guilamo-Ramos, Vincent; Cintrón Bou, Francheska N.

    2009-01-01

    El estigma relacionado con el VIH/SIDA continúa siendo un obstáculo para la prevención primaria y secundaria del VIH. Las consecuencias para las personas que viven con la enfermedad han sido muy documentadas y continúan siendo una gran preocupación para las personas que proveen servicios de salud y para aquellas que investigan el tema. Estas consecuencias son preocupantes cuando el estigma emana de profesionales de la salud porque se puede limitar el acceso a los servicios. Uno de los principales obstáculos para la investigación del estigma relacionado con el VIH en Puerto Rico es la falta de instrumentos cuantitativos para evaluar las manifestaciones del estigma entre profesionales de la salud. El objetivo principal de este estudio fue desarrollar y probar las propiedades psicométricas de una escala sobre el estigma relacionado con el VIH/SIDA culturalmente apropiada para personas que proveen servicios de salud puertorriqueñas y desarrollar una versión corta de la escala que pudiera usarse en escenarios clínicos con tiempo limitado. El instrumento desarrollado estuvo basado en evidencia cualitativa recopilada entre profesionales y estudiantes de profesiones de la salud puertorriqueños/as (n=80) y administrado a una muestra de 421 profesionales de la salud en adiestramiento. La escala contenía 12 dimensiones del estigma relacionado con el VIH/SIDA. El análisis cuantitativo corroboró 11 de ellas, teniendo como resultado un instrumento con validez y confiabilidad satisfactoria. Estas dimensiones, a su vez, fueron subcomponentes de un factor de estigma general superior. PMID:20333258

  15. [Active interventions in hypercholesteroloemia patients with high cardivascular risk in primary care].

    PubMed

    Tárraga López, Pedro J; Garcia-Norro Herreros, F J; Tárraga Marcos, Loreto; Solera Albero, Juan; González López, Esteban; Ruiz García, Antonio; Pallarés Carratalá, Vicente; Castro Navarro, José Luis; Alins Presas, Josep; Panisello Royo, Josefa María

    2015-05-01

    Introducción: La hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y en prevención secundaria especialmente. Objetivo: Comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: Estudio epidemiológico, prospectivo, multicentrico, realizado en Centros de AP de diferentes CC.AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: Los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32% eran varones. El 41,64% presentaba un EVC previo, infarto agudo de miocardio (20,33%), angina (16,07%), ictus/AIT (9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión (71,01%), y obesidad abdominal (69,62%). El 43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron la 2a visita (241) consiguieron el OT. El 62,50% (IC95%: 55,68; 68,98) de los que realizaron la 3a (216) consiguieron el OT. Finalmente, el 77,56% (IC95%: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/ dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/ dL en la 3a visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001) El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las gu

  16. Mexican Secondary School Students' Perception of Learning the History of Mexico in English (La percepción de alumnos mexicanos de secundaria cuando aprenden la historia de México en inglés)

    ERIC Educational Resources Information Center

    Lara Herrera, Romero

    2015-01-01

    This article focuses on Mexican students' perceptions of learning the history of Mexico in English through content-based instruction, which is one of many types of bilingual pedagogical approaches that are now considered established approaches in Mexico and around the globe. A phenomenological approach was chosen in order to understand and examine…

  17. The Impact of Explicit Feedback on EFL High School Students Engaged in Writing Tasks (El Impacto De La Retroalimentación Explícita en Tareas De Escritura en Lengua Inglesa De Estudiantes De Secundaria)

    ERIC Educational Resources Information Center

    Correa Pérez, Roxanna; Martínez Fuentealba, Mariela; Molina De La Barra, María; Silva Rojas, Jessica; Torres Cisternas, Mirta

    2013-01-01

    The aim of this article is to examine the impact of feedback on content and organization in writing tasks developed by learners of English as a foreign language. The type of study is qualitative and the research design is a case study. One study involved three students and a female teacher, and the second consisted of three students and a male…

  18. Concepciones y concepciones alternativas de estudiantes universitarios/as de biologia y futuros maestros/as de Ciencia de escuela secundaria sobre la teoria de evolucion biologica por seleccion natural

    NASA Astrophysics Data System (ADS)

    Morales Ramos, Egda M.

    La teoria de evolucion biologica (TEB) por seleccion natural es uno de los conceptos unificadores mas importantes del curriculo de Biologia. En Puerto Rico se han hecho pocas investigaciones que abunden sobre las concepciones y concepciones alternativas (CA) que tienen los estudiantes universitarios/as de Biologia y los maestros/as de Ciencia del nivel secundario sobre esta teoria. La politica publica educativa actual establece mediante documentos normativos como los Estandares de contenido y Expectativas de grado del Programa de Ciencias [Puerto Rico Core Standards] la ensenanza de esta teoria. Sin embargo, no se encontraron preguntas sobre la seleccion natural en los ejercicios de practica provistos por el Departamento de Educacion para las pruebas estandarizadas lo cual puede influir para que no se ensene adecuadamente. Las preguntas de investigacion fueron 1. ¿Cuales son las concepciones y concepciones alternativas de estudiantes universitarios/as y de los futuros maestros y maestras de Ciencia sobre la TEB? 2. ¿Cuales conceptos que seleccionan los estudiantes universitarios/as y los futuros maestros y maestras de Ciencia sobre la TEB coinciden con lo aceptado como valido por la comunidad cientifica? y 3. ¿Como comparan las respuestas de la prueba original. v. Entendiendo el cambio biologico que mide concepciones y CA sobre la TEB por seleccion natural, con las de la traducida al idioma espanol? Se utilizo el metodo cuantitativo con un diseno de investigacion transversal por encuesta. La tecnica principal para recopilar los datos fue una prueba con doce items, que formo parte de un instrumento para el cual se recopilaron diversas fuentes de evidencia acerca de su validez. Las muestras estuvieron formadas por 69 estudiantes de Ciencias Naturales y por 16 estudiantes futuros maestros y maestras del nivel secundario de la UPR-RP. Se utilizaron estadisticas descriptivas, analisis de Ji cuadrado y se calcularon los coeficientes alfa de Cronbach y de Spearman. Estos demostraron que la prueba es confiable para medir las concepciones y CA de la TEB por seleccion natural. Aunque los estudiantes escogieron conceptos relacionados con esta teoria, mantienen en sus procesos de razonamiento CA sobre la seleccion natural que no se limitan a la lamarckiana y a la teleologica.

  19. Matematica Para La Escuela Secundaria, Primer Curso de Algebra (Parte 2). Traduccion Preliminar de la Edicion Inglesa Revisada. (Mathematics for High School, First Course in Algebra, Part 2. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is part two of a three-part SMSG algebra text for high school students. The principal objective of the text is to help the student develop an understanding and appreciation of some of the algebraic structure as a basis for the techniques of algebra. Chapter topics include addition and multiplication of real numbers, subtraction and division…

  20. Matematica Para La Escuela Secundaria, Primer Curso de Algebra (Parte 1). Traduccion Preliminar de la Edicion Inglesa Revisada. (Mathematics for High School, First Course in Algebra, Part 1. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is the student text for part one of a three-part SMSG algebra course for high school students. The principal objective of the text is to help the student develop an understanding and appreciation of some of the algebraic structure as a basis for the techniques of algebra. Chapter topics include congruence; numbers and variables; operations;…

  1. Matematica Para La Escuela Secundaria, Primer Curso de Algebra (Parte 2), Comentario. Traduccion Preliminar de la Edicion en Ingles Revisada. (Mathematics for High School, First Course in Algebra, Part 2, Teacher's Commentary. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is the teacher's commentary for part two of a three-part SMSG algebra text for high school students. The principal objective of the text is to help the student develop an understanding and appreciation of some of the algebraic structure as a basis for the techniques of algebra. Chapter topics include addition and multiplication of real…

  2. Matematica Para La Escuela Secundaria, Primer Curso de Algebra (Parte 1), Comentario. Traduccion Preliminar de la Edicion en Ingles Revisada. (Mathematics for High School, First Course in Algebra, Part 1, Teacher's Commentary. Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is the teacher's commentary for part one of a three-part SMSG algebra text for high school students. The principal objective of the text is to help the student develop an understanding and appreciation of some of the algebraic structure as a basis for the techniques of algebra. Chapter topics include congruence; numbers and variables;…

  3. Matematica Para La Escuela Secundaria: Geometria (Parte 2). Traduccion Preliminar de la Edicion Inglesa Revisada. (Mathematics for High School: Geometry, Part 2. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is part two of a two-part SMSG mathematics text for high school students. Chapter topics include: (1) perpendicular lines and planes in space; (2) parallel lines in a plane; (3) parallel lines in space; (4) areas of polygonal regions: (5) similarity; (6) circles and spheres; (7) constructions; (8) the area of a circle and related topics; and…

  4. Matematica Para La Escuela Secundaria: Geometria (Parte 1). Traduccion Preliminar de la Edicion Inglesa Revisada. (Mathematics for High School: Geometry, Part 1. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Allen, Frank B.; And Others

    This is part one of a two-part SMSG mathematics text for high school students. Topics include plane geometry, real numbers, triangles and angles, congruence, construction, parallel lines, perpendicular lines, and parallelograms. The text is written in Spanish. (RH)

  5. Multidisciplinary teams involved: detection of drug-related problems through continuity of care.

    PubMed

    Romero-Ventosa, Elena Yaiza; Samartín-Ucha, Marisol; Martín-Vila, Alicia; Martínez-Sánchez, María Lucía; Rey Gómez-Serranillos, Isabel; Pineiro-Corrales, Guadalupe

    2016-11-01

    Objetivo: Cuantificar los problemas relacionados con los medicamentos (PRMs) mediante el establecimiento de un Programa Estratégico de Continuidad Asistencial (Programa e-Conecta-Concilia; e-CC) enfocado a la farmacoterapia de los pacientes pertenecientes a una Estructura Organizativa de Gestión Integrada, para garantizar la eficiencia, seguridad y trazabilidad terapéutica del paciente. Método: Estudio prospectivo de 8 meses de duración. Participaron en el proyecto 22 farmacéuticos de hospital y 12 de Atención Primaria. Se utilizó la historia clínica electrónica accesible a todos los niveles. Se llevaron a cabo las actuaciones necesarias para la creación de un procedimiento normalizado de trabajo (PNT) (creación de los grupos de trabajo, informática, puntos de encuentro) de coordinación entre farmacéuticos de diferentes niveles asistenciales con un sistema de comunicación común. Los grupos de trabajo constituidos por farmacéuticos de ambos niveles asistenciales establecieron los siguientes criterios de inclusión: pacientes con enfermedades crónicas y polimedicados, pacientes en los que se detectaba algún PRM, detección en Atención Primaria de un uso fuera de ficha técnica o discrepancias en la homologación de recetas sanitarias. Resultados: En el seno del Programa e-CC se unificaron las intervenciones y se identificaron discrepancias. Durante este proyecto se detectaron 245 problemas relacionados con los medicamentos, siendo los mayoritarios los de dosis, pauta o duración no adecuada (24%) y los que afectaban a los medicamentos del grupo B (33%), según la clasificación ATC. Conclusiones: La implantación de un PNT de Continuidad Asistencial entre farmacéuticos permitió detectar y resolver PRMs y discrepancias en la farmacoterapia de los pacientes, con un alto porcentaje de aceptación (84,1%) de las intervenciones.

  6. [Protocol for neurophysiological studies of the pelvic floor to appraise anorectal dysfunction in patients with multiple sclerosis].

    PubMed

    Álvarez-Guerrico, Ion; Royo, Inmaculada; Andreu, Montserrat; Roquer-González, Jaume; Munteis, Elvira

    2016-03-01

    Introduccion. Los pacientes con esclerosis multiple (EM) frecuentemente desarrollan disfuncion anorrectal. Las estructuras neuromusculares del suelo pelvico y los mecanismos de control voluntario de la defecacion pueden afectarse por las lesiones parcheadas de la EM o secundarias a la discapacidad del paciente. La implicacion multifactorial limita la comprension de la fisiopatologia de la disfuncion anorrectal en la EM. Tests neurofisiologicos especificos valoran la funcionalidad de los elementos del sistema nervioso central y periferico implicados en las disfunciones anorrectales. Objetivo. Proponer un protocolo diagnostico de estudios neurofisiologicos estandarizados del suelo pelvico para caracterizar la fisiopatologia de la disfuncion anorrectal en los pacientes con EM. Pacientes y metodos. Se realizaron estudios de electromiografia de esfinter anal externo, potenciales evocados somatosensoriales desde el nervio pudendo interno, registro de reflejos sacros anales y neurografia del nervio pudendo a 16 pacientes con EM definida y criterios de estreñimiento o incontinencia fecal. Resultados. Las caracteristicas clinicas y neurofisiologicas fueron heterogeneas. Nueve pacientes presentaron estreñimiento; dos, incontinencia fecal aislada; y cinco, combinacion de ambos. La abolicion o el retraso de la latencia de los potenciales evocados somatosensoriales fue el hallazgo mas frecuente (n = 12), seguido de la deteccion de contraccion paradojica (n = 11) y de reclutamiento deficitario (n = 8) en la electromiografia de esfinter anal externo. Conclusiones. La correcta interpretacion de cada test neurofisiologico disponible y la correlacion de los hallazgos en conjunto permiten comprender la fisiopatologia de la disfuncion anorrectal. La protocolizacion de estudios neurofisiologicos del suelo pelvico permite ajustar el diagnostico al identificar la lesion nerviosa, central o periferica, determinante de disfuncion anorrectal en los pacientes con EM.

  7. The Role of Collaborative Work in the Development of Elementary Students' Writing Skills (El papel del trabajo colaborativo en el desarrollo de las habilidades de escritura de estudiantes de primaria)

    ERIC Educational Resources Information Center

    Yate González,Yuly Yinneth; Saenz, Luis Fernando; Bermeo, Johanna Alejandra; Castañeda Chaves, Andrés Fernando

    2013-01-01

    In this article we report the findings of a two-phase action research study focused on the role of collaborative work in the development of elementary students' writing skills at a Colombian school. This was decided after having identified the students' difficulties in the English classes related to word transfer, literal translation, weak…

  8. Successful Approaches to Helping Students--Including English Learners--Succeed in Elementary School. Parent Guide = Enfoques exitosos para ayudar a los estudiantes--incluyendo a los que aprenden ingles--a triunfar en la escuela primaria. Guia de padres

    ERIC Educational Resources Information Center

    EdSource, 2007

    2007-01-01

    This guide informs parents about some instructional practices that work well for all elementary school students, in particular English learners. It includes questions parents can ask teachers and principals to help them understand how their children's school approaches teaching and learning. Both English and Spanish versions of the document are…

  9. La Palabra es Nuestra: Primaria para Adultos. Segunda Parte, Volumen 1-2. Edicion Experimental (The Language Is Ours: Primer for Adults. Part Two, Volumes 1-2. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    These workbooks are part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process becoming literate or have recently become literate in their native language. They provide readings and exercises for developing literacy skills. Pictures and fill-in-the blank exercises appear frequently. Volume 1…

  10. Validation Evidence for the Elementary School Version of the MUSIC® Model of Academic Motivation Inventory (Pruebas de validación para el Modelo MUSIC® de Inventario de Motivación Educativa para Escuela Primaria)

    ERIC Educational Resources Information Center

    Jones, Brett D.; Sigmon, Miranda L.

    2016-01-01

    Introduction: The purpose of our study was to assess whether the Elementary School version of the MUSIC® Model of Academic Motivation Inventory was valid for use with elementary students in classrooms with regular classroom teachers and student teachers enrolled in a university teacher preparation program. Method: The participants included 535…

  11. Un Programa Personalizado De Lectura En Un Aula Primaria: Reporte De Un Modelo Comprobado (A Personalized Program of Reading in a First Grade Classroom: Report From a Proven Model.)

    ERIC Educational Resources Information Center

    Mendenhall, Susie B.; And Others

    This document written in Spanish describes a personalized reading program and discusses the results of its implementation. The focus of this approach to reading is based on the individual child and his feelings. This model personalizes the child's reading material in the classroom. In personalizing the reading material, the child's attitudes…

  12. Yo Puedo Leer: Un Programa Personalizado de Lectura en un Aula Primaria: Reporte de un Modelo Comprobado (I Can Read: A Personalized Reading Program in a Primary Classroom: A Report on a Verified Model).

    ERIC Educational Resources Information Center

    Mendenhall, Susie B.; Sledjeski, Stephen

    This monograph discusses an investigation carried out in a school which has implemented an experimental reading program. Achievement, self-esteem, and social acceptance gains and their interrelations were investigated. Treatment groups (experimental and control) were the three independent variables providing a 2 x 2 x 2 factorial design. Data were…

  13. Guia de Educacion Ambiental para Maestros del Nivel Primario. Los Recursos Naturales en la Ensenanza Primaria. Segunda Edicion. (Environmental Education Guide for Teachers of Primary Level. Natural Resources in Primary Instruction. Second Edition.)

    ERIC Educational Resources Information Center

    Morillo, Alfredo; Del Valle, Ramona

    This guide contains six elementary grade units which focus on environmental concepts considered of major importance by the agricultural personnel of the Dominican Republic. Each of the units shows a cumulative and sequential building of these concepts. Unit 1 (grade 1) focuses on the basics of plant and animal differentiation and on the properties…

  14. [Criterios utilizados por médicos de atención primaria para el diagnóstico y derivación al reumatólogo del paciente con artritis reumatoide].

    PubMed

    Xibillé-Friedmann, Daniel; Mondragón-Flores, Victor; de la Rosa, César Horcasitas

    2006-09-01

    Rheumatoid arthritis (RA), an important cause of disability, affects 1% of the population. Early diagnosis and referral to a rheumatologist are positive prognostic factor but diagnosis in many cases is in the hands of primary care physicians (PCP). To determine the criteria used by PCP for diagnosis of RA and referral of these patients to a rheumatologist; to evaluate how many cases can be classified as RA according to the ACR. Retrospective study of 530 patients referred by PCP and seen as outpatients at a rheumatology clinic in 2002. Patients with referral diagnosis of RA were identified and symptoms, signs, functional capacity and ACR criteria for RA were evaluated by 2 rheumatologists. 302 patients had a referral diagnosis of RA, 33 male (10.9%) and 269 female (89.1%), median age 50.5 years, with a median time since diagnosis of 45.2 months. 57.9% had FC stage II. 100% of cases had "generalized" joint pain, 67.5% arthritis of 3 or more joints and 51.7% arthritis of hand joints. Arthritis was symmetrical in 58.9% and 77.2% of the patients had morning stiffness (> 30 min). 49.7% of the cases had positive rheumatoid factor, 19.2% had a negative RF and 31.1% had none reported. In 2% ESR was measured. X-ray erosions were reported in 6.6% of cases. When using the ACR criteria, 17.8% of patients had 1, 28.7% had 2 and 53.5% had 3 or more criteria. In only 59 cases (20%) did the rheumatologist agree with the referral diagnosis of RA. 80% of PCP referrals of RA to the rheumatologist were another disease. A poor clinical evaluation and little support from laboratory and x-rays was noticed. The delay in diagnosis and referral was 3 years, worsening prognosis. A vigorous effort in educating PCP is needed to achieve early diagnosis and referral of RA cases. Copyright © 2006 Elsevier España S.L. Barcelona. Published by Elsevier Espana. All rights reserved.

  15. Modelo Pedagogico de Educacion Primaria para Adultos: Manual para la Vinculacion y Funcionamiento de los Comites de Educacion para Adultos (A Teaching Model for Adult Primary Education: Manual for the Continuation and Operation of Adult Education Committees).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This manual is part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. This document describes the concept of a model for community adult education for the purpose of supporting local educational committees…

  16. La Palabra es Nuestra: Primaria para Adultos. Primera Parte, Volumen 1-2. Edicion Experimental. (The Language Is Ours: Primer for Adults. Part One, Volumes 1-2. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    These workbooks are part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. These workbooks, designed to continue developing literacy skills, include pictures, dialogues, crossword puzzles, and fill-in-the blank…

  17. Modelo Pedagogico de Educacion Primaria para Adultos: Manual para el Asesor de Estudiantes Libres. Primera Parte (A Pedagogical Model for Adult Primary Education: Manual for the Student Advisor. Part One).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    This guide, part of a Mexican series of instructional materials, is intended for advisors of students participating in an adult education program offered through public and private organizations in communities in Mexico. The first part of the program comprises Spanish and math; the second, education for family life, education for community life,…

  18. A six-month, multicenter, open-label, noncomparative, prospective, observational study of the efficacy and tolerability of atorvastatin in the primary care setting(estudio del control de las hiperlipidemiasen atención primaria): the cheap study☆

    PubMed Central

    Gómez-Gerique, Juan A.; Álvarez-Sala, Luis A.; Armada, Beatriz; Fernández-Arias, Isabel; Martinez, Javier; Hernández, Gonzalo

    2003-01-01

    Background: A close relationship exists between high levels of total cholesterol (TC) (particularly low-density lipoprotein cholesterol [LDL-C]) and low levels of high-density lipoprotein cholesterol (HDL-C), which is associated with an increased risk for arteriosclerosis and cardiovascular disease (CVD). Evidence shows that atorvastatin produces significantly greater reductions in LDL-C and TC than other hydroxymethylglutaryl-coenzyme A reductase inhibitors. However, the results achieved in clinical studies could be different from those found in general clinical practice, where patient follow-up is less thorough and poorer compliance may reduce the effectiveness of the lipid-lowering therapy. Objective: The aim of this study was to assess the effectiveness of atorvastatin in achieving the LDL-C levels recommended by several Spanish scientific societies, as well as its tolerability in standard clinical use. Methods: This 6-month, open-label, noncomparative, prospective, observational study was conducted in 1351 primary care centers in Spain. All patients were aged 18 to 80 years and had primary hypercholesterolemia (TC >200 mg/dL and triglycerides [TG] 200 mg/dL and fasting TG 200–400 mg/dL). All patients also had LDL-C levels higher than those established by the Spanish Society of Arteriosclerosis (Sociedad Española de Arteriosclerosis [SEA]) according to baseline cardiovascular risk and previous use of lipid-lowering therapy (for patients with low, moderate, or high cardiovascular risk, the recommended LDL-C goals are ≤175 mg/dL, ≤155 mg/dL, and ≤135 mg/dL, respectively; for patients with CVD, the LDL-C goal is ≤100 mg/dL). None of the patients had creatine kinase activity ≥540 U/L or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥60 U/L. Study visits occurred at months 0, 2, and 6 of treatment. Patients received atorvastatin calcium 10 mg/d for 2 months. The dosage was then doubled to 20 mg/d in patients who did not achieve the SEA LDL-C goal and also in those patients whose primary care physicians (PCPs) deemed this higher dosage necessary; this dosage was continued for at least 4 additional months, to complete at least a 6-month course of treatment. The percentage of patients who achieved their goals was used to measure atorvastatin effectiveness. Percentages of change in LDL-C, TC, TG, and HDL-C from baseline to the final study visit also were used as measures of effectiveness. The incidence of adverse events (AEs) per 10,000 patient-months was used for the primary tolerability analysis. A secondary tolerability analysis was performed in all patients treated with atorvastatin who had some recorded follow-up, regardless of whether the patient met inclusion criteria. Information was obtained from data recorded in the case-report forms. Results: A total of 5317 outpatients (2715 women, 2598 men, 4 sex unknown; mean [SD] age, 58.7 [10.5] years) were enrolled. Among patients receiving known dosages of atorvastatin, 1580 of 4033 (39.2%) and 2378 of 3585 (66.3%) patients met the SEA LDL-C goal after 2 and 6 months of therapy, respectively (P

  19. Exploring Elementary Students' Power and Solidarity Relations in an EFL Classroom (Exploración de las relaciones de poder y solidaridad entre estudiantes de primaria en la clase de inglés como lengua extranjera)

    ERIC Educational Resources Information Center

    Méndez, Tatiana; García, Andrea

    2012-01-01

    This article derives from a critical discourse analysis study that reports the characteristics of elementary school students' power and solidarity relations in English as a foreign language classroom in Bogotá, Colombia, while we were doing our teaching English as a foreign language practicum. The study was based on theories of power and…

  20. Guia de Educacion Ambiental para Maestros del Nivel Primario. Los Recursos Naturales en la Ensenanza Primaria. Segunda Edicion. (Environmental Education Guide for Teachers of Primary Level. Natural Resources in Primary Instruction. Second Edition.)

    ERIC Educational Resources Information Center

    Morillo, Alfredo; Del Valle, Ramona

    This guide contains six elementary grade units which focus on environmental concepts considered of major importance by the agricultural personnel of the Dominican Republic. Each of the units shows a cumulative and sequential building of these concepts. Unit 1 (grade 1) focuses on the basics of plant and animal differentiation and on the properties…

  1. A six-month, multicenter, open-label, noncomparative, prospective, observational study of the efficacy and tolerability of atorvastatin in the primary care setting(estudio del control de las hiperlipidemiasen atención primaria): the cheap study.

    PubMed

    Gómez-Gerique, Juan A; Alvarez-Sala, Luis A; Armada, Beatriz; Fernández-Arias, Isabel; Martinez, Javier; Hernández, Gonzalo

    2003-06-01

    A close relationship exists between high levels of total cholesterol (TC) (particularly low-density lipoprotein cholesterol [LDL-C]) and low levels of high-density lipoprotein cholesterol (HDL-C), which is associated with an increased risk for arteriosclerosis and cardiovascular disease (CVD). Evidence shows that atorvastatin produces significantly greater reductions in LDL-C and TC than other hydroxymethylglutaryl-coenzyme A reductase inhibitors. However, the results achieved in clinical studies could be different from those found in general clinical practice, where patient follow-up is less thorough and poorer compliance may reduce the effectiveness of the lipid-lowering therapy. The aim of this study was to assess the effectiveness of atorvastatin in achieving the LDL-C levels recommended by several Spanish scientific societies, as well as its tolerability in standard clinical use. This 6-month, open-label, noncomparative, prospective, observational study was conducted in 1351 primary care centers in Spain. All patients were aged 18 to 80 years and had primary hypercholesterolemia (TC >200 mg/dL and triglycerides [TG] 200 mg/dL and fasting TG 200-400 mg/dL). All patients also had LDL-C levels higher than those established by the Spanish Society of Arteriosclerosis (Sociedad Española de Arteriosclerosis [SEA]) according to baseline cardiovascular risk and previous use of lipid-lowering therapy (for patients with low, moderate, or high cardiovascular risk, the recommended LDL-C goals are ≤175 mg/dL, ≤155 mg/dL, and ≤135 mg/dL, respectively; for patients with CVD, the LDL-C goal is ≤100 mg/dL). None of the patients had creatine kinase activity ≥540 U/L or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥60 U/L. Study visits occurred at months 0, 2, and 6 of treatment. Patients received atorvastatin calcium 10 mg/d for 2 months. The dosage was then doubled to 20 mg/d in patients who did not achieve the SEA LDL-C goal and also in those patients whose primary care physicians (PCPs) deemed this higher dosage necessary; this dosage was continued for at least 4 additional months, to complete at least a 6-month course of treatment. The percentage of patients who achieved their goals was used to measure atorvastatin effectiveness. Percentages of change in LDL-C, TC, TG, and HDL-C from baseline to the final study visit also were used as measures of effectiveness. The incidence of adverse events (AEs) per 10,000 patient-months was used for the primary tolerability analysis. A secondary tolerability analysis was performed in all patients treated with atorvastatin who had some recorded follow-up, regardless of whether the patient met inclusion criteria. Information was obtained from data recorded in the case-report forms. A total of 5317 outpatients (2715 women, 2598 men, 4 sex unknown; mean [SD] age, 58.7 [10.5] years) were enrolled. Among patients receiving known dosages of atorvastatin, 1580 of 4033 (39.2%) and 2378 of 3585 (66.3%) patients met the SEA LDL-C goal after 2 and 6 months of therapy, respectively (P

  2. Matematicas Para La Escuela Primaria, Grado 4 (Parte 2), Comentario. Traduccion Preliminar de la Edicion en Ingles Revisada. (Mathematics for the Elementary School, Grade 4, Part 2, Teacher's Commentary. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Beatty, Leslie; And Others

    This is Part 2 of the teacher's commentary for the grade 4 mathematics program. Part 2 includes the commentary for chapters 6 through 10. Topics covered include addition and subtraction, multiplication and division, geometrical figures, lines and lineal measurement, and fractions. (RH)

  3. Nuestras cuentas diarias: Matematicas. Primaria para adultos, Segunda parte, Volumens 1 y 2. Edicion Experimental (Our Daily Accounting: Mathematics. Primer for Adults, Part Two, Volumes 1 and 2. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    These workbooks are part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. The workbooks are designed to teach skills needed to manage ordinary financial transactions and daily tasks requiring a knowledge of…

  4. Nuestras cuentas diarias: Matematicas. Primaria para adultos, Primera parte, Volumens 1 y 2. Edicion Experimental (Our Daily Accounting: Mathematics. Primer for Adults, Part One, Volumes 1 and 2. Experimental Edition).

    ERIC Educational Resources Information Center

    Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).

    These workbooks are part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. The workbooks, divided in two volumes, are designed to teach skills required in managing ordinary financial transactions and daily tasks…

  5. Matematicas Para La Escuela Primaria, Grado 4 (Parte 1), Comentario. Traduccion Preliminar de la Edicion en Ingles Revisada. (Mathematics for the Elementary School, Grade 4, Part 1, Teacher's Commentary. Preliminary Translation of the Revised English Edition).

    ERIC Educational Resources Information Center

    Beatty, Leslie; And Others

    This is Part 1 of the teacher's commentary for the grade 4 mathematics program. Part 1 includes the commentary for chapters 1 through 5. Topics covered include congruence, numbers and number bases, subtraction of numbers, division of numbers, and elementary geometry. References to the student text are cited. (RH)

  6. Validation Evidence for the Elementary School Version of the MUSIC® Model of Academic Motivation Inventory (Pruebas de validación para el Modelo MUSIC® de Inventario de Motivación Educativa para Escuela Primaria)

    ERIC Educational Resources Information Center

    Jones, Brett D.; Sigmon, Miranda L.

    2016-01-01

    Introduction: The purpose of our study was to assess whether the Elementary School version of the MUSIC® Model of Academic Motivation Inventory was valid for use with elementary students in classrooms with regular classroom teachers and student teachers enrolled in a university teacher preparation program. Method: The participants included 535…

  7. Programa Estrategico do desenvolvimento 1968-70: Area Estrategica IX. Infra-estructura Social. Educacao e Recursos Humanos, 1 e 2 (Strategic Development Program 1968-1970: Strategic Area IX. Education and Human Resources, Volumes 1 & 2).

    ERIC Educational Resources Information Center

    Brazil.

    This document is an English-language abstract (approximately 1,500 words) of a two volume work dealing with education and human resources as part of the Brazilian Government's Strategic Development Program 1968-70. It offers an integral view of education as an instrument of social transformation and an exposition of the quantitative and…

  8. El bosque del parque central de la urbanización El Paraíso: estructura, composición de especies y crecimiento de árboles

    Treesearch

    E. Román Nunci; H. Marcano Vega; I. Vicéns; G. Bortolamedi; A.E. Lugo

    2005-01-01

    We studied an urban forest established in 1988 by residents of the El Paraíso urbanization. In 2007 the forest had 37 forest species (9 native and 28 introduced) with diameter at breast height (dbh) ≥ 4 cm in a 1.0785 ha area. The most common species was the hybrid mahogany (Swietenia macrophylla x mahagony) with an Importance Value of 24.3 percent. The forest had two...

  9. Programa Estrategico do desenvolvimento 1968-70: Area Estrategica IX. Infra-estructura Social. Educacao e Recursos Humanos, 1 e 2 (Strategic Development Program 1968-1970: Strategic Area IX. Education and Human Resources, Volumes 1 & 2).

    ERIC Educational Resources Information Center

    Brazil.

    This document is an English-language abstract (approximately 1,500 words) of a two volume work dealing with education and human resources as part of the Brazilian Government's Strategic Development Program 1968-70. It offers an integral view of education as an instrument of social transformation and an exposition of the quantitative and…

  10. Detección y análisis de pequeñas estructuras magnéticas en las regiones próximas a los polos solares

    NASA Astrophysics Data System (ADS)

    Cabello, I.; Blanco Rodríguez, J.; Balmaceda, L.; Domingo, V.

    2017-10-01

    The solar magnetic field plays a fundamental role in the overall behaviour of the Sun. In the solar photosphere, the magnetic field is evidenced with a wide range of structures with different sizes, shapes and intensities. Bright Points (BPs) are the smallest of these manifestations discernible with the current instruments, and their presence is observable all over the solar disk, on both active and quiet regions. However, due to difficulties in observing polar areas, the presence of BPs in these regions is poorly known so far. The Solar Orbiter mission will be launched in 2018 and will observe the Sun up to 30º outside the ecliptic, allowing the analysis of BPs appearance in areas close to the solar poles. A preliminar study can be done considering the inclination of the ecliptic plane relative to the solar axis, so that these regions can be observed at certain times in the year. In this work, G-band images have been used to detect and analyse BPs located in areas close to the solar poles.

  11. [PHYSICAL EDUCATION CLASSES ONLY IMPROVE CARDIORESPIRATORY FITNESS OF STUDENTS WITH LOWER PHYSICAL FITNESS: A CONTROLLED INTERVENTION STUDY].

    PubMed

    Mayorga-Vega, Daniel; Viciana, Jesús

    2015-07-01

    Introducción: los profesores de educación física deben llevar a cabo programas de intervención con el fin de mejorar los niveles de capacidad cardiorrespiratoria de sus alumnos. Sin embargo, debido a la baja carga lectiva, dichos programas podrían no mejorar la capacidad cardiorrespiratoria de los estudiantes con mayores niveles iniciales. Objetivos: el objetivo del presente estudio fue comparar el efecto de un programa de acondicionamiento físico realizado durante las dos clases de educación física sobre la capacidad cardiorrespiratoria en función del nivel de condición física inicial de los estudiantes. Métodos: una muestra de 71 estudiantes de educación primaria y 107 de educación secundaria obligatoria fue asignada aleatoriamente (por clases naturales) al grupo control y experimental. Durante las clases de educación física, los estudiantes experimentales realizaron un programa de acondicionamiento físico. Resultados: los resultados del análisis de varianza de un factor mostraron que los estudiantes experimentales con menor nivel de condición física incrementaron estadísticamente su capacidad cardiorrespiratoria con respecto a los estudiantes controles (p < 0,01). En cambio, no se encontraron diferencias estadísticamente significativas entre los estudiantes experimentales con mayor nivel y los controles (p > 0,05). Conclusiones: durante las clases de educación física, solo los estudiantes con menor condición física parecen incrementar su capacidad cardiorrespiratoria. En cambio, los alumnos con mayor nivel de condición física no se benefician de estos programas. Por ello, con el objetivo real de incrementar la capacidad cardiorrespiratoria de todos los jóvenes, parece necesario aumentar la carga lectiva de la asignatura de educación física.

  12. [Clinical and demographic characteristics of patients with multiple sclerosis].

    PubMed

    Bertado-Cortés, Brenda; Villamil-Osorio, Lyda; Carrera-Pineda, Raúl; Martínez-Cortés, Carlos; Guerrero-Cantera, José

    2016-01-01

    Introducción: la esclerosis múltiple (EM) es una enfermedad que presenta una compleja interacción de factores genéticos y ambientales en su fisiopatogenia. Dado que esos factores han sido poco abordados en México, describimos las características clínicas y demográficas de una muestra de pacientes con EM. Métodos: estudio observacional, descriptivo, transversal y retrolectivo, realizado en un hospital de tercer nivel. Se obtuvo información de expedientes clínicos de una muestra de pacientes con el diagnóstico de EM, captados de abril de 2014 a julio de 2015. Resultados: se obtuvieron datos de 313 pacientes, 65.5 % mujeres, con edad promedio de 41 años (DE 11.22). La edad mínima del diagnóstico fue de 12 años y la máxima de 66; el promedio de edad del diagnóstico fue 32 años (DE 9.72). De la variante clínica 3.4 % tuvo síndrome neurológico aislado (CIS), EM remitente-recurrente 82 %, EM secundaria progresiva 13.9 % y EM primaria progresiva 0.8 %. El 10 % de los pacientes tenía parentesco de primer o segundo grado con diagnóstico de EM. El 16 % tuvo ascendencia extranjera. El 27 % tenía hábito tabáquico. Los tratamientos utilizados fueron el acetato de glatiramero 28 %, interferon beta 1a IM 18 %, interferon beta 1a SC 16 %, interferon beta 1b SC 30 %, fingolimod 3 % y otros 5 %. Conclusiones: las características clínicas y demográficas son similares a lo reportado en la literatura internacional. Se requieren más estudios para caracterizar mejor a la población mexicana con EM.

  13. [Prevalence of asthma and determination of symptoms as risk indicators].

    PubMed

    Mancilla-Hernández, Eleazar; Medina-Ávalos, Miguel Alejandro; Barnica-Alvarado, Raúl Humberto; Soto-Candia, Diego; Guerrero-Venegas, Rosario; Zecua-Nájera, Yahvéh

    2015-01-01

    Antecedentes: el asma es una enfermedad inflamatoria crónica de las vías aéreas, su prevalencia se ha incrementado especialmente en países industrializados. Los resultados de estudios de prevalencia del asma son variables en diferentes poblaciones y aun en un mismo país; en México hay fluctuaciones de la prevalencia del asma de 7 a 33%. Objetivo: determinar la prevalencia del asma y la magnitud de los síntomas como indicadores de riesgo en población escolar en ciudades de varios estados de México. Material y método: estudio descriptivo de la detección de prevalencia del asma y analítico-observacional comparativo de la determinación de los síntomas de esta afección. Se realizaron encuestas a población de los niveles educativos preescolar, primaria, secundaria y preparatoria en las ciudades de Puebla, Puebla; Tulancingo, Hidalgo; Tlaxcala, Tlaxcala, y Cancún, Quintana Roo. Como instrumento se usó un nuevo cuestionario validado: Cuestionario Diagnóstico de Asma para Estudios Epidemiológicos, conformado por ocho preguntas con valor sumatorio para su diagnóstico. Resultados: se obtuvieron 8,754 encuestas que mostraron una prevalencia en Puebla de 14%, en Tulancingo de 17%, en Tlaxcala de 7% y en Cancún de 14%; el promedio en las cuatro ciudades fue de 13%. La fuerza de asociación de los síntomas con asma en orden decreciente con razón de momios significativa fue: sibilancias recurrentes, dificultad respiratoria, opresión torácica, tos recurrente, tos con frío, cuadros catarrales recurrentes, tos de predominio nocturno y tos que aumenta con el ejercicio. Conclusiones: el promedio de la prevalencia del asma en las ciudades contempladas para las encuestas fue de 13% y los principales síntomas indicadores de riesgo de asma en población escolar fueron: sibilancias recurrentes, dificultad respiratoria, opresión torácica y tos recurrente.

  14. [Latex sensitization prevalence through prick test in patients with genitourinary malformations and more than 3 surgeries].

    PubMed

    Macías-Robles, Ana Paola; Morán-Mendoza, Ana Rocío

    2016-01-01

    Antecedentes: la alergia al látex tiene alta prevalencia en grupos de riesgo conocidos, especialmente en pacientes con espina bífida, malformaciones urinarias y ortopédicas con múltiples cirugías. En México no se cuenta con suficientes estudios que reporten la prevalencia y factores de riesgo asociados. Objetivo: determinar la prevalencia de sensibilización al látex mediante prueba de prick con extracto de látex en pacientes con malformaciones genitourinarias y más de tres cirugías en la Unidad Médica de Alta Especialidad de Pediatría del Centro Médico Nacional de Occidente, así como los factores asociados. Material y método: Se realizó un estudio transversal analítico y descriptivo, que incluyó hombres y mujeres de 1 a 16 años, con malformaciones genitourinarias y más de tres cirugías. Se aplicó una encuesta para conocer los factores de riesgo asociados y se realizó prueba cutánea por punción con extracto de látex, con control positivo y negativo. Se midieron niveles séricos de IgE total y eosinófilos en sangre periférica. Resultados: la prevalencia encontrada fue de 30.7% y los factores de riesgo asociados: atopia personal (p=0.047), antecedente de reacción previa con productos con látex (p=0.003), específicamente con globos (p=0.000) y guantes (p=0.002). No hubo asociación entre el número de cirugías e intervenciones quirúrgicas a edades tempranas, tampoco con concentraciones elevadas de IgE sérica total. Tuvieron reacción cruzada a frutas-látex 25% de los pacientes, los alimentos asociados fueron: aguacate, papaya, fresa y kiwi. Conclusión: la prevalencia de sensibilización al látex es alta en los grupos de riesgo, sobre todo con antecedente de atopia, por lo que es importante que el personal de salud identifique a estos pacientes a fin de implementar oportunamente las medidas de prevención primaria y secundaria; evitar efectos severos potencialmente mortales, como la anafilaxia, para disminuir la morbilidad y la

  15. PubMed

    Gómez, Luis Alberto; Montoya, Gladis; Rivera, Hernán Mauricio; Hernández, Juan Carlos

    2017-04-01

    Introducción. El virus del Zika (ZIKV) es un flavivirus con envoltura, transmitido a los seres humanos principalmente por el vector Aedes aegypti. La infección por ZIKV se ha asociado con un gran neurotropismo y con efectos neuropáticos, como el síndrome de Guillain-Barré en el adulto y la microcefalia fetal y posnatal, así como con un síndrome de infección congénita similar al producido por el virus de la rubéola (RV).Objetivo. Comparar las estructuras moleculares de la proteína de envoltura E del virus del Zika (E-ZIKV) y de la E1 del virus de la rubéola (E1-RV), y plantear posibles implicaciones en el neurotropismo y en las alteraciones del sistema nervioso asociadas con el ZIKV.Materiales y métodos. La secuencia de aminoácidos de la proteína E-ZIKV (PDB: 5iZ7) se alineó con la de la glucopreteína E1 del virus de la rubéola (PDB: 4ADG). Los elementos de la estructura secundaria se determinaron usando los programas Vector NTI Advance®, DSSP y POSA, así como herramientas de gestión de datos (AlignX®). Uno de los criterios principales de comparación y alineación fue la asignación de residuos estructuralmente equivalentes, con más de 70 % de identidad.Resultados. La organización estructural de la proteína E-ZIKV (PDB: 5iZ7) fue similar a la de E1-RV (PDB: 4ADG) (70 a 80 % de identidad), y se observó una correspondencia con la estructura definida para las glucoproteínas de fusión de membrana de clase II de los virus con envoltura. E-ZIKV y E1-RV exhibieron elementos estructurales de fusión muy conservados en la región distal del dominio II, asociados con la unión a los receptores celulares de entrada del virus de la rubéola (glucoproteína de mielina del oligodendrocito, Myelin Oligodendrocyte Glycoprotein, MOG), y con los receptores celulares Axl del ZIKV y de otros flavivirus.Conclusión. La comparación de las proteínas E-ZIKV y E1-RV es un paso necesario hacia la definición de otros factores moleculares determinantes del

  16. "...Una Etapa Siempre Dificil": Concepts of Adolescence and Programs of Secondary Education in Mexico.

    ERIC Educational Resources Information Center

    Levinson, Bradley A.

    An American visiting a Mexican secundaria (equivalent to the U.S. junior high school) noted the strong presence of discourses on "adolescence." This prompted an ideological and historical review of the secundaria since its development in the postrevolutionary ethos of the 1920s-30s. Inspired by a U.S. model of adolescent education in the…

  17. Template Based Design of Anti-Metastatic Drugs from the Active Conformation of Laminin Peptide II

    DTIC Science & Technology

    2001-01-01

    bind to positively charged side-chains (blue) and residues with negatively charged Primaria @ tissue culture 96-well plates as charged side-chains (red... Primaria " plate. Binding of the syn- heparan sulfate followed by peptide 11 elutions, thetic LBP205-2 9 peptide was quantitated using our LBP 2°5-229...Dynex Technologies, Inc. (Chantilly, VA). Positively na State University. The IgG fraction was purified using charged Primaria ®’ and standard Falcon

  18. The Understanding of Astronomy Concepts by Students from Basic Education of a Public School. (Spanish Title: El Entendimiento de Conceptos de Aastronmía Por Los Alumnos de Educación Básica en Una Escuela Pública.) O Entendimento de Conceitos de Astronomia Por Alunos da Educação Básica: O Caso de Uma Escola Pública Brasileira

    NASA Astrophysics Data System (ADS)

    Iria Machado, Daniel; dos Santos, Carlos

    2011-07-01

    We present the results obtained in a research on the comprehension of basic astronomical concepts, in which 561 students from fifth grade middle school to third grade high school of a public school of the city of Foz do Iguaçu (Brazil) took part. A test with 20 multiple-choice questions was applied to indentify the most common conceptions expressed by the students. This test was elaborated based on the literature about misconceptions and covered the following topics: the day-night cycle; the time zones; the seasons of the year; the phases of the Moon; the movement of the Moon; the apparent movement of the Sun in the celestial sphere; the eclipses; the dimensions and distances in the Universe; the brightness of the stars and its observation from Earth. Though a small progress was verified in the proportion of scientifically acceptable answers when comparing the eighth grade of middle school to the fifth, and the third grade of high school to the first, there was an overall predominance of alternative conceptions regarding most of the explored subjects, which persisted up to the last year of secondary school. The comparison to data found in this research made in other socio-cultural contexts revealed, in many aspects, similar notions and difficulties revealed by the students. Se presentan los resultados de una investigación sobre la comprensión de conceptos astronómicos básicos, en la cual participaron 561 estudiantes que cursaban entre el quinto grado de la enseñanza primaria y el tercer año de la enseñanza secundaria de una escuela pública de la ciudad de Foz do Iguaçu (Brasil). Se utilizó un test de 20 preguntas de opción múltiple para identificar las concepciones más comunes expresadas por los estudiantes. Este instrumento de recolección de datos se desarrolló en base a la literatura sobre las concepciones alternativas y trató los siguientes temas: el ciclo día-noche, los husos horarios, las estaciones del año, las fases de la Luna, el

  19. Targeting Stromal Recruitment by Prostate Cancer Cells

    DTIC Science & Technology

    2006-03-01

    Dr. Philip Beachy. Cells were plated in 10% FBS at 90% confluence in Primaria multiwell plates and attached overnight. Media was replaced with 1...FCS (as described for MEF isolation) for 48 h. They were then trypsinized and plated in Multiwell Primaria ™ 24 well plates (Falcon, Franklin Lakes

  20. Virulence Markers of Dengue Viruses

    DTIC Science & Technology

    1990-02-20

    for accurate detection of viral antigen by EIA, cells were cultured in specially treated tissue culture plates " Primaria " (Falcon product...Approximately 1 x 10 cells per well were plated into the 96 well " primaria " plates. Cell cultures were infected with several isolates of dengue-2 virus at the

  1. Neurotoxicity of Hemoglobin in Cortical Cell Culture

    DTIC Science & Technology

    1992-09-23

    suspension was plated on 24-well Primaria (Falcon) multiwell plates at a density of 0.5 hemisphere per plate. Exposure of mixed neuronal and glial...fetal bovine serum, 10% horse serum, and epidermal growth factor (10 ng/ml). The cell suspension was plated on 15 mm Primaria (Falcon) multiwell

  2. Promoting Learner Autonomy through Teacher-Student Partnership Assessment in an American High School: A Cycle of Action Research (El papel de la evaluación negociada en el desarrollo de la autonomía del estudiante en la escuela secundaria norteamericana: un ciclo de investigación-acción)

    ERIC Educational Resources Information Center

    Picón Jácome, Édgar

    2012-01-01

    In this article I present some findings of an action research study intended to find out to what extent a teacher-student partnership in writing assessment could promote high school students' autonomy. The study was conducted in a U.S. school. Two main action strategies in the assessment process were the use of symbols as the form of feedback…

  3. El Cambiante panorama demografico de la poblacion estudiantil en los departamentos de lenguas: soluciones efectivas a nivel universitario y recomendaciones para su implementacion en la escuela secundaria (The Changing Demographics of the Student Population in Foreign Language Departments: Effective University-Level Solutions and Recommendations for Their Implementation in Secondary Schools).

    ERIC Educational Resources Information Center

    Castro, Obdulia

    2002-01-01

    Describes an interdisciplinary program offering modified Spanish classes to students with special needs. Through preliminary identification, eligible students are signed up for classes. Exemplifies an effective way to confront problems related to a more diverse student population; to comply with regulations imposed by the Americans with…

  4. El Cambiante panorama demografico de la poblacion estudiantil en los departamentos de lenguas: soluciones efectivas a nivel universitario y recomendaciones para su implementacion en la escuela secundaria (The Changing Demographics of the Student Population in Foreign Language Departments: Effective University-Level Solutions and Recommendations for Their Implementation in Secondary Schools).

    ERIC Educational Resources Information Center

    Castro, Obdulia

    2002-01-01

    Describes an interdisciplinary program offering modified Spanish classes to students with special needs. Through preliminary identification, eligible students are signed up for classes. Exemplifies an effective way to confront problems related to a more diverse student population; to comply with regulations imposed by the Americans with…

  5. Astronomy in High School: Using a Mini-Planetarium to Understand Details of the Apparent Movement of Stars. (Spanish Title: Astronomía en la Escuela Secundaria: Comprendiendo los Detalles del Movimiento Aparente de Las Estrellas con un Miniplanetario.) Astronomia no Ensino Médio: Compreendendo Detalhes do Movimento Aparente das Estrelas com um Miniplanetário

    NASA Astrophysics Data System (ADS)

    dos Santos Leão, Demetrius

    2013-07-01

    The aim of this article is to present part of the results obtained by the intervention made from the author's Master degree project, which consisted in the development of a set of Astronomy classes for first year of High School students from a private school in the "Distrito Federal", Brasilia, Brazil, making use of a didactical material called mini-planetarium (MP) as the main resource. Using Paulo Freire's contextualization and dialogicity ideas as a theoretical framework guided by these lessons, it was proposed to the students the assembly and application of that resource in a planetarium session. During the project, some subjects such as the apparent trajectory of stars through Brasilia's sky, the location of the cardinal points beginning from the Southern Cross constellation, the color of stars and the stars being seen from a particular place were emphasized. It was found that the students showed an improvement of their understanding about these subjects, as well as a significant excitement with the developed methodology. El objetivo de este trabajo es presentar algunos de los resultados obtenidos en el proyecto de la tesis de maestría del autor, que incluyó el desarrollo de algunas clases de Astronomía, con estudiantes del primer año del bachillerato de una escuela privada del Distrito Federal (Brasilia, Brasil), utilizando como materia prima didáctica el recurso llamado miniplanetario (MP). Utilizando como base teórica orientadora de esas clases las ideas de contextualización y dialógica de Paulo Freire, fue propuesto a los estudiantes el montaje y la utilización de este recurso en una función de planetario. Durante el proyecto, se enfatizaron asuntos tales como la trayectoria aparente de las estrellas del cielo de Brasilia, la ubicación de los puntos cardinales a partir de la constelación de la Cruz del Sur, los colores de las estrellas y las estrellas vistas desde una localidad determinada. Se constató que los estudiantes mostraron una mejora en la comprensión de estas cuestiones y demostraron un gran interés por esta metodología. O objetivo deste artigo é apresentar parte dos resultados obtidos com a intervenção feita como projeto da dissertação de mestrado do autor, que consistiu no desenvolvimento de um conjunto de aulas de Astronomia, com alunos do 1º Ano do Ensino Médio de uma escola da rede privada do Distrito Federal (Brasília, Brasil), empregando como recurso principal um material didático chamado miniplanetário (MP). Utilizando como pressuposto teórico norteador dessas aulas as ideias de contextualização e dialogicidade de Paulo Freire, foi proposta aos estudantes a montagem e utilização desse recurso em uma sessão de planetário. Durante o projeto, enfatizaram-se assuntos como a trajetória aparente das estrelas para o céu de Brasília, a localização dos pontos cardeais a partir da constelação do Cruzeiro do Sul, as cores das estrelas e as estrelas vistas de uma determinada localidade. Apurou-se que os alunos apresentaram melhoria na compreensão desses assuntos, bem como demonstraram expressiva empolgação com essa metodologia desenvolvida.

  6. English-as-a-Second-Language Programs in Basic Skills Education Program 1. Appendix

    DTIC Science & Technology

    1984-01-01

    vocacional-- universidad (programa de dos aftos)- iziiversidad (programa de cuatro afios) ___ _____ ______ ~4. &Cuinto ing1~s sabia uuted antes de...gue pas? escuela secundaria, (high school)- escuela vocacional _____ ______ universidad (prograzia de don aflos-- universidad (program de cuatro affos

  7. Higher levels of C-reactive protein associated with higher adiposity in mexican schoolchildren.

    PubMed

    López-Alcaraz, Fátima; Del Toro-Equihua, Mario; Orta-Duarte, Mariana; Flores-Ruelas, Yunue; Sánchez-Ramírez, Carmen Alicia

    2014-03-01

    Introducción: Las enfermedades crónico-degenerativas, secundarias a la obesidad en niños, ha alertado a los profesionales de la salud sobre la importancia de identificar los factores de riesgo asociados a obesidad y establecer un enfoque preventivo para reducir el riesgo de complicaciones. Algunos estudios realizados en población pediátrica han estudiado el papel de los biomarcadores inflamatorios [específicamente proteína C-reactiva (PCR) y factor de necrosis tumoral alfa (TNF-)] asociado a adiposidad con resultados inconsistentes. Objetivo: Evaluar la relación entre los niveles séricos de PCR y TNF-con adiposidad determinada mediante impedancia bioeléctrica en niños en edad escolar. Métodos: Diseño transversal analítico. Se recopilaron los datos de 74 alumnos seleccionados al azar en una escuela primaria local en la ciudad de Colima, México. La edad media fue de 9,4 años (1.5 DE), treinta y tres (44.6%) fueron niñas. La adiposidad (porcentaje de grasa) se midió mediante impedancia bioeléctrica y antropometría. La PCR y TNF-séricos se determinaron con el ensayo por inmunoabsorción ligado a enzimas (ELISA). Las comparaciones de las variables entre los grupos se analizaron con pruebas no paramétricas (U de Mann Whitney y Kruskall Wallis) y la correlación de Pearson. Resultados: Los niños con obesidad presentaron un nivel sérico [2,90 mg/L (0,07-9,37)] significativamente más alto de PCR en comparación con los niños con un porcentaje normal de grasa [0,71 mg/L (0,07-5,75)] (p < 0,001). Con respecto a los niveles séricos de TNF-no se identificaron diferencias entre los grupos estudiados. Se obtuvieron correlaciones modestas entre los niveles séricos de PCR con la adiposidad determinado por impedancia bioeléctrica (r = 0,453, p < 0,001); índice de masa corporal (r = 0,398, p = 0,001); pliegue cutáneo tricipital (r = 0,369, p = 0,002), y pliegue cutáneo subescapular (r = 0,405, p < 0,001). No se encontró correlaci

  8. The Impact of Regional Differences on Elementary School Teachers' Attitudes towards Their Students' Use of Code Switching in a South Texas School District (El impacto de las diferencias regionales en las actitudes de docentes de primaria respecto a la alternancia de códigos por parte de los estudiantes en un distrito escolar del sur de Texas)

    ERIC Educational Resources Information Center

    Nava Gómez, Guadalupe Nancy; García, Hilda

    2012-01-01

    This study focused on investigating whether the teachers' geographical distribution influences their attitudes towards their students' use of code switching. The study was guided by the following research question: Are there differences between teachers' opinions of the north elementary schools and teachers' opinions of the south elementary…

  9. Teaching of Astronomy: Scenarios of Teaching Practice in Elementary Schools. (Spanish Title: Enseñanza de la Astronomía: Semblanzas de la Práctica Docente en Educación Primaria.) Ensino de Astronomia: Cenários da Prática Docente no Ensino Fundamental

    NASA Astrophysics Data System (ADS)

    Marchi Gonzatti, Sônia Elisa; Spessatto De Maman, Andréia; Fernandes Borragini, Eliana; Kerber, Júlia Cristina; Haetinger, Werner

    2013-12-01

    The present work presents the main results of a research carried out within the Astronomy Education field with Elementary School teachers from two regions of Rio Grande do Sul. The study aimed to show the regional panorama of teaching Astronomy compared to the national panorama already discussed in several studies in the area. It was divided into three main issues: identifying the main topics of Astronomy developed in class, verifying which were the methodological strategies used, and which were the difficulties teachers faced when developing their practice. Regarding the contents, it was found a wide range of covered topics although Earth motion and astronomical phenomena were cited by most participants. Concerning the strategies used in class, two-dimensional resources such as movies, texts, maps and web searching were mainly used. The most relevant difficulties were the lack of specific education related to Astronomy contents and abstraction level, which complicated the understanding for both students and teachers. In general, the indicators met the results already found in other studies that investigated Astronomy teaching practice, in which the teacher's original education deficiency - or even the lack of it - hampers the proper development of Astronomy contents in class. En este trabajo se presentan los principales resultados de una investigación hecha en el campo de la Educación en Astronomía, con profesores de la Enseñanza Fundamental de dos regiones de Rio Grande do Sul. El presente estudio tuvo como objetivo caracterizar el panorama regional de la enseñanza de Astronomía, estableciendo una comparación con el panorama nacional ya presentado en trabajos de referencia en el área. Ese estudio abordó tres cuestiones: identificar los principales temas de astronomía trabajados, las estrategias metodológicas y cuáles fueron las dificultades sufridas por los profesores al presentar su práctica. Con relación a los contenidos, se encontró una atomización de los asuntos, aunque temas como movimientos de la Tierra y fenómenos astronómicos hayan sido citados por la mayoría de los participantes. En cuanto a las estrategias, se verifico que se emplean principalmente clases con el apoyo de recursos bidimensionales, como películas, textos, mapas y búsqueda en internet. Las principales dificultades fueron la falta de formación específica con respecto a los contenidos de Astronomía, y el nivel de abstracción exigido por los contenidos. De modo general, esos indicadores convergen para los resultados ya encontrados en otros estudios, en el que las deficiencias de la formación inicial de los profesores, o incluso su ausencia, dificulta el adecuado abordaje de la Astronomía en las clases. Neste trabalho são apresentados os principais resultados de uma investigação realizada no campo da Educação em Astronomia, com professores do ensino fundamental de duas regiões do Rio Grande do Sul. O objetivo do estudo foi caracterizar o cenário regional do ensino de Astronomia, estabelecendo um comparativo com o cenário nacional. Esse estudo abordou três questões: identificar os principais temas de astronomia trabalhados em sala de aula, as estratégias metodológicas e quais as dificuldades apresentadas pelos professores ao desenvolver sua prática. Quanto aos conteúdos, encontrouse uma pulverização dos assuntos abordados, embora temas como movimentos da Terra e fenômenos astronômicos tenham sido citados pela maioria dos participantes. Sobre estratégias, são utilizadas principalmente aulas com apoio de recursos bidimensionais, como filmes, textos, mapas e pesquisa na internet. As principais dificuldades foram: falta de formação específica em relação a conteúdos de Astronomia; nível de abstração dos conteúdos, que dificultam sua compreensão, tanto pelos alunos quanto pelos próprios professores. De maneira geral, esses indicadores convergem para resultados já encontrados em outros estudos que investigam a prática docente em Astronomia, em que as deficiências da formação inicial dos professores, ou mesmo a falta dela, dificulta a adequada abordagem da Astronomia em sala de aula.

  10. Mejoramiento de la Produccion de Materiales de Educacion en Poblacion para la Ensenanza Primaria y la Post-Alfabetizacion. Taller Regional (Santiago, Chile, 27 mayo-5 junio, 1987). Informe Final (Upgrading the Production of Population Education Materials for Primary Education and Post-Literacy. Regional Workshop (Santiago, Chile, May 27-June 5, 1987). Final Report.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

    This report contains the results of an operational training workshop covering 11 case studies on the production of teaching materials for population education and used for elementary education, literacy, and post-literacy programs. The workshop covered the planning and design for the production of teaching materials including an eight step…

  11. Lo que los Padres Necesitan Saber sobre...Reconocer y Animar los Intereses, las Capacidades, y los Talentos de los Ninos Dotados de la Escuela Primaria. Guia Practica B0213 (What Parents Need To Know about...Recognizing and Encouraging Interests, Strengths, and Talents of Gifted Elementary School Children. Practitioners' Guide B0213).

    ERIC Educational Resources Information Center

    Delcourt, Marcia A. B.

    This brochure, written in Spanish, discusses strategies that Spanish-speaking parents can use to support the interests of their children and how to recognize and extend their children's talents. Parents are urged to: (1) be aware of what their child likes to do and be patient with the changing patterns as the child explores areas of interests and…

  12. Attending School and Learning or Repeating and Leaving. A Study about the Determinants of Grade Repetition and Dropout in Primary School in Honduras. Synthesis of the Study = Asistir y Aprender o Repetir y Desertar. Un Estudio sobre los Factores que Contribuyen a la Repitencia en la Escuela Primaria en Honduras. Sintesis del Informe.

    ERIC Educational Resources Information Center

    McGinn, Noel F.; And Others

    This paper synthesizes a study designed to identify the factors that contribute to primary school repetition and dropout in Honduras. Data were collected by record reviews; teacher, student, and parent interviews; and a test of Spanish. The sample included 1,253 students in grades 1 and 3 in 40 schools in rural Honduras. The main findings of the…

  13. When Theory Meets Practice: Applying Cambourne's Conditions for Learning to Professional Development for Elementary School EFL Teachers (Cuando la teoría y la práctica se encuentran: implementación de las condiciones de aprendizaje de Cambourne en el desarrollo profesional de docentes de inglés de la básica primaria)

    ERIC Educational Resources Information Center

    Cadavid Múnera, Isabel Cristina; Díaz Mosquera, Claudia Patricia; Quinchía Ortiz, Diana Isabel

    2011-01-01

    This article presents a reflection on an action research project carried out by a group of teachers and students at Universidad de Antioquia. The action research project aimed at determining the impact of a professional development proposal for elementary school English teachers in Medellin, Colombia. In the first section, the article describes…

  14. The Role of Songs in First-Graders' Oral Communication Development in English (El papel de las canciones en el desarrollo de la comunicación oral en inglés de niños de primero de primaria)

    ERIC Educational Resources Information Center

    Castro Huertas, Ivon Aleida; Navarro Parra, Lina Jazmín

    2014-01-01

    We report on an action research project aimed at developing oral communication in first-graders, using songs as a strategy for young learners to use and enjoy English. It was developed at a Colombian public school over three months. The teacher-researchers attempted to encourage students using simple and amusing songs to help them learn new…

  15. Mejoramiento de la Produccion de Materiales de Educacion en Poblacion para la Ensenanza Primaria y la Post-Alfabetizacion. Taller Regional (Santiago, Chile, 27 mayo-5 junio, 1987). Informe Final (Upgrading the Production of Population Education Materials for Primary Education and Post-Literacy. Regional Workshop (Santiago, Chile, May 27-June 5, 1987). Final Report.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

    This report contains the results of an operational training workshop covering 11 case studies on the production of teaching materials for population education and used for elementary education, literacy, and post-literacy programs. The workshop covered the planning and design for the production of teaching materials including an eight step…

  16. Tabla de Especificaciones e Instructivo sobre Elaboracion de Pruebas Objetivas en la Ensenanza Primaria, para las asignaturas de Estudios Sociales, Idioma Espanol, Matematicas y Ciencias Naturales (Specification Tables and Instructions for the Construction of Objective Tests in the Primary Grades in Social Studies, Spanish, Mathematics, and Natural Sciences).

    ERIC Educational Resources Information Center

    Ministerio de Educacion, Guatemala City (Guatemala). Direccion de Bienestar Estudiantil y Educacion Especial.

    This booklet presents specification tables illustrating the relative importance given to topics on tests within a particular subject area. The general subject areas are social studies, Spanish, mathematics, and natural sciences. Tables are provided for final exams in each of these areas for several primary grades, illustrating the importance of…

  17. Difficulties of First Years Elementary School Teachers with the Teaching of Astronomy. (Breton Title: Dificuldades de Professores dos Anos Iniciais do Ensino Fundamental em Relação ao Ensino da Astronomia. ) Dificultades de LOS Profesores de los Primeros Años de la Escuela Primaria en Relación a la Enseñanza de la Astronomía

    NASA Astrophysics Data System (ADS)

    Langhi, Rodolfo; Nardi, Roberto

    2005-12-01

    This paper reports Primary School teachers' discourses analysis about their difficulties related to the teaching of Astronomy. It reports partial data of a master's level research carried out in the last two years, named "An exploratory study for inserting Astronomy in primary school teachers' education" (LANGHI, 2004). The study took into consideration students' and teachers' common sense conceptions about astronomical phenomena, conceptual mistakes in textbooks, and Astronomy's suggestions given by the PCN (Parâmetros Curriculares Nacionais - The Brazilian National Curriculum Standards). The paper aims to characterize teachers' difficulties, in order to provide subsides to the implementation of an initial or continuing education program. This study is justified by the fact that courses plans like these only will be adapted to the teacher's (and students') reality, if there is a primary investigation about what the teachers really need to know about Astronomy. This fact was possible here by the enunciations interpretation of a teachers' sample using semi-structured interviews, according to discourse analysis procedures. The research outcomes show difficulties related to factors like: those of personal order, methodological, on teacher's formation, educational infrastructure and other related to information sources for educators. Este artigo, que relata as dificuldades de professores em relação ao ensino da Astronomia, faz parte de um estudo exploratório para a inserção da Astronomia na formação de professores dos anos iniciais do Ensino Fundamental. Esse estudo leva em consideração as concepções alternativas de alunos e professores sobre fenômenos astronômicos, os erros conceituais em livros didáticos e as sugestões de conteúdos de Astronomia constantes nos PCN (Parâmetros Curriculares Nacionais). Caracterizar as dificuldades dos professores é a questão central deste texto, apontando para o objetivo de contribuir com subsídios para um futuro programa de formação continuada neste tema. O estudo se justifica mediante o fato de que planejamentos de cursos como estes só se adequarão à realidade do professor (e do aluno) se houver uma investigação antecipada sobre o que os docentes precisam saber e saber fazer a respeito da Astronomia, o que se concretizou em nosso caso pela interpretação dos discursos de uma amostra de professores coletados através de entrevistas semi-estruturadas, utilizando para interpretação os princípios e métodos da análise do discurso em sua linha francesa. Os resultados da pesquisa indicaram dificuldades de ordem pessoal, metodológica, de formação, de infra-estrutura e outras relacionadas às fontes de informações para docentes. Este artículo que relata las dificultades de los profesores en relación a la enseñanza da laAstronomía es parte de un estudio preliminar para la implantación dela Astrnomía enla formación de profesores de ls primeros años del ciclo primario.El estudio considera las concepciones alternativas de alumnos y profesores respecto a los fenómenos astronómicos, los errores conceptuales en los libros didácticos y las sugerencias de contenidos de Astronomía que constan en los Parámetros Curriculares Nacionales del Brasil. Caracterizar las dificultades de los profesores constituye la cuestión central de este texto, apuntando para el objetivo de contribuir para un futuro programa de educación contínua en este tema. El estudio se justifica mediante el hecho que la planificación de cursos de este tipo solo se adecuarán a la realidade del profesor (y del alumno) si existe una investigación anterior a respecto de lo que los docentes precisan saber y saber realizar en Astronomía, lo cual se concretó en nuestro caso por medio de la interpretación de los discursos de una muestra de profesores obtenidos através de entrevistas semiestructuradas, utilizand para esta interpretación los principios y métodos de análisis del discurso en su línea francesa. Los resultados mostraron dificultades de orden personal, metodológica, formativa, de infraestructura y otras relacionadas a las fuentes de información para los docentes.

  18. [Referral criteria for benign prostatic hyperplasia in primary care.Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina General, Sociedad Española de Medicina de Familia y Comunitaria, Asociación Española de Urología].

    PubMed

    Castiñeiras Fernández, J; Cozar Olmo, J M; Fernández-Pro, A; Martín, J A; Brenes Bermúdez, F J; Naval Pulido, E; Molero, J M; Pérez Morales, D

    2010-01-01

    Benign prostatic hyperplasia (BPH) is a high prevalence condition in men over 50 years that requires continued assistance between primary care and urology. Therefore, consensus around common referral criteria was needed to guide and support both levels. Medical history, symptom assessment with International Prostate Symptom Score (IPSS) questionnaire, digital rectal examination and prostate-specific antigen (PSA) measurement are diagnostic tests available for general practitioners that allow setting a correct BPH diagnose. Patients with an IPSS<8 should be monitored by evaluating them annually. Treatment with alpha-blockers and an evaluation at the first and third month is recommended in patients with an IPSS 8-20 and if the prostate is small, if the prostate size is large treatment with alpha-blockers or 5alpha-reductase inhibitors and evaluation at the third and six month is recommended, and in patients with a large prostate and a PSA >1.5 ng/ ml combined treatment and evaluation at the first and sixth month is recommended. Some clear criteria for referral to urology are established in this document, which help in the management of these patients. Those patients with BPH who do not show any improvement at the third month of treatment with alpha-blockers, or the sixth month with 5alpha-reductase inhibitors, will be referred to urology. Patients will also be referred to urology if they have lower urinary tract symptoms, a pathological finding during rectal examination, IPSS>20, PSA>10 ng/ml or PSA>4 ng/ml and free PSA<20% or if they are <50 years with suspected BHP, or if they have any urological complication.

  19. Attending School and Learning or Repeating and Leaving. A Study about the Determinants of Grade Repetition and Dropout in Primary School in Honduras. Synthesis of the Study = Asistir y Aprender o Repetir y Desertar. Un Estudio sobre los Factores que Contribuyen a la Repitencia en la Escuela Primaria en Honduras. Sintesis del Informe.

    ERIC Educational Resources Information Center

    McGinn, Noel F.; And Others

    This paper synthesizes a study designed to identify the factors that contribute to primary school repetition and dropout in Honduras. Data were collected by record reviews; teacher, student, and parent interviews; and a test of Spanish. The sample included 1,253 students in grades 1 and 3 in 40 schools in rural Honduras. The main findings of the…

  20. [Adverse effects with ambulatory intravenous immunoglobulin administration in adult patients with common variable immunodeficiency].

    PubMed

    Rodríguez-Mireles, Karen A; Galguera-Sauceda, Angélica; Gaspar-López, Arturo; López-Rocha, Eunice G; Campos-Romero, Freya; Del Rivero-Hernández, Leonel; Amaya-Mejía, Adela; Galindo-Pacheco, Lucy; O'Farril-Romanillos, Patricia; Segura-Méndez, Nora Hilda

    2014-01-01

    Antecedentes: la inmunodeficiencia común variable es la inmunodeficiencia primaria sintomática más frecuente, afecta a 1 por cada 25,000 a 75,000 sujetos. Se distingue por la ausencia o disminución de anticuerpos. Su tratamiento consiste en el reemplazo de anticuerpos con inmunoglobulina humana y la vía de administración más frecuente es la intravenosa, a dosis de 400 a 800 mg/kg de peso/dosis cada tres a cuatro semanas. Los efectos adversos asociados con la administración de inmunoglobulina intravenosa (IgIV) ocurren incluso en 25% de todas las infusiones realizadas, las reacciones severas afectan a menos de 1% de los pacientes. Entre las reacciones adversas severas están la insuficiencia renal aguda, que sobreviene 1 a 10 días después del inicio de tratamiento con IgIV. En nuestro centro elaboramos e implementamos un esquema ambulatorio para la aplicación de IgIV que permite su administración en un promedio de 3 h, sin efectos adversos graves. Objetivos: describir los efectos adversos y evaluar la frecuencia de insuficiencia renal secundaria a la aplicación ambulatoria de IgIV en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo y prospectivo en el que participaron pacientes adultos con diagnóstico definitivo de inmunodeficiencia común variable, que recibían IgIV a dosis de sustitución cada tres semanas, a quienes se realizó exploración física, somatometría, determinación sérica de creatinina, albúmina y urea, depuración de creatinina en orina de 24 horas, cálculo de la tasa de filtración glomerular por la fórmula CKD-EPI y evaluación de la función renal inmediata, así como la asociada con la administración acumulada de IgIV a través del cálculo de la tasa de filtración glomerular. Los resultados se analizaron con estadística descriptiva para el reporte de los efectos en la función renal y la dosis acumulada de IgIV. Resultados: se determinó la frecuencia de reacciones adversas

  1. Cuba, Are Sanctions Working?

    DTIC Science & Technology

    2007-11-02

    1993), 870. 50 Ló pez, 4; quoted in Claudia Ma´rguez Linares, Encuesta informal sobre la atención mé dica primaria en Cuba, (CubaNet, 23 March...University Press, 2002. 4. Quoted in Claudia Ma´rguez Linares, Encuesta informal sobre la atencio´n me´dica primaria en Cuba. CubaNet, 23 March 2001

  2. [Study of the diagnostic agreement on headaches between neurology and primary care].

    PubMed

    Santos-Lasaosa, S; Vinueza-Buitron, P R; Velazquez-Benito, A; Iniguez-Martinez, C; Larrode-Pellicer, P; Lopez Del Val, L J; Mauri-Llerda, J A; Sanchez-Valiente, S; Millan-Morales, J L

    2016-06-16

    Introduccion. La cefalea como sintoma es una patologia frecuente y uno de los principales motivos de consulta por parte de atencion primaria. Objetivo. Analizar las caracteristicas de los pacientes derivados desde atencion primaria a la consulta de neurologia general con cefalea o neuralgia como motivo de consulta, y la concordancia diagnostica. Pacientes y metodos. Estudio descriptivo transversal de todos los pacientes remitidos desde atencion primaria; se recogieron variables demograficas/clinicas y se compararon las hipotesis diagnosticas de atencion primaria y neurologia, determinando su concordancia. Resultados. Se remitieron desde atencion primaria 2.514 pacientes (588 de ellos con caracter preferente); en 378 casos el motivo de la consulta fue cefalea o neuralgia (42,46 años de media; el 77,8%, mujeres). En 139 pacientes se establecio tan solo un diagnostico semiologico y en el resto predominaron la migraña episodica (49,79%), la cefalea tensional cronica (18,41%) y la neuralgia del trigemino (12,13%). Desde neurologia, los diagnosticos mas frecuentes fueron, respectivamente, 33,86%, 24,05% y 18,67%. Se obtuvo un coeficiente kappa de 0,543 (p < 0,05), compatible con una concordancia moderada al considerar solo los pacientes remitidos desde atencion primaria con un diagnostico concreto. Conclusiones. Las cefaleas constituyen un motivo de consulta desde atencion primaria muy frecuente (15%). La concordancia diagnostica es moderada en nuestro sector sanitario, por lo que es necesario diseñar programas de formacion que ayuden a perfilar los criterios de derivacion al especialista y mejorar la atencion a nuestros pacientes.

  3. Prevalence of obesity among secondary school students from 2009 to 2014 in China: a meta-analysis.

    PubMed

    Dai, Ning; Tian, Li; Tao, Tao; Li, Tongda; Tang, Tianmiao; Sheng, Ying; Lu, XiaoQian; Tang, Xue; Peng, Baozhen; Lu, Wei; Jin, Yuelong; He, Lianping; Yao, Yingshui

    2014-12-17

    Antecedentes: En los últimos años, la obesidad es un importante problema de salud pública en muchos países. Se calcula que el 8% de los niños son obesos.Sin embargo, poco se sabe acerca de la prevalencia de la obesidad entre los alumnos de secundaria en China, el objetivo de este estudio fue evaluar la prevalencia de la obesidad en general chino, estudiante de la escuela secundaria. Métodos: Publicaciones de 2009 a 2014 en la prevalencia de obesidad entre los estudiantes de la escuela secundaria en China fueron recuperados de PubMed, Online Chinese periódico de bases de datos de texto completo de VIP, CNKI y Wan Fang.Analista del meta fue utilizado analizar el total de las tasas de obesidad para chinos de la escuela secundaria. Resultados: Después de la evaluación de la calidad de los artículos, 33 papeles fueron finalmente incluidos en nuestro estudio, y el total de los tamaños de muestra sobre la obesidad investigación fueron 218317 (107631 macho y 110686 hembra), en la que 27455 (14863 macho y 12590 mujeres) fueron la obesidad.Los resultados mostraron que el analista del meta la prevalencia de la obesidad en estudiantes de secundaria son 8,4% (IC del 95%: 6,2% - 11,3%) y 4,8% (IC del 95%: 3,2% - 7,2%) para chico y chica, respectivamente. Conclusión: Nuestros resultados sugieren que la escuela y Gobierno related Departamento debería prestar más atención a la obesidad entre los estudiantes de la escuela secundaria en China, y tomar algunas medidas adecuadamente a la curva de la tendencia de crecimiento de la obesidad.

  4. Impurity Aggregation Processes and Mechanical behavior in Solid Dielectrics.

    DTIC Science & Technology

    1981-11-30

    8217 Department Optica y Estructura de Area & Work Unit Numrbers la Materia P.E.: 61102F Universidad Autdnoma de Madrid / Proj/Tsk: 2301/DI CantoblancQ...0115 IMPURITY AGGREGATION PROCESSES AND MECHANICAL BEHAVIOR IN SOLID:DIELECTRICS Fernando Agull6-L6pez N, Departamento de Optica y Estructura de la

  5. Vouchers for Private Schooling in Colombia: Evidence from a Randomized Natural Experiment. NBER Working Paper Series.

    ERIC Educational Resources Information Center

    Angrist, Joshua D.; Bettinger, Eric; Bloom, Erik; King, Elizabeth; Kremer, Michael

    This paper examines the impact of Colombia's Programa de Ampliacion de Cobertura de la Educacion Secundaria (PACES), which provided over 125,000 poor students with private secondary school vouchers, many of which were awarded by lottery. Researchers surveyed lottery winners and losers to compare educational and other outcomes. Results showed no…

  6. Extra-Curricular Activities and Academic Performance in Secondary Students

    ERIC Educational Resources Information Center

    Moriana, Juan Antonio; Alos, Francisco; Alcala, Rocio; Pino, Maria-Jose; Herruzo, Javier; Ruiz, Rosario

    2006-01-01

    Introduction: In this paper we study the possible influence of extra-curricular activities (study-related and/or sports) on academic performance of first- and second-year pupils in "Educacion Secundaria Obligatoria (ESO)" [N.T. seventh- and eighth-graders]. Method: We randomly selected 12 schools in the city (9 public and 3 private), and…

  7. Sociopersonal Values and Coexistence Problems in Secondary Education

    ERIC Educational Resources Information Center

    de la Fuente, Jesus; Peralta, Francisco Javier; Sanchez, Maria Dolores

    2006-01-01

    Introduction: The importance of values education in current society continues to be one of the greatest challenges to our Educational System. Its pertinence becomes no less than inexcusable when we speak of education in social values during adolescence, or, during "Educacion Secundaria Obligatoria" ["N.T." Mandatory Secondary…

  8. "Una etapa siempre dificil": Concepts of Adolescence and Secondary Education in Mexico.

    ERIC Educational Resources Information Center

    Levinson, Bradley A.

    1999-01-01

    Draws on ethnographic observations, historical sources, and official documents to examine the historical and contemporary connections among the Mexican "secundaria" (junior high school), the broader ideological and political-economic context of Mexican educational development, and concepts of adolescence in both expert discourse and…

  9. Sociopersonal Values and Coexistence Problems in Secondary Education

    ERIC Educational Resources Information Center

    de la Fuente, Jesus; Peralta, Francisco Javier; Sanchez, Maria Dolores

    2006-01-01

    Introduction: The importance of values education in current society continues to be one of the greatest challenges to our Educational System. Its pertinence becomes no less than inexcusable when we speak of education in social values during adolescence, or, during "Educacion Secundaria Obligatoria" ["N.T." Mandatory Secondary…

  10. Extra-Curricular Activities and Academic Performance in Secondary Students

    ERIC Educational Resources Information Center

    Moriana, Juan Antonio; Alos, Francisco; Alcala, Rocio; Pino, Maria-Jose; Herruzo, Javier; Ruiz, Rosario

    2006-01-01

    Introduction: In this paper we study the possible influence of extra-curricular activities (study-related and/or sports) on academic performance of first- and second-year pupils in "Educacion Secundaria Obligatoria (ESO)" [N.T. seventh- and eighth-graders]. Method: We randomly selected 12 schools in the city (9 public and 3 private), and…

  11. Recipients, Agents, or Partners?: The Contradictions of Teacher Participation in Mexican Secondary Education Reform

    ERIC Educational Resources Information Center

    Levinson, Bradley A.; Blackwood, Janet; Cross, Valerie

    2013-01-01

    The countries of Latin America have been no exception to global calls for educational transformation and teacher professionalization at the secondary level. One of the newest of these reforms is Mexico's Reforma de la Educacion Secundaria (RS) (Reform of Secondary Education), launched in 2006. This article examines portrayals by various actors of…

  12. "Una etapa siempre dificil": Concepts of Adolescence and Secondary Education in Mexico.

    ERIC Educational Resources Information Center

    Levinson, Bradley A.

    1999-01-01

    Draws on ethnographic observations, historical sources, and official documents to examine the historical and contemporary connections among the Mexican "secundaria" (junior high school), the broader ideological and political-economic context of Mexican educational development, and concepts of adolescence in both expert discourse and…

  13. "Do U txt?" -- Using "Txting" to Learn Maternal Languages: A Portuguese Case Study

    ERIC Educational Resources Information Center

    Moreira, Sandra Cortes; Gomez, Ignacio Aguaded

    2011-01-01

    Analysing the influence of new technologies/media (e.g., mobile phones, chats, instant messaging services) on the use and learning of maternal languages basic rules is the goal of this investigation, involving teachers and students (10th, 11th and 12th grade pupils, aged between 16 and 21) at the "Escola Secundaria de Silves" -- ESS…

  14. Recipients, Agents, or Partners?: The Contradictions of Teacher Participation in Mexican Secondary Education Reform

    ERIC Educational Resources Information Center

    Levinson, Bradley A.; Blackwood, Janet; Cross, Valerie

    2013-01-01

    The countries of Latin America have been no exception to global calls for educational transformation and teacher professionalization at the secondary level. One of the newest of these reforms is Mexico's Reforma de la Educacion Secundaria (RS) (Reform of Secondary Education), launched in 2006. This article examines portrayals by various actors of…

  15. The significance of microbial processes in hydrogeology and geochemistry

    NASA Astrophysics Data System (ADS)

    Chapelle, Francis H.

    dar lugar a una mayor solubilidad del mineral, lo que supone un aumento en porosidad secundaria y permeabilidad. Por el contrario, los procesos microbianos pueden dar lugar a la producción de carbonato, ión ferroso y sulfuro, precipitando calcita o pirita y reduciendo la porosidad primaria y la permeabilidad.

  16. Observing Sites in NW Argentina

    NASA Astrophysics Data System (ADS)

    Muriel, H.

    En esta comunicacion se propone revisar la importancia que los grandes relevamientos de galaxias y los diferentes catalogos que de ellos se derivan, tienen en los estudios sobre estructura y evolucion del Universo.

  17. War of the Masses: a Component of Guerrilla Warfare.

    DTIC Science & Technology

    2016-05-10

    Estructuras Funcionales,” Revista Semana, September 01, 2007, accessed September 14, 2015, http://www.semana.com/opinion/articulo/dos-estructuras...accessed November 5, 2015, http://www.lahaine.org/internacional/uribe.htm. 52 Paul Rossel, “Carl Von Clausewitz y la teoría de la guerra,” Eco. Revista ...independencia: un análisis al movimiento Colombiano Marcha Patriótica,” Protestantismo Em Revista 36, (2015): 104, accessed November 23, 2015, http

  18. An Overall View of English in Mexico.

    ERIC Educational Resources Information Center

    Scott, Grace C.

    At pre-primary and primary levels in Mexico there are 50,000 schools, where English is not required. There are about 3,000 bilingual private English/Spanish schools, but no overall standards apply for the English program. At the secundaria (junior high) level, 2,200,000 students attend 6,500 schools, and are required to study English or French…

  19. Strategies for improving outcome of assisted reproduction in women with polycystic ovary syndrome: systematic review and meta-analysis.

    PubMed

    Kollmann, M; Martins, W P; Lima, M L S; Craciunas, L; Nastri, C O; Richardson, A; Raine-Fenning, N

    2016-12-01

    they reduce the incidence of OHSS without interfering with clinical pregnancy and live birth for women with PCOS. Additionally there is low-quality evidence pointing to a benefit of metformin supplementation on clinical pregnancy and live birth; and that ovulation induction and administration of estradiol seem to be equally effective for endometrial preparation before FET for women with PCOS. For all other interventions, the evidence is of very low quality, not allowing any meaningful conclusions to be drawn. Estrategias para mejorar el resultado de la reproducción asistida en mujeres con síndrome de ovario poliquístico: revisión sistemática y metaanálisis RESUMEN OBJETIVOS: Identificar, evaluar y resumir la evidencia actual sobre la eficacia de las estrategias para mejorar las técnicas de reproducción asistida en mujeres con síndrome de ovario poliquístico (SOP). MÉTODOS: Se realizó una búsqueda exhaustiva de literatura en las bases de datos médicas estándar. La última búsqueda electrónica se realizó en julio de 2015. Las medidas de resultado primarias fueron los nacimientos vivos/embarazos en curso y el síndrome de hiperestimulación ovárica (SHO). Las medidas de resultado secundarias fueron el embarazo confirmado ecográficamente y el aborto. Se cribaron 1021 registros, de los que se evaluaron por completo 173, para finalmente incluir 66 estudios en el análisis cuantitativo. Aunque se evaluaron muchas intervenciones diferentes, en general la calidad de los estudios fue baja. Se observó evidencia de calidad moderada de que no hay diferencias relevantes clínicamente en las tasas de nacimientos vivos/embarazos en curso (riesgo relativo (RR): 0,95 (IC 95%, 0,84-1,08)), o de embarazos confirmados ecográficamente (RR: 1,02 (IC 95%, 0,91-1,15)), cuando se comparan los protocolos de antagonistas y agonistas para la estimulación ovárica. Además, se encontró evidencia de baja calidad en que la metformina mejora las tasas de nacimientos vivos

  20. Diagnosis of compliance of health care product processing in Primary Health Care.

    PubMed

    Roseira, Camila Eugenia; Silva, Darlyani Mariano da; Passos, Isis Pienta Batista Dias; Orlandi, Fabiana Souza; Padoveze, Maria Clara; Figueiredo, Rosely Moralez de

    2016-11-21

    úde o de menor índice de conformidade, enquanto indicador de recursos técnico-operacionais para preparo, acondicionamento, desinfecção/esterilização, guarda e distribuição de produtos para saúde, o de melhor índice. o diagnóstico de conformidade do processamento de produtos para saúde nas unidades avaliadas indica comprometimento da qualidade do processo, uma vez que não foram obtidos resultados próximos ao valor ideal em nenhuma unidade. Além disso, não houve diferença estatisticamente significante desses indicadores entre os dois tipos de unidades estudadas. identificar la conformidad del procesamiento de productos para la salud en la Atención Primaria a la Salud y evaluar una posible diferencia en la conformidad entre las unidades caracterizadas: Unidad Básica de Salud y Unidad Salud de la Familia. estudio cuantitativo, observacional, descriptivo e inferencial; se aplicaron indicadores de estructura, proceso y resultado, referentes al procesamiento de productos para la salud en diez unidades de un municipio del interior de Sao Paulo, Brasil. todos los indicadores obtuvieron índice de conformidad inferior a lo ideal. No hubo diferencia estadísticamente significativa de los indicadores entre los dos tipos de unidades investigadas, siendo el indicador de limpieza de productos para la salud el de menor índice de conformidad; por otro lado, como indicador de recursos técnico-operacionales para preparación, acondicionamiento, desinfección/esterilización, almacenamiento y distribución de productos para la salud, fue el de mejor índice. el diagnóstico de conformidad del procesamiento de productos para la salud en las unidades evaluadas indica que está comprometida la calidad del proceso, ya que no fueron obtenidos resultados próximos al valor ideal en ninguna unidad. Además de eso, no hubo diferencia estadísticamente significativa de esos indicadores entre los dos tipos de unidades estudiadas.

  1. A Grounded theory study of the intention of nurses to leave the profession.

    PubMed

    Alilu, Leyla; Zamanzadeh, Vahid; Valizadeh, Leila; Habibzadeh, Hosein; Gillespie, Mark

    2017-06-05

    de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los. este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la

  2. Three new species of Seira Lubbock (Collembola, Entomobryidae) from Caatinga Domain, northeastern Brazil.

    PubMed

    Godeiro, Nerivania N; Bellini, Bruno C

    2014-02-10

    Three new species of Seira Lubbock, Seira jiboiensis sp.nov., Seira primaria sp. nov. and Seira harena sp.nov. from Neotropical Region are described and illustrated. All species were collected from humid areas of Caatinga Biogeographic Domain, northeastern Brazil. Seira jiboiensis sp.nov. shows some similarities with S. mendoncea Bellini & Zeppelini and S. ritae Bellini & Zeppelini, while S. primaria sp.nov. resembles S. pseudoannulata Bellini & Zeppelini and S. paraibensis Bellini & Zeppelini in dorsal chaetotaxy in some aspects. Seira harena sp.nov. belongs to a subgroup of Seira originally described in the subgenus Lepidocyrtinus Börner, which has modified macrochaetae on distal manubrium and proximal dens, like S. prodiga (Arlé), S. xinguensis (Arlé) and S. nigrans (Arlé).

  3. Radio Brightness Temperatures and Angular Dimensions of Recently Predicted Vl-Bi Small-Scale Structures

    NASA Astrophysics Data System (ADS)

    Opher, R.

    1990-11-01

    RESUMEN. Muestro que analisis recientes publicados de fuentes de radio galacticas y extragalacticas predicen estructuras en pequera escala en fuentes de radio extendidas, remanentes de supernova, vientos protoestelares, nubes moleculares, distorsiones del fondo de 3 K, enanas blancas magnetizadas, estrellas de tipo tardio y el Sol. Discuto las temperatu- ras de brillo de radio de estas estructuras y sus ditnensiones. Muestro que estas estructuras son detectables con las sensibilidades actuales de VLBI (o en el futuro cercano). ABSTRACT. I show that recently published analysis of galactic and extragalactic radio sources make predictions of small-scale structures in extended radio sources, supernovae remnants, protostellar winds, molecu- lar clouds, distortions of the 3 K background, magnetized white dwarf binaries, late-type stars and the sun. I discuss the radio brightness temperatures of these structures and their dimensions. I show that these structures are detectable with present (or near future) VLBI sensitivities. : RADIO SOURCES-EXTENDED

  4. HI en la dirección de la denominada ``Ventana de Puppis"

    NASA Astrophysics Data System (ADS)

    Morras, R.; Pöppel, W. G. L.; Arnal, E. M.; Bajaja, E.

    Analizando los datos combinados de los relevamientos de HI de Hartmann & Burton (1997) y Arnal et.al (2000), hemos detectado la presencia de una estructura en forma de ``shell" en la denominada ``ventana de Puppis". Esta estructura, cuyo centro se encuentra en la dirección (l = 245 deg, b = -5 deg) tiene un diámetro angular de ˜ 18 deg y es detectada en el rango de velocidades (LSR) entre -9 y +6 km/seg. El análisis de los datos sugiere que esta estructura puede haberse originado en una perturbación en el denominado ``Feature A" de Lindblad (1973), a una distancia de 150-200 pc del Sol. Se determinaron parámetros tales como Masa y Energía Cinética del Shell y se analiza un posible origen del mismo.

  5. [Easily implemented cognitive behaviour techniques in primary care (part 2)].

    PubMed

    Ibáñez-Tarín, C; Manzanera-Escartí, R

    2014-01-01

    Cognitive behavioural therapy has shown to be very effective for treating the vast majority of mental health disorders. In this second part of the article, we continue commenting on those techniques that can be easily used in the Primary Care setting. Copyright © 2011 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. [Primary posterior perineal hernia. Case report and review of the literature].

    PubMed

    Rodríguez-Wong, Ulises

    2014-01-01

    Antecedentes: las hernias perineales pueden aparecer luego de una intervención quirúrgica en esta región o como una lesión primaria. Entre las hernias menos frecuentes están las perineales. Caso clínico: paciente femenina de 42 años de edad, con un tumor perianal a la derecha del orificio anal, de aparición espontánea y de cinco años de evolución, con dimensiones de 6 × 10 cm, blando y reductible por detrás del músculo transverso del periné. Con diagnóstico de hernia perineal posterior primaria se intervino quirúrgicamente por vía perineal y se le colocó una malla de mersilene. Después de 18 meses de seguimiento no hubo recidiva. Conclusiones: la plastia perineal puede ser una buena alternativa para el tratamiento quirúrgico de las hernias perineales primarias porque permite efectuar un cierre mejor, disecar el saco herniario y reducirlo adecuadamente.

  7. The effects of surface chemistry and adsorbed proteins on monocyte/macrophage adhesion to chemically modified polystyrene surfaces.

    PubMed

    Shen, M; Horbett, T A

    2001-12-05

    Monocytes and macrophages play critical roles in inflammatory responses to implanted biomaterials. Monocyte adhesion may lead to macrophage activation and the foreign body response. We report that surface chemistry, preadsorbed proteins, and adhesion time all play important roles during monocyte adhesion in vitro. The surface chemistry of tissue culture polystyrene (TCPS), polystyrene, Primaria, and ultra low attachment (ULA) used for adhesion studies was characterized by electron spectroscopy for chemical analysis. Fibrinogen adsorption measured by (125)I-labeled fibrinogen was the lowest on ULA, higher on TCPS, and the highest on polystyrene or Primaria. Monocyte adhesion on protein preadsorbed surfaces for 2 h or 1 day was measured with a lactate-dehydrogenase method. Monocyte adhesion decreased over time. The ability of preadsorbed proteins to modulate monocyte adhesion was surface dependent. Adhesion was the lowest on ULA, higher and similar on TCPS or polystyrene, and the highest on Primaria. Monocyte adhesion on plasma or fibrinogen adsorbed surfaces correlated positively and linearly to the amount of adsorbed fibrinogen. Preadsorbed fibronectin, immunoglobulin G, plasma, or serum also promoted adhesion compared with albumin preadsorbed or uncoated surfaces. Overall, biomaterial surface chemistry, the type and amount of adsorbed proteins, and adhesion time all affected monocyte adhesion in vitro. Copyright 2001 John Wiley & Sons, Inc. J Biomed Mater Res 57: 336-345, 2001

  8. Glossary of MS Terms

    MedlinePlus

    ... su determinación y función en la estructura o fisiología del cuerpo humano Grupo de apoyo Un grupo, ... a) especializado en el estudio de la anatomía, fisiología y enfermedades de vías urinarias tanto masculinas como ...

  9. Three Dimensional Modeling of Breaking

    DTIC Science & Technology

    2005-09-30

    R.A. Dalrymple, A.J.C. Crespo, and D. Cerquiero, "Uso de la Tecnica SPH para el Estudio de la Interaccion entre Olas y Estructuras," Ingenieria del...published] Rogers, B.D., R.A. Dalrymple, M. Gesteira, and O. Knio, ``Smoothed Particle Hydrodynamics for Naval Hydrodynamics,” Proc. Int. Workshop on

  10. Cobertura desarrollada de Puerto Rico

    Treesearch

    William A. Gould; Sebastian Martinuzzi; Olga M. Ramos Gonzalez

    2008-01-01

    Este mapa representa la cobertura desarrollada en Puerto Rico (Martinuzzi et al. 2007). Cobertura desarrollada se define aqui como areas urbanas, construidas y sin vegetacion, que resultan de actividad humana. Tipicamente, estas incluyen estructuras construidas, concreto, asfalto, u otra infraestructura. La cobertura desarrollada se creo mediante el analisis de...

  11. Ecologia de las lombrices de tierra

    Treesearch

    Grizelle Gonzalez

    2014-01-01

    De los organismos de suelo, las lombrices de tierra son las mas conocidas y a menudo son consideradas las mas importantes por su influencia en el funcionamiento de ecosistemas de suelo (Hendriz y Bohlen, 2002). Tienen un efecto significativo en la estructura del suelo, el ciclo de nutrimentos y ls productividad de las cosechas. En terminos de biomasa, generalmente...

  12. Agrarian Structure and Labor Migration in Rural Mexico: The Case of Circular Migration of Undocumented Workers to the U.S.

    DTIC Science & Technology

    1980-07-01

    34 Migraciones en el Desarrollo Capitalista." Migraci6n y Desarrollo 3: AnAlisis Hist6ricos y Aspectos Relacionados a la Estructura Agraria y al Proceso de...Portfolio Theory and Capital Markets. New York: McGraw Hill. Singer, Paul I. 1972 " Migraciones Internas: Consideraciones Te6ricas sobre el Estudio

  13. The Decade of the Seventies in El Salvador: Prelude to Revolution

    DTIC Science & Technology

    1992-06-05

    Victor. "Estructura y Desarrollo Social en El Salvador," Desarrollo Economica 20:77 (1981): 121-134. Druger, Alexander. "El Salvador’s Marxist Revolution...Studies Vol.13 (April, 1985), pp. 129-152. Gordon, Sara. "El Salvador: Crisis Politica y Movimiento Popular," Estudios Sociales Centroamericanos. 9:27

  14. Instabilities in a Relativistic Viscous Fluid

    NASA Astrophysics Data System (ADS)

    Corona-Galindo, M. G.; Klapp, J.; Vazquez, A.

    1990-11-01

    RESUMEN. Las ecuaciones hidrodinamicas de un fluido imperfecto relativista son resueltas, y los modos hidrodinamicos son analizados con el prop6sito de estabiecer correlaciones con las estructuras cosmol6gicas. ABSTRACT The hydrodynamical equations of a relativistic imperfect fluid are solved, and the hydrodynamical modes are analysed with the aim to establish correlations with cosmological structures. Ke, words: COSMOLOGY - HYDRODYNAMICS - RELATIVITY

  15. Proceedings of the NATO-Advanced Study Institute on Computer Aided Analysis of Rigid and Flexible Mechanical Systems Held in Troia, Portugal on June 27-July 9, 1993. Volume 1. Main Lectures

    DTIC Science & Technology

    1993-07-09

    S71-887. r 26. A. Cardona and A. Cassano (1992) .lntegrador temporal de paso variable para anilisis Z dinimico de estructuras y mecanismos’, Revista ...Research Development, project P77; JNICT - Junta Nacional de Investigagio Cientifica e -i Tecnologica, Project STRD/CtIPRo569/92. Also the

  16. On Categorizing Sounds.

    DTIC Science & Technology

    1987-11-17

    Introductino to its perceptual, neural, and social prospects. G. Stevens (Ed.), 1975, NY, Wiley. 11. Ward, L. M. & Lockhead, G. R. Category judgments...Objeto: Estructura y Procesos., S. Ballesteros and B. Shepp (Eds.), Universidad Nacional de Educacion a Distancia, Madrid, Spain, in press. 15

  17. Ácaros del mango

    USDA-ARS?s Scientific Manuscript database

    Los ácaros constituyen un grupo abundante y diverso que ocupa diferentes hábitats en árboles frutales y la estructura y disposición del follaje y ramas del mango, contribuyen significativamente a que se presente gran diversidad de ácaros benéficos y dañinos asociados a esta especie frutal. En Colomb...

  18. [Why do we call the brain 'brain'?

    PubMed

    Garcia-Molina, A; Ensenat, A

    2017-01-16

    Introduccion. Todos los dias, millones de profesionales utilizan un sinfin de palabras tecnicas para referirse a las distintas estructuras que se hallan dentro del craneo, pero pocos sabrian explicar su procedencia. En este trabajo se indaga sobre el origen etimologico de algunos de estos terminos neuroanatomicos. Desarrollo. Se realiza un recorrido etimologico por el sistema nervioso central; recorrido que no pretende ser una revision exhaustiva y pormenorizada de los terminos actualmente en uso, sino familiarizar al lector con el pasado linguistico de palabras como cerebro, hipocampo, talamo, claustro, fornix, cuerpo calloso o sistema limbico. Todas ellas provienen del griego o del latin, durante siglos las lenguas francas de la ciencia. Tambien se analiza la evolucion de la palabra meninges, originalmente de procedencia grecolatina, si bien los usos actuales derivan del arabe. Conclusiones. Los terminos neuroanatomicos que se utilizan hoy en dia no proceden de palabras que asocien una determinada estructura encefalica con su funcion, sino de palabras que reflejan la similitud formal o conceptual entre una estructura y una entidad familiar o cotidiana (por ejemplo, un objeto o una parte del cuerpo humano). En otros casos, estas palabras indican la ubicacion espacial de la estructura neuroanatomica respecto a un tercero, o bien son terminos derivados de personajes de la mitologia grecolatina.

  19. Proceedings of the International Conference on Recent Advances in Structural Dynamics (2nd) held at the University of Southampton (England) on 9-13 April 1984. Volume 2,

    DTIC Science & Technology

    1984-01-01

    Materia. Metodos de doble discretizacion aplicados al analisis dinamico de estructuras. 6. S. IDELSOHN and A. CARDONA 1983 Report GTM-23, INTEC, Santa...transform of response at point I Fj : Furier transform of force at point J UIjk , Vj k : real and imaginary part resp. of the modal 0 displacement of

  20. High Altitude Atmospheric Investigations. Part II. Development of in-situ Experiments for Measurements in the D-Region of the Ionosphere and Their Results.

    DTIC Science & Technology

    1981-06-03

    solar flux data related to Aeronomy (Solar Cycle 20), COSPAR Technique manual Series, Manual No. 7, (Febr. 1978). 22 Sanchez Muniosguren, L.V...Estructura de la alta Mesosfera, Publicacion A-68, Servicio Meteorologico Nacional, Madrid (1977). 23 Becker W.: Personal communication 24 Rose G., and H.U

  1. [Epileptic seizures complicated by Takotsubo syndrome].

    PubMed

    Garea Garcia-Malvar, M J; Gonzalez-Silva, Y; Epureanu-Epureanu, V

    2014-11-01

    Introduccion. El sindrome de takotsubo es un trastorno caracterizado por disfuncion ventricular reversible, dolor precordial de tipo anginoso y cambios electrocardiograficos sin evidencia de obstruccion coronaria en coronariografia. Se desencadena por estres, y es frecuente tras crisis epilepticas. Presentamos el caso de una paciente que inicia esta miocardiopatia tras una crisis epileptica al finalizar su sesion de hemodialisis. Caso clinico. Mujer de 55 años en hemodialisis por insuficiencia renal cronica, con epilepsia secundaria a lesion residual frontoparietal derecha por un hematoma que preciso evacuacion quirurgica. Tras una sesion de hemodialisis experimenta una crisis epileptica focal con generalizacion secundaria y, horas despues de esta, dolor centrotoracico. En seriacion enzimatica se objetiva elevacion de troponina I y, electrocardiograficamente, ondas T negativas en derivaciones precordiales (V2-V6). Se realiza coronariografia, cuyo resultado es normal, y se demuestran alteraciones de la contractilidad, confirmadas como de caracter transitorio en un estudio ecocardiografico seriado. Todos los datos anteriores hacen sospechar el diagnostico de sindrome de takotsubo. Conclusion. Las complicaciones cardiacas son una de las causas de morbimortalidad en la epilepsia, y entre ellas se encuentra el sindrome de takotsubo. La incidencia real de dicho sindrome se desconoce, pero dada su implicacion en la mortalidad de causa cardiaca en la epilepsia es importante sospecharlo ante la presencia de disfuncion cardiaca tras una crisis epileptica.

  2. [Acute optic neuropathy: differential diagnoses].

    PubMed

    Buompadre, María Celeste

    2013-09-06

    Introduccion. La alteracion funcional del nervio optico se caracteriza por un deficit en la agudeza visual, en la vision cromatica y en el campo visual, defecto pupilar aferente y, en algunos casos, edema del nervio o atrofia y palidez. Objetivo. Describir el espectro de neuropatias opticas agudas, su clinica, diagnostico y tratamiento, con mayor interes en aquellas de presentacion en la edad pediatrica. Desarrollo. La neuritis optica puede ser monofasica, recurrente o el componente de un cuadro desmielinizante polisintomatico. El objetivo del tratamiento es reducir el numero y la gravedad de los ataques y prevenir discapacidad. La infecciosa es secundaria a diferentes microorganismos (bacterias, virus, hongos y protozoos). El tratamiento depende de la etiologia. La isquemica anterior no arteritica o idiopatica es la forma mas frecuente y es secundaria a enfermedad de pequeños vasos (ciliares posteriores). La neuropatia optica hereditaria o de Leber representa una causa importante de afectacion visual cronica y se caracteriza por la afectacion selectiva de las celulas ganglionares de la retina. Hasta el momento, la terapia solo es de apoyo. En el papiledema asociado a hipertension endocraneal, la agudeza visual generalmente se conserva pero existe aumento de la mancha ciega. El tratamiento se basa en disminuir la hipertension y el factor etiologico si existe. Conclusiones. Las neuropatias opticas agudas constituyen un amplio grupo de entidades, de etiologia diversa y con un pronostico visual variable. La presencia de signos del examen neurologico, fondo de ojo y neuroimagenes pueden orientar hacia el diagnostico y tratamiento oportuno.

  3. Prevalence of overweight and obesity among primary school children aged 5 to 14 years in Wannan area, China.

    PubMed

    He, Lianping; Ren, Xiaohua; Chen, Yan; Jin, Yuelong; Pan, Rui; Wei, Ningkai; Qiu, Shenwei; Lu, Wei; Ding, Lingling; Guo, Daoxia; Wang, Linghong; Nie, Zhonghua; Yao, Yingshui

    2014-10-01

    Antecedentes: El sobrepeso y la obesidad son epidemia en todo el mundo. El propósito de esta investigacion es estimar si la prevalencia de la obesidad entre los niños de la escuela primaria es alto, y a identificar sus posibles factores determinantes para optimizar los métodos de prevención para combatir nuevas subidas en sobrepeso infantil. Métodos: Un estudio transversal fue diseñado para recoger los exámenes de salud de rutina datos para la escuela primaria los niños de 5 a 14 años en Wannan Area, China, el sobrepeso y la obesidad se determinaron utilizando la International Obesity Task Force Standard (IOTF) IMC puntos de corte. Resultados: Un total de 67956 sujetos (36664 macho y 31239 hembra) de 5 a 14 años fueron reclutados en este estudio. Dependiendo de las referencias utilizadas (IOTF), la prevalencia de sobrepeso, incluyendo la obesidad de los sujetos fue 17,85%, la prevalencia de sobrepeso, incluyendo la obesidad fue del 22,9% en sujetos masculinos y el 11,9% en mujeres, respectivamente. La prevalencia global de la obesidad was 3,7%, la prevalencia de obesidad fue de 5,2% en sujetos masculinos y 1,8% de mujeres, respectivamente. Una observación interesante es que la prevalencia de sobrepeso fue alta en sujetos masculinos. Conclusiones: El sobrepeso es la prevalencia entre los niños de la escuela primaria, especialmente en los niños varones. escuela y Departamento de Gobierno debería tomar algo de placer para reducir la prevalencia del sobrepeso y la obesidad.

  4. [Nutritional analysis of dietary patterns in students of primary education with normal nutritional status].

    PubMed

    Durá-Gúrpide, Beatriz; Durá-Travé, Teodoro

    2014-06-01

    Objetivo: Realizar un análisis nutricional del modelo dietético en un grupo de alumnos de Educación Primaria (9-12 años) con estado nutricional normal. Material y Métodos: Registro de consumo de alimentos de dos días lectivos consecutivos en una muestra de 353 alumnos de Educación Primaria (188 varones y 165 mujeres) con una situación nutricional normal. Se ha calculado el consumo calórico y de macronutrientes, minerales y vitaminas comparándose con las ingestas recomendadas. Resultados: El valor medio del aporte calórico diario era de 2.066,9 kcal. Los cereales (33%), lácteos (19%) y carnes (17%) aportaban el 70% de la ingesta calórica total. Las proteínas aportaban el 20,3% de la ingesta calórica, los glúcidos el 48,8%, los lípidos el 30,9%, y las grasas saturadas el 12,6%. La ingesta de colesterol era excesiva y 2/3 de la ingesta proteica eran de origen animal. El valor medio de la ingesta de calcio, yodo y vitaminas A, D y E eran inferiores a los aportes dietéticos recomendados. Conclusiones: El modelo dietético de los alumnos de Educación Primaria con estado nutricional normal difiere del prototipo mediterráneo, con un consumo excesivo de carnes, limitado de cereales y lácteos, y deficiente en verduras y hortalizas, frutas, legumbres y pescados; dando lugar a un incremento del aporte de proteínas y grasas animales en detrimento de los hidratos de carbono complejos y un aporte deficiente de calcio, yodo y vitaminas A, D y E.

  5. Tension-free primary closure for the treatment of pilonidal disease.

    PubMed

    Arer, Ilker Murat; Yabanoglu, Hakan; Caliskan, Kenan

    2015-01-01

    Il sinus pilonidali (SP) è una patologia comune che colpisce in genere la popolazione giovane e localizzandosi nella regione intergflutea. Per la sua cura sono state utilizzate tecniche conservative e descritte diverse tecniche chirurgiche, queste ultime consistenti in chiusura primaria dell’escissione chirurgica, la marsupializzazione e le chiusura con flap della breccia chirurgica. Il presente studio si propone di valutare l’efficacia di un metodo chirurgico. La casistica si riferisce a 151 pazienti sottoposti a trattamento chirurgico tra Gennaio 2007 e Settembre 2014, che vengono suddivisi per età, sesso, durata dell’intervento e della degenza postoperatoria, oltre alle complicanze (deiscenze ed infezioni della ferita), recidive e domensioni pel pezzo operatorio. L’età media dei pazienti affetti da sinus pilonidalis si aggira tra i 14 ed i 66 anni (media 25,18). In 105 pazienti (69,5% del totale) si è proceduto a chiusura primaria della ferita, ed il 46 (30,5% del totale) si è adottata la tecnica tension-free. Non si sono osservate differenze statistiche tra i gruppi rispetto all’età, al sesso, alla durata dell’intervento ed a quella della degenza postoperatoria. Solo 9 pazienti operati con chiusura primaria (8,6%) e 3 pazienti (6,5%) operati con tecnica tension-free hanno presentato una recidiva postoperatoria. In 17 pazienti (7,9%) si è osservata la deiscenza della ferita, di cui 15 (14,3%) tra quelli trattati con chiusura primitive e 2 (4,3%) in quelli trattati con tecnica tension- free. Il 16 pazienti (10.6%) è stata osservata la formazione postoperatoria di sieroma o di infezione. In conclusione la tecnica tension free si dimostra metodo altrettanto efficace della chiusura primitiva.

  6. [Ethics committees in the experience of the IMSS: a Latin American instance].

    PubMed

    Valdez-Martínez, Edith; Mata-Valderrama, Guadalupe; Bedolla, Miguel; Fajardo-Dolci, Germán Enrique

    2015-01-01

    Introducción: el objetivo es examinar la situación actual de los comités hospitalarios de bioética (CHB) y de los comités locales de investigación y ética en investigación en salud (CLIEIS) del Instituto Mexicano del Seguro Social (IMSS). Métodos: estudio cuantitativo, transversal descriptivo, realizado entre octubre y noviembre de 2014. Se enviaron por correo electrónico dos cuestionarios, autoadministrados o de autorreporte, a todos los hospitales del IMSS (N = 262): uno para los CHB y otro para los CLIEIS. Cinco apartados contenían ambos cuestionarios: localización del comité, fecha en la que fue constituido, estado actual de actividad, composición, funciones y experiencia. Resultados: la tasa de respuesta fue de 85 %. Se identificaron 150 CHB activos y 67 CLIEIS activos. En ambos grupos predominó la profesión médica y el personal directivo entre sus integrantes. Los representantes de la ciudadanía sólo fueron reportados en siete CHB. La función primaria reportada por los CHB fue la consultiva, y su meta primaria: “mejorar la calidad de la atención médica”. Los CLIEIS señalaron como función primaria: “evaluar y dictaminar protocolos de investigación en salud” y dentro de sus metas el “proteger los derechos y el bienestar de los sujetos de investigación”. Conclusiones: ambos grupos de comités debieran ser evaluados regularmente a través de ciclos de auditoría con el propósito de identificar las acciones educativas que promuevan su eficiencia.

  7. [Email in a dedicated headache clinic: experience gained over a five-year period].

    PubMed

    Pedraza, M Isabel; Herrero-Velázquez, Sonia; López-Mesonero, Luis; Ruiz-Piñero, Marina; Posadas, Javier; Guerrero-Peral, Ángel L

    2015-06-16

    Introduccion. El correo electronico puede facilitar la comunicacion entre niveles. Nuestros medicos de atencion primaria disponen del correo de la consulta monografica de cefaleas (CMC) desde noviembre de 2009, por lo que se pretende analizar la utilizacion del correo electronico durante cinco años. Pacientes y metodos. Recogimos prospectivamente datos de los correos enviados hasta octubre de 2014. Las preguntas se clasificaron en necesidad de derivacion a la CMC (grupo 1), evolucion de casos atendidos en la CMC (grupo 2), formacion en cefaleas (grupo 3) o tratamiento de la cefalea padecida por el propio medico de atencion primaria como paciente (grupo 4). Resultados. Analizamos 274 correos. Las consultas mensuales se han incrementado (de 1,5 al mes durante el primer año a 7,5 al mes durante el quinto). El 10,2% de los correos provenia de centros de salud rurales y el 89,8% de centros de salud urbanos. Se contestaron en 2 ± 2,8 dias (rango: 0-24 dias). En el grupo 1 se encuadraron 130 consultas (47,4%), y en 60 se recomendo (46,2%) la derivacion por via normal, en 47 (36,2%) la preferente y en 23 (17,6%) la no derivacion. En el grupo 2 se incluyeron 125 correos (45,7%), y en 80 no fue necesaria nueva cita o adelanto de la prevista (64%). Trece consultas (4,7%) se clasificaron en el grupo 3 y seis (2,2%) en el grupo 4. Conclusiones. Nuestros medicos de atencion primaria manejan cada vez mas el correo electronico de la CMC. Permite detectar pacientes en los que procede un adelanto de cita, bien primera visita o revision, o resolver cuestiones sin necesidad de derivacion. Es eficaz para la atencion del medico con cefalea y como herramienta de formacion continuada.

  8. [Atraumatic hip pain in young adults].

    PubMed

    González Murillo, M; Turcu, V; De Nicolás Navas, M B; Yeguas Bermejo, A

    2016-01-01

    Hip pain in the young adult is a disabling pathophysiological process may be related to multiple etiologies. The process must be determined in order to make a diagnosis and follow-up treatment. The case is presented of a 29 year old woman with anemia, atraumatic hip pain on the right side, and a limp of one month onset. The differential diagnosis includes infectious, rheumatological, tumor, avascular necrosis of hip, hip impingement, hip dysplasia, osteoarthritis and other syndromes. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Acral acanthosis nigricans associated with taking growth hormone].

    PubMed

    Peña Irún, A

    2014-01-01

    Acanthosis nigricans is a skin lesion characterized by the presence of a hyperpigmented, velvety cutaneous thickening that usually appears in flexural areas. Less frequently, it can occur in other locations, such as the dorsum of hands and feet. In this case it is called acral acanthosis nigricans. It is a dermatological manifestation of systemic disease. It is often associated with insulin resistance-mediated endocrine diseases. A case is presented on a patient with acanthosis nigricans secondary to the use of growth hormone. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. [Ethical issues in health care of gender violence].

    PubMed

    Bugarín-González, R; Bugarín-Diz, C

    2014-01-01

    Gender violence is a health problem that occasionally gives rise to ethical dilemmas for the family doctor. One of the most important conflict is probably when a patient admits to being abused by her partner, but appeals to keep the information confidential, and refuses to present an injury report. There also other problematic situations. This essay attempts to reflect on these issues and help professionals in making decisions. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. [Experience in treating mucoceles in Primary Care].

    PubMed

    Sabando Carranza, J A; Cortés Martinez, M; Calvo Carrasco, D

    2016-03-01

    Several cases of mucocele have been treated in our Primary Health Care centre. These are benign lesions, relatively frequent (2.5/1000), which is caused by a retention of mucous from the minor salivary glands into the oral cavity, mainly at the level of the lower lip. The experience in their treatment in this centre is presented, along with a review of the literature to see if our treatment was correct. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. [Ultrasound of gallbladder and bile duct].

    PubMed

    Segura Grau, A; Joleini, S; Díaz Rodríguez, N; Segura Cabral, J M

    2016-01-01

    The cystic nature of the gallbladder and bile duct when dilated, and the advantages of ultrasound as a quick, reproducible, convenient, cheap and low risk technique, with a high sensitivity and specificity, make it the most eligible technique in biliary pathology studies. Ultrasound has become a valuable tool for doctors studying biliary pathology and its complications, from abnormal liver function results, right upper quadrant pain, or jaundice, to cholelithiasis, cholecystitis, or suspicion of biliary tumors. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. [Mucosecretor adenocarcinoma of the lung with pleural involvement presenting as a pneumothorax. Presentation of a clinical case].

    PubMed

    Hermida Pérez, J A; Hernández Guerra, J S; Bermejo Hernandez, Á; Sobenes Gutierrez, R J

    2013-10-01

    The combination of a pneumothorax and lung cancer is rare and diagnosis is complex. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, as well as the clinical significance, the recommended diagnostic approach, and therapeutic guidelines. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  14. [What would you do when faced with a Muslim patient with a conversational disorder?

    PubMed

    Martínez Gandolfi, A; Rodríguez Mir, J

    2017-09-07

    The purpose of this work is to present the approach to mental disorders in Moroccan patients from a sociocultural perspective. The anthropology of health and ethno-psychiatry will allow us to analyze the concepts of health and disease. From the Moroccan cosmovision we will analyze the alternative treatments and their association with other therapeutic models. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Radiographic changes in children with primary immunodeficiency].

    PubMed

    González-Uribe, Víctor; Pietropaolo-Cienfuegos, Dino Roberto; Del Río-Navarro, Blanca Estela; Del Río-Chivardi, Jaime Mariano; Sienra-Monge, Juan José Luis

    2015-01-01

    Antecedentes: si bien se cuenta con información epidemiológica de las inmunodeficiencias primarias, la información disponible en México es escasa. Objetivos: dar información epidemiológica del retraso del diagnóstico de las inmunodeficiencias primarias y de su correlación con daño pulmonar crónico. Material y método: estudio retrospectivo, analítico, efectuado en pacientes de 0 a 18 años de edad con diagnóstico de inmunodeficiencias primarias durante 11 años en el Hospital Infantil de México Federico Gómez; las variables estudiadas fueron: edad al inicio de los síntomas, edad al diagnóstico, tiempo desde el inicio de los síntomas al diagnóstico, número de neumonías previas y estudios radiográficos con datos de daño pulmonar crónico. Resultados: se incluyeron 48 pacientes que cumplieron los criterios de inclusión; 33 tenían daño pulmonar al diagnóstico, el déficit de anticuerpos fue el grupo con mayor afectación. Al correlacionar la edad de inicio de los síntomas y la diferencia de tiempo del inicio de los síntomas al diagnóstico se obtuvo una fuerte correlación (p <0.001, Rho > 0.80). Se observó una correlación moderada entre la diferencia en tiempo vs número de neumonías (p=0.005, Rho=0.495) y la correlación entre número de neumonías y daño pulmonar mostró significación alta (p <0.001, Rho=0.704). Conclusión: se encontró una relación estrecha entre el tiempo transcurrido desde el inicio de los síntomas y el número de neumonías con el daño pulmonar, por lo que las neumonías de repetición (más de dos) deben hacer sospechar el diagnóstico de inmunodeficiencia primaria, como se recomienda en la bibliografía mundial.

  16. Dinámica y frecuencias características de una protuberancia solar observada con los instrumentos SUMER y CDS/SOHO

    NASA Astrophysics Data System (ADS)

    Rovira, M.; Costa, A.; Bocchialini, K.

    La estructura de la protuberancia estudiada puede dividirse en cuatro regiones. A partir del análisis de las imágenes del CDS y los espectros del SUMER utilizando técnicas de multiresolución con Wavelets se obtuvieron las frecuencias y velocidades relativas de cada una de las regiones. Se observan frecuencias características del orden de los 5 min y otras de largo período. Se obtuvo una fuerte anticorrelación entre las intensidades y las velocidades Doppler. La presencia de las oscilaciones de 5 min en todas las regiones sugieren el acoplamiento entre la estructura cromosférica y la protuberancia.

  17. International Workshop on Non-Crystalline Solids (3rd) Held in Matalascanas, Spain on November 5-8, 1991. Programme and Abstracts

    DTIC Science & Technology

    1991-11-01

    M.D. Bar6, N. Clavaguera* and M.T. Clavaguera- Mora Fisica de Materials. Dept. Fisica , UAB, 08193 Bellaterra, Spain * Dept. d’Estructura i Constituents...TREATMENT IN GE-SE GLASSES X. Torrelles, S. Bordas. N. Clavaguera and M.T. Clavaguera- Mora Fisica de Materials, Departament de Fisica , Universitat...GLASSES IN THE GLASS TRANSITION REGION E.Illekova +, M.D. Bar6, S. Surifiach, N. Clavaguera and M.T. Clavaguera- Mora . Fisica de Materials. Dept

  18. El medio interestelar alrededor de estrellas Of: HD 108

    NASA Astrophysics Data System (ADS)

    Cappa, C.; Testori, J. C.

    Hemos analizado la distribución del hidrógeno neutro interestelar en la vecindad de la estrella Of HD 108 en base a perfiles de la línea de 21 cm. Estos datos nos han permitido encontrar una probable burbuja interestelar asociada a la estrella. Comparamos estos resultados con la emisión en otros rangos espectrales y estimamos los principales parámetros físicos de la estructura.

  19. Formación del contínuo de Lyman en atmósferas de estrellas B

    NASA Astrophysics Data System (ADS)

    Rohrmann, R. D.

    Se presentan resultados de modelos de atmósferas para estrellas tempranas que poseen una estructura cromosférica y una atmósfera extendida en expansión. Se analiza con rigurosidad el acople del campo de radiación en el continuo de Lyman y su relación con las poblaciones en equilibrio estadístico del H y He.

  20. Categorizing Sounds

    DTIC Science & Technology

    1989-12-01

    Eds.), Percepcion del Obieto: Estructura y Procesos, 553-596. Universidad Nacional de Educacion a Distancia. Lisanby, S. H., & Lockhead, G. R. (accepted...to suggest that new insights might come from studying individual subjects, although they might. Rather, the view I plan to pursue is that the reason...Psychological Association, Wash. D.C. 22 Lockhead, G.R. (in preparation) Sequence effects in bivariate judgments. Planned for submission to Perception

  1. Structural Determination of a Transcribing RNA Polymerase II Complex

    DTIC Science & Technology

    2000-05-01

    clamp domain, which has moved from its position in the model, was confirmed by two means. Firstly, the clamp domain was manually moved to align the zinc...isomorphous and anomalous amino acid residues, were manually fit into the difference Pattersons were 6 or and 5 ar, respectively. The resolution range of...detected with the Infrared Space Obser- stituto de Estructura de Ia Materia, Departamento Fisica Molecular, Serrano 121, 28006 Madrid, Spain. vatory

  2. CALQ8: A FORTRAN-IV Calculator Emulation Program.

    DTIC Science & Technology

    1980-11-18

    as maintainence manual . The extensive help features of the program obviate the need for many examples to aid the user in implementing the program. 2...34Inte- grated Matl’ Calculator Program." b. " Estructura de un Simulador de Calculadora Anologica (CAN), Revista de Informatica y Automatica 11 37...1978. 5. RTE FORTRAN-IV Reference Manual , Hewlett-Packard Co., 1979, Appendix D. 6. DOS/RTE Relocatable Library Reference Manual , Hewlett-Packard Co

  3. [Consensus document on the aetiology, diagnosis and treatment of acute otitis media].

    PubMed

    Del Castillo Martín, F; Baquero Artigao, F; de la Calle Cabrera, T; López Robles, M V; Ruiz Canela, J; Alfayate Miguelez, S; Moraga Llop, F; Cilleruelo Ortega, M J; Calvo Rey, C

    2012-11-01

    This is the consensus document on acute otitis media (AOM) of the Sociedad Española de Infectología Pediatrica (SEIP), Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP), Sociedad Española de Urgencias Pediátricas (SEUP) and Asociación Española de Pediatría de Atención Primaria (AEPAP). It discusses the aetiology of the disease and its potential changes after the introduction of the pneumococcal 7-valent, 10-valent and 13-valent vaccines. A proposal is made based on diagnostic classification of otitis media as either confirmed or likely. AOM is considered confirmed if 3 criteria are fulfilled: acute onset, signs of occupation of the middle ear (or otorrhea) and inflammatory signs or symptoms, such as otalgia or severe tympanic hyperaemia. Oral amoxicillin is the antibiotic treatment of choice (80mg/kg/day divided every 8hours). Amoxicillin-clavulanate (80mg/kg/day) is indicated in the following cases: when the child is under 6 months, in infants with severe clinical manifestations (fever>39°C or severe pain), there is family history of AOM sequels, and after amoxiciline treatment failure.

  4. INFEZIONI VIRALI CONGENITE, PERINATALI E NEONATALI VIRAL INFECTIONS OF THE FETUS AND NEWBORN INFANT

    PubMed Central

    Tremolada, Sara; Delbue, Serena; Ferrante, Pasquale

    2009-01-01

    Riassunto Alcuni virus possono essere trasmessi verticalmente da madre a figlio in seguito allo sviluppo, da parte della madre, di un’infezione primaria, ricorrente o cronica. La trasmissione materno-fetale dei virus, che può avvenire in utero (infezione congenita), durante il travaglio del parto (infezione perinatale), oppure attraverso l’allattamento (infezione postnatale), può causare aborto spontaneo, morte fetale, ritardo di crescita intrauterino, anomalie congenite e patologie neonatali o postnatali di diversa entità. Alcuni fattori di rischio sembrano influenzare l’incidenza di trasmissione materno-fetale dei virus, come ad esempio la presenza di altre infezioni virali, la carica virale materna, il tipo di infezione (primaria o ricorrente), la durata della rottura delle membrane, la modalità con cui avviene il parto, le condizioni socio-economiche e l’allattamento. Oggi è possibile prevenire la trasmissione materno-fetale di molti virus grazie all’utilizzo di vaccini, immunizzazione passiva e farmaci antivirali. Il rischio di trasmissione delle infezioni perinatali e postnatali, inoltre, può essere diminuito evitando l’allattamento o ricorrendo ad un parto cesareo. PMID:19216201

  5. Expert recommendation: contributions to clinical practice of the new prodrug lisdexamfetamine dimesylate (LDX) in the treatment of attention deficit hyperactivity disorder (ADHD).

    PubMed

    Alda, José A; Soutullo, César; Ramos-Quiroga, Josep A; Quintero, Javier; Hervás, Amaia; Hernández-Otero, Isabel; Sans-Fitó, Anna; Cardo-Jalón, Esther Cardo-Jalón; Fernández-Jaén, Alberto; Fernández-Pérez, Maximino; Hidalgo-Vicario, M Inés; Eddy-Ives, Lefa S; Sánchez, Javier

    2014-12-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobiological disorders in childhood, and is characterized by inappropriate levels of inattention, hyperactivity and/or impulsiveness, with an estimated prevalence of 5.29%. ADHD can have a negative impact upon all areas of the life of the patient. The main clinical guides accept multimodal treatment, involving both pharmacological and psychological measures, as the best management approach in ADHD (psychoeducational, behavioural and academic). Lisdexamfetamine dimesylate (LDX) is a new drug for the treatment of ADHD. A multidiscipline expert document has been developed, compiling the scientific evidence referred to this new molecule. The study also addresses the existing shortcomings in current drug therapy for ADHD and the contributions of LDX to routine clinical practice, in an attempt to help and guide physicians in the use of this new treatment. This document is endorsed by the ADHD and Psychoeducational Development task Group of the Spanish Society of Primary Care Pediatrics (Grupo de TDAH y Desarrollo Psicoeducativo de la Asociación Española de Pediatría de Atención Primaria, AEPap), the Spanish Society of Pediatric Neurology (Sociedad Española de Neurología Pediátrica, SENEP) and the Spanish Society of Out-hospital Pediatrics and Primary Care (Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria, SEPEAP).

  6. [Cultural domain of the causes of diabetes in three generations of popular stratum in Guadalajara, Mexico].

    PubMed

    García de Alba-García, Javier E; Salcedo-Rocha, Ana L; Hayes Bautista, David; Milke Najar, María Eugenia

    2015-01-01

    Introducción: la creciente prevalencia de diabetes se debe afrontar de diversas maneras. Determinar la transmisión generacional del conocimiento cultural ofrece pautas para la prevención y el control de la enfermedad. Al identificar y comparar las estructuras semánticas del conocimiento compartido, sentamos las bases de una atención culturalmente comprensiva. El objetivo es caracterizar los principales elementos relacionados con el dominio cultural sobre las causas de la diabetes en una población de abuelos, padres e hijos pertenecientes a estratos populares en Guadalajara, México. Métodos: estudio antropológico cognitivo en 104 personas seleccionadas al azar en el sector Libertad de Guadalajara, Jalisco, México. Se aplicaron técnicas de listas libres para obtener el modelo semántico y el promedio de conocimiento cultural sobre las causas del padecimiento por análisis de consenso. Resultados: los grupos estudiados se dividieron por generación de abuelos, padres e hijos. Se evidenció transmisión intergeneracional al presentar el conocimiento cultural una estructura semántica básica y un consenso significativo. Conclusiones: la estructura semántica sobre causas de la diabetes incluye como elementos: a) las emociones, como dimensión tradicional; b) conductas relacionadas al estilo de vida, como dimensión cotidiana; c) algunos conceptos biomédicos, como dimensión emergente.

  7. [Is the prefrontal cortex the center of the universe?].

    PubMed

    Garcia-Molina, A; Ensenat, A

    2015-10-16

    Introduccion. Actualmente, cuando reflexionamos sobre cual es la estructura mas relevante del encefalo humano invariablemente pensamos en las regiones anteriores de la corteza cerebral, concretamente en la corteza prefrontal. Si bien este ha sido el dogma predominante a lo largo de mas de 150 años, investigadores de reconocido prestigio han cuestionado abiertamente tal supuesto. Desarrollo. A caballo entre los siglos XIX y XX, diversos investigadores consideraron que las regiones corticales posteriores son la sede neuroanatomica de las mas altas facultades intelectuales. Entre todos ellos destaco, por la elaboracion de sus propuestas e impacto en la comunidad cientifica, el neuroanatomista aleman Paul Emil Flechsig (1847-1929). Wilder Graves Penfield (1891-1976) fue otro detractor del dogma que considera la corteza prefrontal el sustrato anatomico de los procesos mentales mas complejos y sublimes del ser humano. A mediados del siglo XX, Penfield mantuvo la hipotesis de la existencia de lo que denomino el sistema de integracion centrencefalico, responsable del nivel mas elevado de integracion del sistema nervioso central. Conclusiones. Las concepciones corticocentricas otorgan el preciado cetro de 'estructura mas importante del encefalo' a la corteza prefrontal. Sin embargo, no han faltado propuestas alternativas que, con mayor o menor exito, han intentado arrebatarselo en favor de otras estructuras encefalicas.

  8. Prevalence of overweight and obesity among secondary school children aged 14 to 18 years (china).

    PubMed

    Zhu, Lijun; Chen, Yan; Ding, Lingling; Guo, Daoxia; Wang, Linghong; Ren, Xiaohua; Gu, Qijun; Nie, Zhognhua; He, Lianping; Jin, Yuelong; Yao, Yingshui

    2015-05-01

    Antecedentes: La Prevalencia de sobrepeso y obesidad en adolescentes ha ido en aumento durante los últimos decenios. El presente estudio pretende evaluar la prevalencia de la obesidad en los niños de la escuela secundaria de 14 a 18 años de edad Anhui, y proporcionar directrices más amplias para los programas de intervención. Métodos: Este estudio transversal se llevó a cabo en 4788 niños de escuela secundaria, y la fecha de la encuesta de salud de rutina fue analizado. Los trabajadores sanitarios capacitados tomaron medidas antropométricas, la altura y el peso, en la escuela. La definicion de los niños con sobrepeso y obesidad basada en la edad y sexo del índice de masa corporal estándar de referencia propuesto por el Grupo de trabajo internacional sobre obesidad y el Centro Nacional de estadísticas de salud. Resultados: De acuerdo a la IOTF Standard la prevalencia de sobrepeso (obesidad) y la obesidad reveló disminución tendencia con la edad en varones (sobrepeso, del 17,3% en 14-y a 5,3% en 18-y; la obesidad, from 3.8% en 14-y al 2,3% en 18-y). Dependiendo de la NCHS referencias utilizadas, la prevalencia global de sobrepeso (obesidad) y la obesidad en hombres de entre 14 y 18 años de edad disminuye a partir de un 16,4% a 11,7% y del 4,6% al 2,8%, respectivamente. Conclusión: El sobrepeso (obesidad) y la obesidad de diciembre de los 14 a los 18 años de edad tienen una tendencia a la disminucion, y más atención debe ser tomado para estudiantes varones en China. Estos hallazgos sugieren que la escuela secundaria y el Gobierno deben formular directrices apropiadas para mantener saludables a los adolescentes en China.

  9. PARTNeR: A Tool for Outreach and Teaching Astronomy

    NASA Astrophysics Data System (ADS)

    Gallego, Juan Ángel Vaquerizo; Fuertes, Carmen Blasco

    PARTNeR is an acronym for Proyecto Académico con el Radio Telescopio de NASA en Robledo (Academic Project with the NASA Radio Telescope at Robledo). It is intended for general Astronomy outreach and, in particular, radioastronomy, throughout Spanish educational centres. To satisfy this target, a new educational material has been developed in 2007 to help not only teachers but also students. This material supports cross curricular programs and provides with the possibility of including Astronomy in related subjects like Physics, Chemistry, Technology, Mathematics or even English language. In this paper, the material that has been developed will be shown in detail and how it can be adapted to the disciplines from 4th year ESO (Enseñanza Secundaria Obligatoria-Compulsory Secondary Education) to High School. The pedagogic results obtained for the first year it has been implemented with students in classrooms will also be presented.

  10. [Serum lactate as a biomarker of severe sepsis in children with cancer, neutropenia and fever].

    PubMed

    Pacheco-Rosas, Daniel Octavio; Huelgas-Plaza, Ana Celia; Miranda-Novales, María Guadalupe

    2014-01-01

    INTRODUCCIÓN: la neutropenia es una complicación frecuente secundaria a la quimioterapia en los pacientes con cáncer, en quienes la prevalencia de sepsis es de 12.9 a 17.4 % y la letalidad es de 16 %. El objetivo de este estudio fue determinar la utilidad del lactato como biomarcador de sepsis grave en niños con cáncer, fiebre y neutropenia. MÉTODOS: se realizó un estudio de prueba diagnóstica fase II. Se midieron los niveles del lactato al ingreso. Los episodios de neutropenia se clasificaron en tres grupos: I, con sepsis II, sin sepsis; III, pacientes neutropénicos sin fiebre (controles). Se calculó sensibilidad, especificidad, valores predictivos positivo y negativo e índices de verosimilitud. El estándar de oro fue el diagnóstico clínico de sepsis grave.

  11. Integrating Virtual Worlds with Tangible User Interfaces for Teaching Mathematics: A Pilot Study.

    PubMed

    Guerrero, Graciela; Ayala, Andrés; Mateu, Juan; Casades, Laura; Alamán, Xavier

    2016-10-25

    This article presents a pilot study of the use of two new tangible interfaces and virtual worlds for teaching geometry in a secondary school. The first tangible device allows the user to control a virtual object in six degrees of freedom. The second tangible device is used to modify virtual objects, changing attributes such as position, size, rotation and color. A pilot study on using these devices was carried out at the "Florida Secundaria" high school. A virtual world was built where students used the tangible interfaces to manipulate geometrical figures in order to learn different geometrical concepts. The pilot experiment results suggest that the use of tangible interfaces and virtual worlds allowed a more meaningful learning (concepts learnt were more durable).

  12. [Cyberbullying at school].

    PubMed

    González Arévalo, Blanca

    2013-10-01

    The aim of this study is to known the prevalence of cyberbullying, and how these students behave. We designed a transversal, descriptive and observational study in two educative centers of Educación Secundaria Obligatoria (ESO) in Toledo (Spain). The sample comprised 190 students of both genders and ages between 11 and 16 years. Results indicated that 46.8% of the adolescents had been bullied by Information and communication technology (ICT). The behaviors and communication channels that are most frequently used to harass, have been offensive messages through mobile and/or Internet and spreading rumors to harm the victim. It is worth noting that almost a third of students harassed not request any help to deal with it. The cyberbullying phenomenon is clearly established in our society and a small percentage of cases it becomes a serious problem.

  13. [Changes in smoking prevalence among adolescents in Spain].

    PubMed

    Villalbí, Joan R; Suelves, Josep M; García-Continente, Xavier; Saltó, Esteve; Ariza, Carles; Cabezas, Carmen

    2012-01-01

    To analyse information on adolescent use of tobacco in Spain from different school surveys. Data on daily smoking prevalence by sex at the end of compulsory education is extracted and figures are compared, analysing trends. The five representative studies on adolescents in Spain are reviewed: The National Survey on Drug Use in Secondary School Children (Encuesta estatal sobre uso de drogas en estudiantes de secundaria (ESTUDES); Survey of Health Behaviour in School-aged Children (HBSC-ECERS); Surveillance System of Risk Factors Associated With Non-Transmittable diseases in the Young Population (Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No Transmisibles dirigido a población Juvenil)(SIVFRENT-J); Study of Risk Factors in Secondary School Children (Estudio de factores de riesgo en estudiantes de secundaria) (FRESC); Surveillance Study of Health Behaviour in Adolescents (Estudio de Monitorización de las Conductas de Salud de los Adolescentes) (EMCSAT). The prevalence of daily smokers varies among studies, in boys from 8.5 to 13.3% and in girls from 12.7 to 16.4%. Although some series show variations, the trend from 1993 to 2008 is downwards. With data from recent years, weighted annual declines in smoking prevalence in adolescence can be estimated to be 6.47% for boys and 6.96% for girls. There is a decreasing pattern in adolescent daily smoking prevalence in Spain from the different existing studies, which provide consistent data, although surveillance must be kept due to fluctuations. This is in agreement with tobacco sales statistics and health surveys in the adult population. However, the pace of change should be more rapid and constant. © 2010 Elsevier España, S.L. All rights reserved.

  14. [Assessment of surveys of adolescents about smoking and the use of alcohol and cannabis in Spain].

    PubMed

    Villalbí, Joan R; Suelves, Josep M; Saltó, Esteve; Cabezas, Carmen

    2011-01-01

    Monitoring health-related behaviors in adolescence requires instruments capable of providing valid data The objective of this paper is to review and assess existing information sources on smoking and alcohol and cannabis use by age and sex among adolescents in Spain. A search was carried out for studies with repeated observations over time, and their methods and characteristics reviewed. For each study, the number of surveys, their frequency and their sample size are assessed, as well as the instrument used, the available indicators, and the availability, accessibility and comparability of the information. Five sources of information providing data over extended periods of time with accessible data are identified: the National survey on drug use in secondary-school children (Encuesta estatal sobre uso de drogas en estudiantes de secundaria; ESTUDES); the Health behavior in school-aged children study (ECERSHBSC); the Monitoring system for risk factors associated with non-transmissible diseases in young people (Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No Transmisibles dirigido a poblacion juvenil; SIVFRENT-J); the Study of risk factors in secondary school children (Estudio de factores de riesgo en estudiantes de secundaria; FRESC); and the Monitoring study of health behaviors in adolescents (Estudio de monitorizacion de las conductas de salud de los adolescents; EMCSAT). Two of the surveys cover the whole of Spain, one is regional, and two are city-specific. All use solid methods and representative sampling techniques. In some, changes have occurred that make comparison of the evolution of some indicators difficult. Report accessibility is variable; comparability is limited for some surveys. Some provide almost no stratified data. There are valuable sources of data, but all have shortcomings. Changing the measurement instrument in a survey for comparison with others raises dilemmas as to the internal comparability of series.

  15. [Metabolic myopathies].

    PubMed

    Papazian, Óscar; Rivas-Chacón, Rafael

    2013-09-06

    Objetivo. Revisar las miopatias metabolicas manifestadas solamente por crisis de mialgias, calambres y rigidez musculares con dificultad para contraer los musculos afectados y el examen neurologico normal entre las crisis en niños y adolescentes. Desarrollo. Estas miopatias metabolicas se deben a deficits enzimaticos heredados en forma autosomica recesiva del metabolismo de los carbohidratos y lipidos. El resultado final es una reduccion del trifosfato de adenosina principalmente a traves de la fosforilacion oxidativa mitocondrial con disminucion de la energia disponible para la contraccion muscular. Las secundarias a trastornos del metabolismo de los carbohidratos se producen por ejercicios de alta intensidad y breves (< 10 min) y las secundarias a trastornos de los lipidos, por ejercicios de baja intensidad y prolongados (> 10 min). Los deficits enzimaticos en el primer grupo son de miofosforilasa (glucogenosis V), fosfofructocinasa muscular (glucogenosis VII), fosfoglicerato mutasa 1 (glucogenosis X) y beta enolasa (glucogenosis XIII), y en el segundo, de carnitina palmitol transferasa tipo II y de acil-CoA deshidrogenasa de cadena muy larga. Conclusiones. Las caracteristicas diferenciales de los pacientes en cada grupo y dentro de cada grupo permitiran el diagnostico clinico presuntivo inicial en la mayoria y solicitar solamente los examenes necesarios para corroborar el diagnostico. El tratamiento de las crisis consiste en hidratacion, glucosa y alcalinizacion de la orina. Las medidas preventivas son evitar el tipo de ejercicio que induce las crisis y el ayuno. No existe cura o tratamiento especifico. El pronostico es bueno con la excepcion de casos raros de insuficiencia renal aguda debido a la elevacion sanguinea de la mioglobina producto de una rabdomiolisis grave.

  16. [Discriminant analysis to predict the clinical diagnosis of primary immunodeficiencies: a preliminary report].

    PubMed

    Murata, Chiharu; Ramírez, Ana Belén; Ramírez, Guadalupe; Cruz, Alonso; Morales, José Luis; Lugo-Reyes, Saul Oswaldo

    2015-01-01

    Antecedentes: las características clínicas de un paciente con sospecha de inmunodeficiencia primaria orientan el diagnóstico diferencial por medio del reconocimiento de patrones. Las inmunodeficiencias primarias son un grupo heterogéneo de más de 250 enfermedades congénitas con mayor susceptibilidad a padecer infecciones, autoinflamación, autoinmunidad, alergia y cáncer. El análisis discriminante lineal es un método multivariante de clasificación supervisada para agrupar a los sujetos a partir de encontrar combinaciones lineales de un número de variables. Objetivo: identificar las características que mejor explican la pertenencia de pacientes pediátricos con inmunodeficiencias primarias a un grupo de defectos o a una enfermedad. Material y método: estudio analítico transversal en el que a partir de una base de datos preexistente, con registros clínicos y de laboratorio de 168 pacientes con inmunodeficiencia primaria, seguidos en el Instituto Nacional de Pediatría de 1991 a 2012, construimos modelos discriminantes lineales para explicar la pertenencia de cada paciente a los diferentes grupos de defectos y a las inmunodeficiencias primarias más prevalentes en nuestro registro. Luego de una corrida preliminar se incluyeron únicamente las 30 variables (4 demográficas, 10 clínicas, 10 de laboratorio y 6 gérmenes) de mayor peso, a partir de las que se construyeron los modelos de entrenamiento con el algoritmo paso-a-paso (stepwise) hacia atrás, utilizando selección automatizada de variables e incorporación manual “teórica” por un experto humano. Se evaluó la utilidad clínica de los modelos resultantes (sensibilidad, especificidad, exactitud y coeficiente kappa), con intervalos de confianza de 95%. Resultados: los modelos incluyeron 6 a 14 variables para explicar la pertenencia de 168 pacientes con inmunodeficiencias primarias a los cinco grupos más numerosos (combinados, anticuerpos, bien definidos, desregulación y fagocitosis) y las

  17. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-01-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. [Venous thromboembolic disease: presentation of a case].

    PubMed

    Mirpuri-Mirpuri, P G; Álvarez-Cordovés, M M; Pérez-Monje, A

    2013-01-01

    Venous thromboembolic disease in its clinical spectrum includes both deep vein thrombosis and pulmonary thromboembolism, which is usually a complication of deep vein thrombosis. It is a relatively common disease with significant morbidity and requires an accurate diagnosis. They are numerous risk factors for venous thromboembolism, and there is evidence that the risk of thromboembolic disease increases proportionally to the number of predisposing risk factors present. The primary care physician should know the risk factors and suspect the presence of venous thromboembolic disease when there is a compatible clnical picture. The treatment for this pathology is anticoagulation. We report a patient with cardiovascular risk factors who was seen with pain in the right leg and shortness of breath and referred to the hospital with suspected venous thromboembolism, atrial fibrillation and pleural effusion. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  19. [Secondary pulmonary embolism to right atrial myxoma].

    PubMed

    Vico Besó, L; Zúñiga Cedó, E

    2013-10-01

    A case of pulmonary thromboembolism secondary to atrial myxoma right. The myxoma is a primary cardiac tumor, namely, has his origin in the cardiac tissue. Primary cardiac tumors are rare, including myxomas, the most common type. Have a predilection for females and the most useful tool for diagnosis is echocardiography. About 75% of myxomas occur in the left atrium of the heart and rest are in the right atrium. Right atrial myxomas in some sometimes associated with tricuspid stenosis and atrial fibrillation. The most common clinical manifestations include symptoms of this neoplasm constitutional, and embolic phenomena resulting from the obstruction to the flow intracavitary. The treatment of this condition is surgical. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  20. [Onset of myasthenia gravis in primary care. Presentation of a case].

    PubMed

    Álvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Pérez-Monje, A

    2013-10-01

    Myasthenia gravis is an autoimmune disorder of neuromuscular transmission involving the production of autoantibodies directed against skeletal muscle receptors, in most cases of acetylcholine. Clinically it is characterized by the appearance of muscle weakness after prolonged activity, which tends to recover after a period of rest, or administration of acetylcholinesterase inhibitors. It is a relatively rare disease, although the prevalence has increased by improved diagnosis and increased longevity of the population. The diagnosis can be based on evidence after it is suspected using pharmacological, immunological or electrophysiology tests. Treatment can be divided into: symptomatic, short term and long term. We report the case of a patient who complained of diplopia, this muscle weakness being the most common initial symptom of the disease. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  1. [Palliative care in Primary Care: presentation of a case].

    PubMed

    Álvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Gonzalez-Losada, J; Chávez-Díaz, B

    2013-10-01

    We present a case of a patient diagnosed with glioblastoma multiforme refractory to treatment. Glioblastoma multiforme is the most common primary brain tumour and unfortunately the most aggressive, with an estimated mortality of about 90% in the first year after diagnosis. In our case the patient had reached a stage of life where quality of life was importsnt, with palliative care being the only recourse. The family is the mainstay in the provision of care of terminally ill patients, and without their active participation it would be difficult to achieve the objectives in patient care. We must also consider the family of the terminally ill in our care aim, as its members will experience a series of changes that will affect multiple areas where we should take action. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. [Low back pain during pregnancy. Multidisciplinary approach].

    PubMed

    Gallo-Padilla, D; Gallo-Padilla, C; Gallo-Vallejo, F J; Gallo-Vallejo, J L

    2016-09-01

    After explaining that low back pain is considered the most common pregnancy complication, its pathogenesis, risk factors and the clinical characteristics of the very painful symptoms of this condition are described. As for its approach, it is stressed that it must be multidisciplinary, introducing very important preventive measures, including proper postural hygiene. For its treatment, the methods may be based on non-surgical or pharmacological interventions of a conservative non-invasive nature. Thus, physiotherapy, osteopathic manipulation, multimodal intervention (exercise and education), exercises performed in water environment, acupuncture, etc., have proven to be effective. Finally, it is emphasised that given the significant impact on their quality of life, different health professionals must be proactive and treat the lumbar disease in pregnant women. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. [The enigma of quaternary prevention in Primary Care. When and when not to do it (presentation of two cases)].

    PubMed

    Cucalón, J M; Guiu, M

    2013-09-01

    Quaternary prevention has been commonly defined with the "primum non nocere" of classical texts by many authors. The daily life of our primary care consultations are full of patients in which we wondered if we try to obtain the benefit of our intervention will exceed the damage we cause him to intervene. Patients with multiple comorbidities, polypharmacy and complex are common in our consultations and it is becoming more difficult to move the balance of our actions, diagnostic or therapeutic benefit to the side. Through 2 cases often move to the reflection of this problem. Quaternary prevention must also be present in our daily activities. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. [Conflicts of interests in clinical research in primary health care].

    PubMed

    González-de Paz, L; Navarro-Rubio, M D; Sisó-Almirall, A

    2014-03-01

    Conflicts of interests between professionals and patients in biomedical research, is an ethical problem. None of the laws in Spain mention whether the clinical researcher has to clarify to participants the reasons why it proposes them to participate in a clinical trial. In this article, conflicts of interests in research are discussed in the context of primary healthcare. In this area conflicts of interests might alter the confidence between patients and healthcare professionals. Finally, we suggest some practical strategies that can help participants make the decision to participate in a clinical trial more willingly and freely. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  5. [Suspected Hirayama disease. Presentation of a case and a clinical review].

    PubMed

    Álvarez-Cordovés, M M; Mirpuri-Mirpuri, P G; Pérez-Monje, A

    2013-01-01

    Hirayama's disease, or juvenile muscular atrophy of distal upper extremity, is a cervical myelopathy. It affects adolescent males, and is characterized by progressive muscle weakness and atrophy of the distal upper extremities, followed by slow paralysis. Although the cause remains unclear, radiological findings suggest neuropathic forward displacement of the posterior cervical dural sac during neck flexion, causing compression of the cervical cord, resulting in atrophic changes and ischemic disease of the medullar anterior horn. Since the bending of the neck was recognized as a cause of the disease, cervical orthosis, spinal fusion, and duraplasty combined with fusion, have been proposed as treatment. A solid understanding of Hirayama disease is critical as early recognition and effective treatment can stop the deterioration. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. [Antidepressants in the elderly].

    PubMed

    Cortajarena García, M C; Ron Martin, S; Miranda Vicario, E; Ruiz de Vergara Eguino, A; Azpiazu Gomez, P J; Lopez Aldana, J

    2016-10-01

    Depression in the elderly is a changing, difficult and common disorder. At this age, there are more relapses and more long-life treatment is required. The pharmacology approach is a challenge because of concurrent factors that make their treatment more difficult. It is very important to have a basic antidepressant scheme, in order to help treat this disorder with efficiency and success from Primary Care. There are no drugs without side effects, and their characteristics have to be known in order to make the right selection depending on effectiveness, safety and tolerance. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. [Edematous and painful leg. Pathophysiology in the spotlight: presentation of a case].

    PubMed

    Estalayo-Gutiérrez, B

    2013-01-01

    We report on a 74-year-old woman visually impaired and under treatment with amlodipine, valsartan and thyroid hormone. The patient complained of her unique, edematous and painful leg after a local trauma. The worsening was slow and gradual, affecting walk and state of mind. Several unsuccessful diagnoses were done before suspecting and confirming a Complex Regional Pain Syndrome. Edema disappeared dramatically after amlodipine empirical discontinuation. Pain improved gradually with rehabilitation exercises but, mainly, after gaining skills and self-esteem due to cataract surgery of her unique functional eye. It was necessary to decrease thyroid hormone dosage after a long lasting balance. The sympathetic nervous system role of the case is discussed. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. [An earlier diagnosis of depression].

    PubMed

    Campagne, D M

    2017-06-19

    Data of the last decade indicate that, in the Western world and also in Spain, an important part of general practicioners' consultations are related to mental health, but depression is consistently underdiagnosed. Causes are lack of time and back-up, as well as lack of specific training. In Spain, there is no national health service primary care database with actualized clinical information as to mental health. There is evident clinical interest in a more agile diagnostic, resulting from a recollection of data from voluntary selective screening and continuing evaluation of adult depression along the model used by other National Health Systems. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Venous thromboembolism prevention in pregnancy and the postpartum period in Primary and Specialized Care].

    PubMed

    Gallo-Vallejo, J L; Naveiro-Fuentes, M; Puertas-Prieto, A; Gallo-Vallejo, F J

    2016-11-23

    After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. [Persistent backache in a 62 year-old male: mechanical pain?].

    PubMed

    Cardenal González, I M; Lafuente Salanova, F M; Lozano Espinosa, M; Barbosa Orellana, J L; Martínez Monje, F; Leal Hernández, M

    2014-01-01

    The case is presented of a 62 year old man with a history of pulmonary tuberculosis, repeatedly consulting his primary care physician for treatment of analgesic / anti-inflammatory resistant back pain, and usually coincided with physical activity. It was initially diagnosed as mechanical pain, but in the absence of response to rest and treatment a magnetic resonance of the spine was requested, which reported bone metastases. The patient was then referred to Internal Medicine for further tests in hospital. The histopathology ruled out the presence of neoplastic cells, and imaging tests showed radiographic abnormalities in vertebral bodies (osteomyelitis-discitis) associated with epidural abscess, compatible with Pott's disease, a kind of tuberculous arthritis of the intervertebral joints. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. [Normal abdominal ultrasound anatomy. Examination procedure].

    PubMed

    Salcedo Joven, I; Segura Grau, A; Rodríguez Lorenzo, A; Segura Cabral, J M

    2014-01-01

    To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  12. [Eosinophilic esophagitis, a pathology on the rise].

    PubMed

    Miranda García, M; Gutiérrez Teira, B

    2013-10-01

    The eosinophilic esofagitis is a pathology that consists of an inflammatory condition of the esophagus, which is characterized for having a high percentage of eosinophils. It is a problem of allergic origin and his diagnosis is increasing in the population, especially in children and adult young persons, throughout last decade. The fisiopathology is not completely established nowadays. The diagnosis is confirmed with endoscopia and capture of biopsies. The differential diagnosis is necessary to be done with the disease for reflux gastroesofágico, gastroenteritis eosinofílica, by Crohn's disease, pathology of connective fabric, syndrome hipereosinofílico, infections and response of hypersensitivity to medicaments. Nowadays there is no a treatment that is definitive. We present a clinical case, which was valued initially for the consultation of Primary care. Copyright © 2011 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. [Inhaled in chronic obstructive pulmonary disease therapy update].

    PubMed

    Viejo-Casas, A; Bonnardeaux-Chadburn, C; Ginel-Mendoza, L; Quintano-Jimenez, J A

    2016-10-01

    Knowledge of chronic obstructive pulmonary disease has increased significantly in recent years, and today we have a more comprehensive concept of the disease. Additionally, drug development allows having a wide range of therapeutic options. The inhaled route is the choice, as it allows drugs to act directly on the bronchial tree. In the past few months, new molecules and devices have been developed that increases our options when treating, but also our doubts when choosing one or the other, so an update of inhaled medications for chronic obstructive pulmonary disease is necessary. The different types of inhalers currently available are reviewed in this article, as well as the advantages and disadvantages of each of them, in order to determine how to choose the right device. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Subphrenic abscess in the context of low back pain and reading analytics in the primary care consultations].

    PubMed

    Mirpuri-Mirpuri, P G; Álvarez-Cordovés, M M; Pérez-Monje, A

    2013-01-01

    The subphrenic space is defined as the area below the diaphragm and above the transverse colon. Most abscesses are due to direct subphrenic contamination associated with, surgery, local disease, or trauma, but the cause still remain undefined or unknown. It is a disease rarely diagnosed in primary care. About 55% of subphrenic abscesses are located on the right side, with 25% on the left, and 20% are multiple. These can be extended to the thoracic cavity, which sometimes produce empyema, lung abscess, or pneumonia. The mortality of subphrenic abscess is between 11%-31%, and may be due to uncontrolled infection, malnutrition, and complications of prolonged hospitalization, such as nosocomial infections. Ultrasound or computed tomography-guided percutaneous drainage is now the preferred treatment, combined with antibiotics. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  15. [Thyroid dysfunction in pregnancy. Consensus document. Andalusian Society of Endocrinology and Nutrition (SAEN)].

    PubMed

    Santiago Fernández, P; González-Romero, S; Martín Hernández, T; Navarro González, E; Velasco López, I; Millón Ramírez, M C

    2015-09-01

    A position statement on the diagnosis and treatment of thyroid dysfunction in pregnancy has been agreed on behalf of The Sociedad Andaluza de Endocrinología y Nutrición (SAEN), based on a review of the literature to date and all good clinical practice guidelines. The document is set out in different sections as regards the diagnosis and treatment of, overt and subclinical hypo- and hyperthyroidism, isolated hypothyroxinaemia and postpartum thyroiditis. It also justifies the implementation of universal screening for thyroid dysfunction in pregnancy, and provides practitioners who care for these patients with tool for rational decision making. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Horseshoe kidney, stone disease and prostate cancer: a case presentation].

    PubMed

    Hermida Pérez, J A; Bermejo Hernández, A; Hernández Guerra, J S; Sobenes Gutierrez, R J

    2013-01-01

    The horseshoe kidney is the most common congenital renal fusion anomalies. It occurs in 0.25% of the population, or 1 in every 400 people. It is more frequent in males (ratio 2:1). The most observed complication of horseshoe kidney is stone disease, although there may be others such as, abdominal pain, urinary infections, haematuria, hydronephrosis, trauma and tumours (most commonly associated with hypernephroma and Wilms tumour). We describe a case of a male patient with horseshoe kidney, stone disease and adenocarcinoma of the prostate. One carrier of this condition who suffered a transitional cell carcinoma of the prostate was found in a review of the literature. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  17. [Pycnodysostosis: a rare disease with frequent fractures].

    PubMed

    Sánchez Lázaro, J A; Linares Álvarez, L

    2014-04-01

    Pycnodysostosis is a rare disease caused by a dysfunction of the osteoclasts due to a mutation in the cathepsin K gene. We present a case of a young adult patient with the above mentioned syndrome, who suffered an atypical fracture of the tibia after a low energy fall. Some bone changes that could have predisposed the fracture were observed when examined in the Emergency Department. Not long afterwards he suffered the same type of fracture in another tibia. Due to the conditions typical of the pycnodysostosis, the above mentioned fracture required an unconventional approach for this mid-shaft tibial fracture (osteosynthesis plate), combined with a longer consolidation time. The case was finally resolved satisfactorily. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. [Ultrasound of the urinary system].

    PubMed

    Segura-Grau, A; Herzog, R; Díaz-Rodriguez, N; Segura-Cabral, J M

    2016-09-01

    Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Pancreatic ultrasonography].

    PubMed

    Fernández-Rodríguez, T; Segura-Grau, A; Rodríguez-Lorenzo, A; Segura-Cabral, J M

    2015-04-01

    Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  20. [What the family doctor must know about lung transplant (Part 1)].

    PubMed

    Zurbano, L; Zurbano, F

    2017-09-01

    Lung transplant is a therapeutic, medical-surgical procedure indicated for pulmonary diseases (except lung cancer), that are terminal and irreversible with current medical treatment. More than 3,500 lung transplants have been performed in Spain, with a rate of over 6 per million and increasing. In this review, an analysis is made of the types of transplants, their indications and contraindications, the procedures, immunosuppressive treatments, their side effects and medical interactions, current prophylaxis. A list of easily accessible literature references is also include, the majority being by national authors. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Ultrasound diagnosis of pulmonary infarction in emergencies. A case presentation].

    PubMed

    Jaloud-Saavedra, E; Oviedo-García, A A; Algaba-Montes, M; Núñez-Hospital, D

    2013-01-01

    Pulmonary infarction is a parenchymal ischemic lesion that occurs in the context of a pulmonary embolism when arterial blockage deprives perfusion to that area and the adjacent bronchial circulation does not provide the necessary flow. It appears in approximately 40% of pulmonary embolisms. Emergency Physicians are able to diagnose a pulmonary infraction at the patient bedside, in a quick, easy, safe and efficient way with the availability of ultrasound in our Emergency Rooms and Health Centres. The possibility of approaching the aetiology, firstly with a clinical suspicion then adding risk factors, symptoms, clinical and radiological signs and the use of in situ imaging, increases the sensitivity and specificity of the diagnosis. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. [What would you do with a 29-weeks pregnant woman with generalised pruritus?].

    PubMed

    Moreno, B; López Faraldo, A

    2014-10-01

    Intrahepatic cholestasis of pregnancy is a reversible disease of variable frequency. The pathophysiology involves an increase of the bile acids in the fetal blood of the mother and the fetus. The high concentrations of the bile acids cause maternal pruritus and high perinatal morbimortality. Primary Care physicians in close contact with the patient must have a high index of suspicion when faced with typical symptoms of cholestasis, such as generalized pruritus in women in the second or third trimester of gestation to be able to act on the consequences. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. [Cancer and unemployment].

    PubMed

    Lastra-del-Prado, R; Rodríguez-García, Juan; Muñoz Cifuentes, P; Gimeno Feliú, L A

    2016-03-01

    The lack of work is a increasingly dramatic situation in the times we are living. Daily experience of clinicians provides us with important clues that remind us of the existence of a direct relationship between prolonged unemployment and predisposition to serious health problems, in particular to suffering certain types of cancer. This paper aims to review the major epidemiological studies that have dealt the relationship between cancer and unemployment. Several hypotheses may be formulated with the results of this review arising from the possible etiological relationship between unemployment and development (or poor prognosis) of neoplastic processes. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [What would you do with an adult patient who consults due to head muscle weakness and has dropped head?

    PubMed

    Paino, L; Blasco, N

    2017-06-03

    The dropped head syndrome, whether due to muscle weakness, rigidity, or ankylosis, is not uncommon in the elderly. It is characterised by a "chin-on-chest" reducible kyphosis, which is secondary to head muscle debility. It may be associated with a neuromuscular group of diseases such as polymyositis, chronic Inflammatory demyelinating polyneuropathy, myasthenia gravis, amyotrophic lateral sclerosis, and inclusion-body myositis. Some cases associated with hypothyroidism and hyperparathyroidism have also been described. Prognosis without treatment is poor. Therefore, familiarity with this condition, together with a complete anamnesis and physical examination, should lead us to the clinical suspicion and selection of the appropriate complementary tests. In this article, a case of dropped head syndrome is reported, as well as an algorithm for its diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. [Out-of-hospital births].

    PubMed

    Fernández Domínguez, N; Leal Gómez, E; García Lavandeira, S; Vázquez Rodríguez, M

    2016-01-01

    Childbirth is a physiological process and, as such, there should be limited assistance for the woman to ensure that it follows its natural process, avoiding any possible complication and, if they do appear, attempting to resolve them. Health personnel should try to achieve a balance between safety and the least possible outside assistance. The out-of-hospital delivery is considered an emergency as it happens unexpectedly, that is, without being previously planned. Given that it has to be treated outside the ideal conditions of a maternity ward, it is considered as an emergency. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Female sexual dysfunction: Drug treatment options].

    PubMed

    Alcántara Montero, A; Sánchez Carnerero, C I

    2016-01-01

    Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. [Early detection or screening in the prevention of prostate cancer?

    PubMed

    Brenes Bermúdez, F J; Alcántara Montero, A

    2017-03-01

    Prostate cancer (PC) is the most common malignancy in men in the developed world and the second leading cause of cancer death in men in the USA, behind lung cancer. In Europe, it is the third leading cause of cancer death in men (after lung and colorectal cancers). The role of PC screening is currently being questioned. The following article summarises the most relevant epidemiological aspects of PC, as well as major clinical trials of PC screening, and recommendations of the various medical scientific associations on whether or not to screen for PC. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Need of specific criteria for psychotherapy referral in the public health system: A proposal].

    PubMed

    García-Haro, J; Fernández-Briz, N

    2015-01-01

    This study discusses the need of specific criteria for psychotherapy referral in the public services. the use of psychotherapy as a supplement to traditional medication, and its comparison with informal methods of support, has been questioned. This study proposes the establishment of basic criteria for the integration of psychotherapy, based on an analysis of the conditions that allow it to function. It thus aims to contribute to improving the reputation and the practice conditions of psychotherapy in the public health system. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Ultrasound of the large abdominal vessels].

    PubMed

    Oviedo-García, A A; Algaba-Montes, M; Segura-Grau, A; Rodríguez-Lorenzo, Á

    2016-01-01

    Ultrasound has recently become an indispensable tool for the family physician, whether exercised in primary care and emergency department; and likewise it has spread to many other specialties: internal medicine, critical care, neurology, pneumology, digestive, etc. and that ultrasound has proven to be a safe diagnostic tool and have great capacity. We firmly believe that ultrasound done to «bedside» the patient by the family doctor, can greatly complement the physical examination and greatly improve clinical effectiveness, allowing the browser an immediate view of the anatomy and physiology of certain structures. It is within this context is particularly relevant ultrasonography of the Aorta and large abdominal vessels, made by the family doctor or the emergency itself, which will develop along this chapter. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. [Journey to what is essentially invisible: pysochosocial aspects of disease].

    PubMed

    Turabián, J L; Pérez-Franco, B

    2014-03-01

    Physicians may be well equipped for the biological aspects of disease, but not for its psychosocial dimensions, an issue that has been absent in family medicine. The psychosocial aspects of the disease are the factors involved in how patients react to the disease, play a role in the expression of symptoms and disease, and have implications on the lives of patients. Moreover, the biological effects (specific) and psychosocial effects (non-specific) are not simply additive but interactive. Physicians should be aware of this hidden, essentially invisible patient psychosocial morbidity, and must incorporate bio-psychosocial interventions into routine medical care to be more effective. In addition, to consider these aspects in the context of care contributes to the distinctive elements of family medicine. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. [Increased height in obese schoolchildren versus healthy weight schoolchildren].

    PubMed

    Larrosa-Haro, Alfredo; González-Pérez, Guillermo Julián; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Chávez-Palencia, Clío; Salazar-Preciado, Laura Leticia; Lizárraga-Corona, Elizabeth

    2014-01-01

    IBTRODUCCIÓN: la asociación entre crecimiento y obesidad ha sido poco estudiada en la población de escolares obesos mexicanos. El objetivo de este estudio fue comparar la talla para la edad entre escolares obesos y con peso saludable. MÉTODOS: estudio transversal realizado en 369 escolares con peso saludable y 162 obesos en una escuela primaria; 49.4 % era de sexo femenino. Se utilizó la clasificación percentilar del Índice de masa corporal: peso saludable: del percentil 5 al 84, obesidad: valor > percentil 95; se agruparon por sexo e intervalos de clase de un año. El análisis estadístico se hizo con U de Mann-Whitney.

  12. PubMed

    Fernandez-Gallego, V; Hernández Herrera, G; Moreno Arciniegas, A; Moreno Rolando, E

    2016-12-30

    Presentamos el caso de un paciente que sufrió una parada cardiorrespiratoria extrahospitalaria en helicóptero sanitario, refractaria a tratamiento médico y eléctrico convencional. El paciente recuperó la circulación espontánea tras 58 minutos en paro cardiaco y 31 descargas eléctricas, estando monitorizado en todo momento de la reanimación cardiopulmonar con capnografía (valores > 20 mm/Hg). A su llegada al hospital, se le realizó una angioplastia primaria, colocándosele un stent en la arteria coronaria derecha. El paciente fue dado de alta hospitalaria, sin secuelas neurológicas (categoría de función cerebral 1).

  13. [The advertising message of drugs advertisements in Spanish medical journals].

    PubMed

    Riera, Eusebi J Castaño; de la Fuente, David Oterino; Rodrígueza, Rosa M Rodríguez

    2007-01-01

    To describe the characteristics of advertising in Spanish medical journals and to analyze the advertising message in drug advertisements. Six issues of 4 Spanish medical journals published in 2001 were reviewed to identify the number of advertisements and their characteristics. The journals selected were Atención Primaria, Anales Españoles de Pediatría, Medicina Clínica and Gaceta Sanitaria. The advertising message was analyzed by evaluating 5 factors: communication aim, sales argument, communication treatment, and use of text and image. 609 advertisements were found. Drug advertisements were the most numerous (69.9%). Advertising pressure was highest in Atención Primaria (36%), followed by Anales Españoles de Pediatría (22%), Medicina Clínica (12%) and Gaceta Sanitaria (4%). Of the 195 drug advertisements analyzed, the aim of the advertising message was mostly to present or remind readers of an existing product (70.8%). The sales argument was rational in 86.5%. The communication treatment was advertising in 72.6%. The text of the advertisement contained a headline in 82.4% or a slogan in 50.8%. The advertisement image was a photograph in 74.7% and the aim of the image was to present the product (48.7%), to promise a benefit (45.1%), or to argue its qualities (31.1%). In the journals aimed at prescribing physicians advertising pressure was higher and advertisements were intercalated in article text. Advertising concerned already existing products, used rational arguments, and the communication treatment was advertising.

  14. Prevalence of obesity among primary students between 2009 to 2014 in China: a meta-analysis.

    PubMed

    Qi, Yanhong; Yu, Yang; Li, Kaisheng; Chen, Zhihong; Liu, Yuanchang; Zhang, Hongmei

    2014-09-12

    Introducción: En los últimos años, la obesidad se ha convertido en el principal problema de salud pública a nivel mundial. La tasa de detección de obesidad infantil está creciendo alarmantemente entre los niños y los adolescentes en China, cuya población de 120 millones se sitúa en el rango de obesidad. Se calculó que el 8% de los niños son obesos. Métodos: Se recopilaron publicaciones entre 2009 y 2014 sobre la prevalencia de obesidad entre los alumnos de primaria en China de PubMed, textos completos de bases de datos de periódicos chinos online de VIP, CNKI y Wanfang. Se empleó software de meta-análisis para resumir y analizar las tasas de detección incluidas en la bibliografía previamente obtenida. Resultados: Después de la evaluación de la calidad de los artículos, finalmente incluimos 18 artículos en nuestro estudio, y los tamaños de la muestra total en la investigación sobre obesidad fueron 247547, donde 26466 presentaron obesidad. Los resultados de los meta-análisis mostraron que la prevalencia de la obesidad en los alumnos de primaria es del 10,0% (IC del 95%: 7,2% - 13,5%). Conclusión: Nuestros resultados indican que la prevalencia de obesidad en China todavía supone un problema preocupante, dado que la situación será peor si no se toman medidas eficaces y prácticas.

  15. Clinical and Demographic Characteristics of Binge Drinkers Associated with Lack of Efficacy of Brief Intervention and Medical Advice.

    PubMed

    Rubio, Gabriel; López-Rodríguez, Juan A; Zuluaga, Pilar; Ponce, Guillermo; Martínez-Gras, Isabel; Jiménez-Arriero, Miguel Ángel

    2015-06-17

    La Intervención Breve (IB) y el Consejo Médico simple (CM) son intervenciones psicoterapéuticas usadas para el tratamiento del consumo de alcohol por atracones en Atención Primaria. A pesar de la frecuencia de este patrón de abuso en Europa y en los Estados Unidos, ningún estudio ha evaluado las características de los sujetos que no responden a esas dos técnicas. Objetivo. Determinar las características demográficas y clínicas de los bebedores por atracones en los que la IB y el CM no son efectivos para la reducción del consumo perjudicial de alcohol. Métodos. Se trata de un análisis secundario de los datos obtenidos en un ensayo aleatorizado de intervención breve en alcohol con un período de seguimiento de 12 meses. Un total de 674 sujetos (89%) participaron durante todo el estudio hasta el final. La variable principal fue el cambio en el uso perjudicial de alcohol tras 12 meses de seguimiento. Resultados. Para ambos grupos de tratamiento las variables que predecían la continuidad en el consumo perjudicial tras el seguimiento eran: bajo nivel educativo, ser jóvenes, el número de cigarrillos fumados, la historia familiar de alcoholismo y la gravedad del consumo de alcohol basalmente. Conclusiones. Las características clínicas y sociodemográficas de los sujetos con un patrón de consumo de alcohol por atracones atendidos en Atención primaria influyen en el pronóstico de las Intervenciones breves y del Consejo Médico.

  16. [Clinic of humoral primary immunodeficiencies in adults. Experience in a tertiary hospital].

    PubMed

    Cambray-Gutiérrez, Julio César; Herrera-Sánchez, Diana Andrea; Blancas-Galicia, Lizbeth; O'Farrill-Romanillos, Patricia María

    2016-01-01

    Antecedentes: Las inmunodeficiencias primarias (IDP) son trastornos de los componentes del sistema inmune. Las deficiencias humorales representan el 50%. Las más comunes son el déficit selectivo de IgA, agammaglobulinemia de Bruton y la inmunodeficiencia común variable (IDCV). Objetivo: Describir las características epidemiológicas y clínicas de adultos con IDP humorales, atendidos en una Clínica de Inmunodeficiencias Primarias Humorales. Métodos: Estudio descriptivo trasversal que abarcó un año de análisis, en el que se incluyeron 35 pacientes con IDP humoral. Los datos se analizaron con estadística descriptiva. Resultados: De 35 pacientes estudiados, 31 tuvieron IDCV (88.5%) y 4 (11.5%) agammaglobulinemia de Bruton; 21 fueron hombres y 14 mujeres. La edad al inicio de los síntomas fue de 22.7 años y el tiempo de retraso en el diagnóstico fue de 7.2 años; 11.4% de los pacientes con IDCV fallecieron durante el estudio; 4 padecieron neoplasias, 22.8% enfermedades autoinmunes y 48.5% alteraciones gastrointestinales. Los pacientes con agammaglobulinemia de Bruton no presentaron comorbilidades. Conclusiones: A diferencia de lo informado en la literatura, la IDCV fue la causa más común de IDP humoral en el grupo estudiado, con predominio en hombres; la alteración gastrointestinal más común fue el trastorno funcional intestinal.

  17. [Food consumption in and around the school].

    PubMed

    Alvear-Galindo, M Guadalupe; Yamamoto-Kimura, Liria T; Morán-Álvarez, Cristina; Solís-Días, M Guadalupe; Torres-Durán, Patricia Victoria; Juárez-Oropeza, Marco Antonio; Acuña-Sánchez, M Eugenia; Ferreira-Hermosillo, Aldo

    2013-01-01

    Introducción: en México, los niños de primaria permanecen aproximadamente 4.5 horas en la escuela, por lo que fuera de ese espacio es donde consumen la mayor parte de sus alimentos. El objetivo de esta investigación fue explorar las conductas alimentarias más allá del entorno escolar que pudieran favorecer la obesidad. Métodos: estudio descriptivo de niños de una escuela primaria oficial en el Distrito Federal. Los hábitos alimentarios se conocieron por un cuestionario y las características antropométricas, por medición física. Resultados: los participantes indicaron consumir refrescos y jugos enlatados con alta frecuencia y en cantidades importantes (80 %), así como productos lácteos industrializados con alto valor calórico y bajo contenido de proteínas; ingerían pocos alimentos de origen animal; 30 % comía cuatro o cinco veces al día y 10 %, una o dos veces. Los resultados se asociaron con las características omatométricas de los niños, 37.6 % de los cuales presentó sobrepeso u obesidad y 12 %, bajo peso. Conclusiones: para la prevención de la obesidad son necesarios programas de educación que involucren a profesores, padres de familia y escolares, para obtener conductas saludables y preservar la salud.

  18. [Use of non-vitamin K antagonist oral anticoagulants in Primary Care: ACTUA study].

    PubMed

    Barrios, V; Escobar, C; Lobos, J M; Polo, J; Vargas, D

    2016-10-28

    Approximately 40% of patients with non-valvular auricular fibrillation (NVAF) who receive vitamin K antagonists (VKA) in Primary Care in Spain have poor anticoagulation control. The objective of the study Actuación en antiCoagulación, Tratamiento y Uso de anticoagulantes orales de acción directa (ACOD) en Atención primaria (ACTUA) (Action in Coagulation, Treatment and Use of direct oral anticoagulants [DOACs]) in Primary Care) was to analyse the current situation regarding the use of VKA and non-vitamin K antagonist oral anticoagulants (NOACs) in patients with NVAF in Primary Care in Spain and the possible issues arising from it. An online survey was created covering various aspects of the use of oral anticoagulants in NAFV. A two-round modified Delphi approach was used. Results were compiled as a set of practical guidelines. Forty-four experts responded to the survey. Consensus was reached in 62% (37/60) of the items. Experts concluded that a considerable number of patients with NVAF who receive VKA do not have a well-controlled INR and that a substantial group of patients who could benefit from being treated with NOACs do not receive them. The use of NOACs increases the probability of having good anticoagulation control and decreases the risk of severe and intracranial haemorrhage. Current limitations to the use of NOACs include administrative barriers, insufficient knowledge about the benefits and risks of NOACs, limited experience of doctors in using them, and their price. Renal insufficiency influences the choice of a particular anticoagulant. The ACTUA study highlights the existing controversies about the use of oral anticoagulants for the treatment of NVAF in Primary Care in Spain, and provides consensus recommendations that may help to improve the use of these medications. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-01-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  20. Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society.

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-03-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. [Descriptive study of statistical methods in the original article published on the cigarette smoking habit in four Spanish medical journals (1985-1996)].

    PubMed

    García López, J A

    2000-01-01

    Being the tobacco use a high-priority subject of investigation and having itself increased the utilization of statistical techniques in biomedical publication the used statistical techniques are described and the statistical accessibility is quantified in the original articles on tobacco use published in four Spanish medical journals. Retrospective descriptive study of 154 original articles on the cigarette smoking habit published in 1985-1996 in the journals Atención Primaria, Medicina Clínica (Barcelona), Revista Española de Salud Pública and Revista Clínica Española. An only observer codified the statistic techniques in 14 categories in agreement with the classification processed by Carré et al (1995) from the classification settled down by Emerson and Colditz (1983). The knowledge of bivariable techniques, to simple lineal regression, was stablished as the reference for the study of statistical accessibility. 81.8% original articles used inferential statistics. The most frequently used categories were "Contingency tables" (37.0%), "Descriptive statistics" (18.2%) and "Life tables and analysis of survival" (9.7%). A reader familiarized with bivariable techniques has statistical access to 96.0% for the originals of Revista Española de Salud Pública, 86.2% of Atención Primaria, 66.7% of Medicina Clínia (Barcelona) and 33.3% of Revista Clínica Española. The same reader had statistical access to 100% for the originals published from 1985 to 1987 and 68.1% from 1994 to 1996. The use of statistical methods depends on the investigation subject and design, the journal and the year of the publication. The decrease of the statistical accessibility recommends to identify the profile of the standard reader in Spain, to adjust his knowledge to the current biomedical literature demand.

  2. [Orofacial clinical manifestations in adult patients with variable common immunodeficiency].

    PubMed

    Chávez-García, Aurora Alejandra; Moreno-Alba, Miguel Ángel; Elizalde-Monroy, Martín; Segura-Méndez, Nora Hilda; Romero-Flores, Jovita; Cambray-Gutiérrez, Julio César; López-Pérez, Patricia; Del Rivero-Hernández, Leonel Gerardo

    2015-01-01

    Antecedentes: la inmunodeficiencia común variable es la inmunodeficienci primaria más común en adultos. Su prevalencia se estima en 1 por cada 25,000 a 75,000 recién nacidos vivos; existen variaciones por grupos étnicos, se estima en 50 a 70% en pacientes de raza caucásica. Las lesiones de la cavidad oral raramente se describen en pacientes adultos con inmunodeficiencia común variable, en niños con esta enfermedad existen informes de lesiones principalmente de origen infeccioso. Objetivo: describir las lesiones orofaciales (cavidad oral, macizo facial y cuello) en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio transversal, prospectivo, efectuado en todos los adultos con inmunodeficiencia común variable adscritos a la Clínica de inmunodeficiencias primarias, del Hospital de Especialidades, Centro Médico Nacional Siglo XXI, que fueron examinados por un cirujano maxilofacial; se realizó el reporte de hallazgos en lista de cotejo y, posteriormente, el análisis descriptivo de las lesiones. Resultados: se incluyeron 26 pacientes, 16 mujeres y 10 hombres, con edad promedio de 38.6 años. En 18 de 26 pacientes estudiados se observaron lesiones orales, con siete lesiones diferentes y predominio en el sexo femenino 2:1. Las lesiones más frecuentes fueron: hiperplasia de glándulas salivales menores (19/26), petequias (12/26) y úlceras herpetiformes (7/26). En la cara y el cuello se observaron cuatro lesiones distintas, las adenopatías < 2 cm (4/26) fueron las más comunes. Conclusiones: las alteraciones inmunológicas asociadas con la inmunodeficiencia común variable favorecen la aparición de lesiones de origen infeccioso y probablemente autoinmunitario que afectan la cavidad oral, la cara y el cuello.

  3. [Disclosure of sources of funding in biomedical journals. Descriptive study of four Spanish publications].

    PubMed

    Roig, F; Borrego, A

    2015-01-01

    The source of research funding can result in bias, and its disclosure is essential in the publication of results. The aim of the study is to identify the frequency and type of sources of funding in the articles published by four Spanish biomedical journals published in Spanish. The frequency and type of financial disclosures in the articles published during 2012 in the ordinary numbers of Atención Primaria, Medicina Clínica, Revista Clínica Española and Revista Española de Cardiología were analyzed. Articles described as "Editorial", "Original article", "Consensus Document", "Review" and "Special Article" were considered. It was decided in each case whether or not the article included any funding disclosure and the type of the declared funding (public or private). Four hundred and twelve publications were analyzed. In 32.5% there was disclosure of funding: 38% in Atención Primaria, 27% in Medicina Clínica, 15% in Revista Clínica Española and 45% in Revista Española de Cardiología. By type of articles, 47% of original articles, 44% of consensus documents, 21% of reviews, 14% of special articles and 8% of editorials had a funding source. In 51.5% of the cases, funding was exclusively public, in 36.5% exclusively private and in 10% mixed. There is considerable variability in the disclosure of funding sources in articles appearing in these four Spanish biomedical journals. It would be necessary to improve the disclosure requirements of sources of funding, making them uniform, clear and transparent.

  4. [Bilateral ovarian Burkitt's lymphoma. A case presentation].

    PubMed

    Briseño-Hernández, Andrés Alejandro; Quezada-López, Deissy Roxana; Castañeda-Chávez, Agar; Dassaejv Macías-Amezcua, Michel; Pintor-Belmontes, Julio Cesar

    2014-01-01

    Antecedentes: el linfoma de Burkitt es una forma agresiva de los linfomas no Hodgkin de células B que ocurre con mayor frecuencia en niños y adultos jóvenes; el linfoma de ovario puede aparecer como lesión primaria o, más comúnmente, como una metástasis. Las lesiones primarias de ovario son manifestaciones raras que corresponden a 0.5% de los linfomas no Hodgkin y 1.5% de los tumores de ovario. Caso clínico: paciente femenina de 31 años de edad, con debilidad generalizada, incapacidad para la marcha, disnea, hiporexia, fiebre, diaforesis, pérdida de 20 kg de peso, abdomen plano, con dolor abdominal; Ca125 610 U/mL. La tomografía computada abdominal mostró un gran tumor de aspecto sólido que afectaba a la cavidad pélvica derecha. Se extirparon los tumores ováricos bilaterales. Desde el punto de vista microscópico ambas lesiones muestran una imagen en "cielo estrellado" compuesta por un patrón de infiltrado monótono de linfocitos mezclada con macrófagos de citoplasma amplio y claro, abundantes mitosis atípicas, zonas de necrosis y hemorragia. La inmunohistoquímica reveló positividad para CDI0 y CD20, negativo con CD3, índice de proliferación Ki67 alto. Se diagnosticó linfoma tipo Burkitt bilateral de ovario. Conclusiones: el linfoma de Burkitt de ovario bilateral es poco frecuente, con variabilidad de presentación; el dolor abdominal y los tumores abdominales son lo más frecuente. El pronóstico a corto plazo de las pacientes es malo, por lo que es necesario conocer esta afección para poder establecer el diagnóstico temprano.

  5. Fine Structure in the Mm-Wavelength Spectra of the Active Region

    NASA Astrophysics Data System (ADS)

    Sawant, H. S.; Cecatto, J. R.

    1990-11-01

    RESUMEN. Faltan observaciones solares espectrosc6picas en la longitud de onda milimetrica. Hay sugerencias de que se puede superponer una fi na estructura en frecuencia a la componente-S de la regi6n solar activa, asi como a la componente del brote en las longitudes de onda milimetri- cas. Se ha desarrollado un receptor de alta sensibilidad de pasos de frecuencia que opera en el intervalo de 23-18 GHz con una resoluci6n de 1 GHz y resoluci6n de tiempo variable entre 1.2 y 96 sec, usando la an- tena de Itapetinga de 13.7-m para estudiar la estructura fina en frecuencia y tiempo. Discutimos el espectro en longitud de onda-mm en re- giones activas y su evoluci6n en el tiempo. El estudio de Ia evoluci6n en el tiempo de la regi6n activa en AR 5569 observada el 29 de junio de 1989, sugiere la existencia de estructuras finas como funci6n deltiempo. ABSTRACT. There is a lack of mm-wavelength spectroscopic solar observations. There are suggestions that a fine structure in frequency may be superimposed on the S-component of solar active region as well as on the burst component at inm-wavelengths. To study fine structure in frequency and time, a high sensitivity step frequency receiver operating in the frequency range 23-18 GHz with frequency resolution of 1 GHz and variable time resolution 1.2 to 96 sec, using 13.7 m diameter Itapetinga radome covered antenna, has been developed. Here, we discuss mm-wavelength spectra of active regions and their time evolution. Study of time evolution of an active region AR 5569 observed on 29th June, 1989 suggests existence of fine structures as a function of time. ( Ck : SUN-ACTIVITY - SUN-RADIO RADIATION

  6. Quality of Primary Health Care for children and adolescents living with HIV.

    PubMed

    Nascimento, Leticia do; Paula, Cristiane Cardoso de; Magnago, Tania Solange Bosi de Souza; Padoin, Stela Maris de Mello; Harzheim, Erno; Silva, Clarissa Bohrer da

    2016-08-29

    derivado, assim como nos atributos integralidade e orientação comunitária. Especialização em Atenção Primária à Saúde, outro emprego, vínculo estatutário mostraram-se associados à qualidade da atenção. destaca-se a Estratégia Saúde da Família com maior qualidade de atenção à saúde da criança e adolescente vivendo com HIV, entretanto, a cobertura ainda é baixa. Evidencia-se a necessidade de ampliação dessa cobertura, bem como investimento na qualificação profissional direcionada para Atenção Primária e na efetivação dos profissionais, por meio de concurso público, além de programa de aperfeiçoamento que reconheça a demanda do cuidado, nesses cenários, às crianças e adolescentes infectadas pelo HIV. evaluar la calidad de la atención de la Salud del niño y adolescente que viven con el virus HIV entre los diferentes tipos de servicio de Atención Primaria de la Salud, de Santa María, Rio Grande do Sul. estudio transversal, desarrollado con 118 profesionales de la Atención Primaria de la Salud. Se utilizó el Instrumento de Evaluación de la Atención Primaria, versión Profesionales. Para verificar las variables asociadas a un alto puntaje, fue utilizada la Regresión de Poisson. los profesionales de la Estrategia Salud de la Familia cuando comparados a los de Unidades Básicas de Salud, obtuvieron mayor grado de orientación para la atención primaria, tanto por el puntaje general como por el derivado, así como en los atributos integralidad y orientación comunitaria. La especialización en Atención Primaria de la Salud, tener otro empleo y el vínculo institucional se mostraron asociados a la calidad de la atención. se destaca la Estrategia Salud de la Familia con mayor calidad de atención de la Salud del niño y adolescente que viven con el virus HIV, entre tanto, la cobertura todavía es baja. Fue puesta en evidencia la necesidad de ampliar dicha cobertura, así como hacer inversiones en la calificación profesional orientada

  7. [In Process Citation].

    PubMed

    Blanco, José R; Ornelas, Martha; Viciana, Jesús; Rodríguez, Judith M

    2016-03-25

    Introducción: la autoeficacia es un importante factor mediador hacia cómo los individuos sienten, piensan, se motivan y se comportan. La expectativa de autoeficacia es un predictor importante de las intenciones y acciones de los individuos frente a diversas situaciones, siendo por tanto necesaria su medición. Objetivos: el presente estudio pretende indagar las propiedades psicométricas para una escala de autoeficacia en el cuidado de la alimentación y salud fisca, comprobando su estructura y su invarianza factorial. Métodos: la muestra se compuso de 1.313 estudiantes universitarios de las licenciaturas de Educación Física y Motricidad Humana que se imparten en la Universidad (omitido por anonimato), con una edad media de 20,46 años (± 1,87). La estructura factorial del cuestionario se analizó a través de análisis factoriales confirmatorios. Resultados: los análisis mostraron la adecuación de una estructura de cinco factores (ejercicio físico, cuidado de la alimentación, afrontamiento de problemas, evitación del consumo de tabaco y evitación del consumo de alcohol), mostrando adecuados índices de ajuste de fiabilidad (valores superiores a 0,85) y validez (GFI = 0,907; RMSEA = 0,053; CFI = 0,960), y explicando más del 70% de la varianza. Además, los resultados de los análisis factoriales llevados a cabo con dos submuestras indicaron fuertes evidencias de estabilidad de la estructura factorial (diferencia de CFI inferiores a 0,01). Conclusiones: la escala de autoeficacia en el cuidado de la alimentación y salud física es adecuada y puede usarse en estudios científicos. Futuras investigaciones deberían corroborar estos hallazgos.

  8. Fluctuaciones cuánticas y cosmología

    NASA Astrophysics Data System (ADS)

    Calzetta, E.

    El objetivo de la charla es repasar 1) los motivos para creer que el Universo pasó por una etapa inflacionaria antes del período dominado por la radiación, durante la cual se habrían formado las fluctuaciones primordiales en la densidad de energía que luego colapsaron para formar estructuras cosmológicas 2) los mecanismos que crearon dichas fluctuaciones a partir de fluctuaciones cuánticas del campo del ``inflaton" durante dicho período y 3) los problemas abiertos en el estudio de modelos inflacionarios, especialmente respecto al inicio y final del mismo.

  9. Burbujas interestelares alrededor de estrellas masivas: observaciones en frecuencias de Radio

    NASA Astrophysics Data System (ADS)

    Cappa, C.

    Los vientos estelares de estrellas masivas interactúan con el medio interestelar circundante originando burbujas interestelares que pueden detectarse en diversas bandas del espectro electromagnético, incluyendo la banda de radio. En esta presentación se hace una puesta al día de los resultados obtenidos a partir de observaciones en el continuo de radio y en líneas espectrales en dirección de estas estructuras. Estas observaciones nos permiten estudiar el material ionizado, atómico y molecular asociado a las burbujas interestelares.

  10. Estudio del Hidrógeno neutro en dirección al remanente de supernova W28

    NASA Astrophysics Data System (ADS)

    Dubner, G.; Velazquez, P.; Green, A.; Goss, W. M.; Reynoso, E.

    Se presenta un relevamiento del hidrógeno neutro alrededor del remanente de supernova W28 realizado con el radiotelescopio australiano de Parkes. Se analizan rasgos de emisión y absorción. Se muestra la existencia de estructuras anulares asociadas con el remanente. Se compara la distribución del hidrógeno neutro con la ubicación de máseres de OH detectados en la línea de 1720 MHz.

  11. Parsec-scale radio structures in Quasars

    NASA Astrophysics Data System (ADS)

    Coldwell, G.; Paragi, Z.; Gurvits, L.

    Very Long Baseline Interferometry (VLBI) con su nueva extensión para el radio telescopio orbital, VSOP/HALCA, ofrece una incomparable resolución angular alcanzando escalas de milisegundos y submilisegundos de arco a longitudes de onda de centímetros. En este trabajo presentamos observaciones y análisis de estructuras en radio, en escalas de parsec, para 3 radio fuentes extragalácticas de la muestra de VSOP Survey y 1 quasar, 1442+101, del proyecto `VSOP High Redshift'.

  12. El medio interestelar alrededor de estrellas Of

    NASA Astrophysics Data System (ADS)

    Caballero, N.; Cappa, C.

    Se analiza la distribución del hidrógeno neutro interestelar en la vecindad de algunas estrellas Of con el fin de investigar la presencia de burbujas de H I vinculadas a las estrellas. Se determinan los parámetros físicos de las burbujas de H I encontradas y se comparan con estructuras similares vinculadas a estrellas Wolf-Rayet. El estudio se lleva a cabo en base a datos pertenecientes al relevamiento de Weaver y Willians (1973).

  13. [The National Medical Arbitration Commission: 20 years].

    PubMed

    de la Fuente, Juan Ramón

    Cuando la Secretaría de Salud todavía tenía el logotipo azul que decía SSA, corrían tiempos difíciles porque no había dinero y la idea de crear nuevas instituciones era recibida con reservas, no sólo por el Presidente Zedillo, siempre generoso y atento a las necesidades de salud de la población, sino también, como ya es costumbre, por el secretario de Hacienda, responsable de cuidar el erario público. Y es que la idea de hacer crecer el gasto corriente del gobierno se percibía, no sin razón, como un acto que podía infligir el riesgo de fomentar estructuras administrativas ineficaces y obesas. No ha sido el caso de la Comisión Nacional de Arbitraje Médico (CONAMED), pues sus aproximadamente 200 trabajadores siguen realizando una labor inmensa con una estructura ligera.

  14. Impact of a high-fat diet containing canola or soybean oil on body development and bone; parameters in adult male rats.

    PubMed

    Soares da Costa, Carlos Alberto; De Sousa dos Santos, Aline; Santana Carlos, Aluana; Lopes Gonzalez, Gabrielle de Paula; Pontes Gaspar Reis, Rejane; Carneiro, Cynthia; Soares Alves, Sanderson; Pereira Albuquerque, Karine; Alves da Silva, Paula Cristina; Cavalcante Ribeiro, Danielle; Teles Boaventura, Gilson; de Moura, Egberto Gaspar; Alves do Nascimento-Saba, Celly Cristina

    2015-05-01

    Introducción: El papel del ácido graso en la prevención o la progresión de las enfermedades crónicas ha generado un interés significativo por parte de los investigadores. Por lo tanto, nuestro objetivo fue evaluar los efectos a largo plazo de la dieta alta en grasas que contienen soja o aceite de canola en los parámetros de desarrollo del cuerpo y los huesos de ratas macho. Métodos: Después del destete, las ratas se agruparon y se alimentaron con una dieta control (7S) o una dieta alta en grasa que contiene soja (19S) o aceite de canola (19C). Fémur y vértebras lumbares (LV4) estructura se determinaron a los 180 días por absorciometría dual de rayos X y tomografía computarizada. Resultados: Los grupos mostraron similares ingesta de alimentos, la masa corporal y el desarrollo de longitud. Los parámetros óseos de la 19C fueron similares al grupo control, mientras que los 19S mostró parámetros óseos inferiores en comparación con los otros grupos. Conclusiones: La dieta alta en grasas que contiene aceite de soja fue desfavorable a la estructura ósea, mientras que el aceite de canola contribuyó salud de los huesos en la etapa adulta de la vida.

  15. Observaciones de la corona solar interior con un coronógrafo de espejo

    NASA Astrophysics Data System (ADS)

    Stenborg, G.; Schwenn, R.; Francile, C.; Rovira, M.

    El plasma de la corona solar es un buen indicador de las líneas de fuerza del campo magnético. Por lo tanto, el análisis de estructuras coronales cuasiestacionarias en la corona da importante información sobre el campo magnético y la actividad asociada. Se trata de poner límites a los modelos teóricos existentes mediante el estudio de distintas estructuras en la corona interior. En agosto de 1997 comenzó a operar el coronógrafo solar (MICA) en El Leoncito como parte del Observatorio Solar Alemán-Argentino. Desde su instalación obtiene imágenes de la corona solar (1.05 a 2.0 radios solares) en 2 líneas espectrales correspondientes a la emisión de Fe XIV y Fe X. El instrumento puede obtener imágenes cada minuto por lo que es ideal para estudiar procesos rápidos. Presentamos observaciones recientes que muestran la capacidad del coronógrafo así como la evolución de algunos eventos dinámicos observados por MICA.

  16. Dispersión de velocidades en cúmulos de galaxias

    NASA Astrophysics Data System (ADS)

    Muriel, H.; García Lambas, D.; Quintana, H.; Infante, L.

    Se ha estudiado la dinámica de galaxias en cúmulos en base a una muestra de aproximadamente 4000 galaxias con estimas de velocidad radial pertenecientes a 40 cúmulos. Se desarrolló un algoritmo para identificar sub-estructuras del tipo ``grupos de galaxias". Una vez eliminada este tipo de sub-estructura se computaron los perfiles radiales de dispersión de velocidades (VDP) para los 40 cúmulos de galaxias. Dada las características de la muestra, fue posible estimar el VDP hasta grandes distancias del centro del cúmulo llegando en algunos casos hasta 7 Mpc-1. Los resultados indican que el 65% de los cúmulos presentan un VDP plano a grandes radios consistente con el modelo isotermo. Estos resultados son discutidos en el marco de las recientes controversias suscitadas respecto de la dinámica de los cúmulos vía los perfiles de temperaturas de cúmulos derivados de la emisión en rayos-X.

  17. [The neural networks of facial expression].

    PubMed

    Gordillo, F; Mestas, L; Castillo, G; Perez, M A; Lopez, R M; Arana, J M

    2017-02-01

    Introduccion. La percepcion de caras involucra una amplia red de conexiones entre regiones corticales y subcorticales que intercambian y sincronizan informacion a traves de haces de sustancia blanca. Este preciso sistema de comunicacion puede verse afectado tanto a traves de las propias estructuras como por las vias que las conectan. Objetivos. Delimitar el sustrato neuronal que subyace a la percepcion de la expresion facial y analizar los diferentes factores que participan modulando la integridad de esta red neuronal, con el fin de proponer mejoras en los programas de rehabilitacion. Desarrollo. Cuando la compleja red de conexiones que participa en la percepcion de la expresion facial se altera por traumatismos, patologias neurodegenerativas, trastornos del desarrollo, incluso por aislamiento social o contextos negativos, se deteriora tambien la capacidad para interactuar de manera adaptativa con el entorno. Conclusiones. La posibilidad de restaurar la integridad de la red neuronal encargada del procesamiento de la expresion facial pasa por tener en cuenta diferentes variables que en mayor o menor grado se han mostrado capaces de modificar la estructura o funcionalidad de las redes neuronales, como el entrenamiento aerobico, la estimulacion magnetica transcraneal, la estimulacion electrica transcraneal y el aprendizaje, sin bien estas variables estarian condicionadas por la edad, el tipo y evolucion del trastorno o el contexto generador, lo que plantearia la necesidad de protocolos de rehabilitacion ajustados y orientados a delimitar el sustrato neuronal del deficit.

  18. Características del viento en estrellas Be derivadas del perfil Hα

    NASA Astrophysics Data System (ADS)

    Rohrmann, R.; Cidale, L.

    El estudio teórico de perfiles Hα y su variabilidad en estrellas Be ha sido frecuentemente desarrollado en base a modelos de envolturas circunestelares inhomogéneas, donde la geometría del material es responsable de la forma del perfil dependiendo de la dirección de observación. Nosotros damos una interpretación alternativa y proponemos que la mayoría de las propiedades de esta línea tienen origen en la base de un viento estelar y de una estructura cromosférica anexa a la fotósfera. Encontramos que típicos perfiles Hα en Be, como son los llamados pole-on y winebottle, pueden ser reproducidos cualitativamente sin recurrir a la existencia de una envoltura asimétrica. Analizamos como la línea Hα permite identificar la posible estructura del viento en la región donde éste se inicia.

  19. Del sujeto que ha intentado suicidarse y el Otro: la Institución Psiquiátrica

    PubMed Central

    Liliana, Mondragón B.; Miguel Ángel, Caballero G.

    2009-01-01

    El hospital psiquiátrico se ha constituido como un lugar donde se posibilita legitimar la exclusión y la radicalidad de ese otro “que no es igual”, como es el caso del sujeto que atenta contra su propia vida. En consecuencia, el intento de suicidio desde el pensamiento foucaultiano, es una resistencia que desmantela la estructura de dominación a través de un acto de poder, el cual se ejerce sobre el propio cuerpo. Así, la intención de este texto es mostrar que la relación Otro-otro es un lugar en la estructura subjetiva, que se deposita en la institución psiquiátrica, la cual representa el poder, la ley, y es aquello a lo que se le quiere agredir, resistir, abatir con un intento de suicidio. Para demostrar como se materializan estos hechos, se exponen los testimonios de tres adolescentes atendidas en un hospital psiquiátrico por intentos suicidas, en los cuales se señalan los diferentes significados que le atribuyen a la institución psiquiátrica en tanto que representa un Otro en sus actos autoinfligidos. PMID:25400324

  20. [ANDALIES project: consumption, offer and promotion of healthy eating habits within secondary schools in Andalusia].

    PubMed

    González Rodríguez, Angustias; García Padilla, Francisca M; Martos Cerezuela, Ildefonso; Silvano Arranz, Agustina; Fernández Lao, Isabel

    2015-04-01

    Introducción. El contexto escolar destaca como uno de los factores influyentes en las prácticas alimentarias de los-las adolescentes. Las prácticas de consumo alimentario durante la jornada escolar, la oferta de las cafeterías y las actividades de promoción propuestas desde los centros son objetos de atención creciente para la salud comunitaria. Objetivos. Describir las prácticas alimentarias del alumnado durante la jornada escolar; conocer la oferta de las cafeterías escolares y establecimientos periféricos; y valorar si los centros de secundaria son entornos favorecedores de una alimentación saludable. Diseño y muestra. Estudio descriptivo transversal durante los cursos 2010-2012. Unidades de muestreo: centros de secundaria públicos (95) y alumnado (8.068). Muestreo polietápico por conglomerados: selección aleatoria y estratificada por provincia y tamaño de hábitat. Elección del alumnado: muestreo sistemático de aulas. Resultados. El 77,5% del alumnado desayuna en casa: lácteo con cereal (40,9%) o ingesta líquida (29,2%); el 70,3% come algo en el centro y eligen el bocadillo de embutidos mayoritariamente. La fruta, anecdótica (2,5%) y, el zumo comercial, my frecuente (63,3%). El 75% consume chucherías siendo significativamente superior en centros con cafeterías. Las cafeterías ofertan multitud de productos desaconsejados: refrescos (97,3%), embutidos (91,8%), golosinas y fritos envasados (89%). Ausencia de control de la oferta en los centros (68,42%); solo el 28,4% de directivos conocen la ley que la regula. El 72,5% de los centros realiza promoción de la alimentación con rasgos de efemérides. El 71,5% de los centros tienen en sus alrededores comercios que abastecen al alumnado. Discusión. Encontramos una baja protección de la salud alimentaria del alumnado debido a: déficits alimentarios del alumnado; baja calidad de la oferta en cafeterías escolares y locales externos e inexistencia de actividades de promoción en los centros

  1. [Nutritional status of patients with cancer of oral cavity].

    PubMed

    Pérez Camargo, Dana Aline; De Nicola Delfín, Luigina; Ñamendys-Silva, Silvio A; Copca Mendoza, Erika Thalia; Hernández Méndez, Margarita; Herrera Gómez, Ángel; Meneses García, Abelardo

    2013-01-01

    Introducción: El cáncer de cavidad oral ocupa el doceavo lugar a nivel mundial. El tratamiento del cáncer de cavidad oral es habitualmente cirugía seguida de radioterapia, la cual puede estar indicada sola o con quimioterapia; este tipo de terapias tienen importantes efectos secundarios funcionales sobre el estado nutricio del paciente. Objetivo: El objetivo de este trabajo es conocer el impacto de los diferentes tratamientos sobre el estado nutricional de los pacientes con cáncer de cavidad oral atendidos en el Instituto Nacional de Cancerología durante el período comprendido del 2009 al 2011. Material y métodos: Se realizó un estudio descriptivo, y retrospectivo. Se incluyeron 99 pacientes con cáncer de cavidad oral. Se registraron las siguientes variables; género, edad, tipo de tratamiento (cirugía, quimioterapia, radioterapia), complicaciones más importantes secundarias a tratamiento, pérdida de peso, índice de masa corporal (IMC) y albumina. Resultados y discusión: La prevalencia de cáncer de cavidad oral fue mayor en mujeres (58,6%); la edad promedio fue de 61,22 años. Las complicaciones secundarias al tratamiento fueron xerostomía (20%) seguida de odinofagia y mucositis (19%), la relación de pérdida de peso y sintomatología se observó en el (54%) de los pacientes, debido al tipo de alimentación previo, durante y después del tratamiento en los cuales tuvo mayor predominio el uso de papillas. Conclusión: Se observó una pérdida de peso debido a las complicaciones del tratamiento médico que afectaron el estado nutricio, por ello es importante tener un monitoreo continuo que apoye el éxito del tratamiento multidisciplinario.

  2. [Endoscopic third ventriculostomy for chronic communicating hydrocephalus in adults].

    PubMed

    Sandoval-Balanzario, Miguel Antonio; Rincón-Navarro, Raúl Abraham; Granados-López, Rommel; Santos-Franco, Jorge Arturo

    2015-01-01

    Introducción: la derivación valvular para tratar la hidrocefalia se asocia con disfunción del 81 % a 12 años y 10 % de infección. El objetivo es evaluar la seguridad y la eficacia clínica de la tercer ventriculostomía endoscópica secundaria (TVE) en pacientes con hidrocefalia comunicante crónica. Métodos: se incluyeron ocho pacientes adultos entre septiembre de 2012 y abril de 2013 con hidrocefalia por disfunción valvular de etiología comunicante. Se les hizo estudio de tomografía axial computarizada al ingreso, postoperatoria, y después de 30, 180 y 365 días. El seguimiento clínico fue de 251 días (el mayor fue de 459 días). Las variables incluidas fueron: edad, sexo, etiología, tiempo de evolución y número de sistemas valvulares fallidos. Se aplicó técnica convencional con endoscopio rígido 30°, retiro de catéter disfuncional, y colocación de sistema valvular ligado. Resultados: cuatro hombres y cuatro mujeres, con edad promedio de 42 años (27-63 años), neurocisticercosis en cinco pacientes (62.5 %), evolución promedio de 18 años (15-30 años), estancia hospitalaria promedio 6.5 días (3-22días), disfunciones valvulares previas promedio 4 (1-6). Complicaciones: hubo neuroinfección en un paciente y disfunción en tres pacientes. Ninguno murió. Conclusión: la TVE secundaria es un procedimiento seguro en el tratamiento de hidrocefalia comunicante crónica, con una eficacia mayor al 60 %. En neurocisticercosis se observaron mejores resultados con antecedente de dos o menos recambios valvulares.

  3. Long-term effects of the keepin' it REAL model program in Mexico: substance use trajectories of Guadalajara middle school students.

    PubMed

    Marsiglia, Flavio F; Kulis, Stephen S; Booth, Jaime M; Nuño-Gutierrez, Bertha L; Robbins, Danielle E

    2015-04-01

    In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin' it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico.

  4. Modos de produccion cientifica: Culturas y metodologias de investigacion en la Universidad de Cadiz

    NASA Astrophysics Data System (ADS)

    Gonzalez Ramos, Ana M.

    2004-12-01

    Este trabajo de investigacion supone un modelo teorico de caracter aplicado, que proporciona la oportunidad de evaluar la produccion cientifica de los investigadores. Se encuadra dentro de la tradiccion de la estadistica aplicada y la sociologia del conocimiento. Atiende especialmente a dos conjuntos de temas de interes, por una parte, las caracteristicas principales que determinan el nivel y tipo de produccion academica producida por las unidades de investigacion y por los propios investigadores; por otra, la utilizacion que se hace de los metodos y tecnicas de investigacion puesto que de ello tambien depende el modo de produccion cientifica. Los puntos novedosos de esta tesis son: la medicion cuantitativa del objeto de estudio, la suma de los productos y las condiciones externas a la produccion del conocimiento mas otros elementos internos como las caracteristicas de los investigadores y la metodologia utilizada para desarrollar sus trabajos; y, finalmente, el uso de las nuevas tecnologias. El aprovechamiento de los recursos estadisticos y las fuentes de informacion secundarias se complementan con el diseno propio de una encuesta donde se implementa las caracteristicas descritas en un capitulo anterior sobre los metodos cientificos mas idoneos descritos en los principales manuales y articulos cientificos desde distintas disciplinas de conocimiento. Dicha encuesta ha sido desarrollada como un programa propio y en base a los mas innovadores usos de la tecnologia en la metodologia de encuestas.

  5. [Aetiology and treatment of epilepsy in a series of 1,557 patients].

    PubMed

    Torres-Ferrús, Marta; Toledo, Manuel; González-Cuevas, Montserrat; Seró-Ballesteros, Laia; Santamarina, Esteban; Raspall-Chaure, Miquel; Sueiras-Gil, María; Cambrodí-Masip, Roser; Sarria, Silvana; Álvarez-Sabín, José; Salas-Puig, Javier

    2013-10-01

    Introduccion. La etiologia de la epilepsia es un determinante importante del tratamiento y el pronostico. Los avances diagnosticos y terapeuticos hacen pensar que la distribucion causal, el tratamiento y el pronostico de la poblacion con epilepsia se hayan podido ver modificados. Objetivo. Describir la distribucion sindromica, etiologica y el tratamiento farmacologico en los pacientes con epilepsia. Pacientes y metodos. Estudio descriptivo transversal de pacientes con epilepsia atendidos de manera consecutiva en la consulta de nuestra unidad de epilepsia. Se recogieron datos demograficos, de sindrome, etiologia y tratamiento farmacologico en el momento de la inclusion. Se analizaron los datos de modo conjunto y por grupos de edad. Resultados. Se incluyeron 1.557 pacientes, el 54% varones. El 73% de la muestra tenia una epilepsia focal, que era secundaria a una lesion estructural en el 56%. Las epilepsias generalizadas representaron el 20%. El 5% fue inclasificable. Por edad, la etiologia vascular predominaba en practicamente todos los grupos y su prevalencia aumentaba en relacion con la edad. Los farmacos antiepilepticos mas utilizados fueron acido valproico (29%), levetiracetam (27%) y carbamacepina (20%). El 70% de las epilepsias generalizadas y el 57% de las focales seguian tratamiento en monoterapia. Conclusiones. La prevalencia por grupos de edad fue similar a la descrita en paises desarrollados aunque se observo una menor prevalencia de epilepsias criptogenicas. Mas del 60% de los pacientes seguia monoterapia y el acido valproico fue el mas utilizado.

  6. Long-Term Effects of the keepin’ it REAL Model Program in Mexico: Substance Use Trajectories of Guadalajara Middle School Students

    PubMed Central

    Marsiglia, Flavio F.; Booth, Jaime M.; Nuño-Gutierrez, Bertha L.; Robbins, Danielle E.

    2015-01-01

    In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin’ it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin’ it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico. PMID:25416154

  7. [Central nervous system in IgG4-related disease: case report and literature review].

    PubMed

    Vanegas-Garcia, A L; Calle-Lopez, Y; Zapata, C H; Alvarez-Espinal, D M; Saavedra-Gonzalez, Y A; Arango-Viana, J C

    2016-08-01

    Introduccion. La enfermedad relacionada con IgG4 es una entidad clinica multisistemica recientemente descrita y que se presenta con diferentes manifestaciones clinicas. Los organos que estan afectados con mayor frecuencia son el pancreas, la via biliar y las glandulas salivales, y es menos frecuente la afeccion del sistema nervioso central. Caso clinico. Mujer de 33 años con alteraciones cognitivas, alucinaciones, cefalea, sindrome convulsivo, sinusitis maxilar con afeccion osea y evidencia de paquimeningitis y panhipopituitarismo, con biopsia meningea que confirmo una enfermedad relacionada con IgG4, tras haberse descartado causas secundarias. Se inicio tratamiento con glucocorticoides y azatioprina, sin recaidas despues de 12 meses de seguimiento. Conclusiones. Se debe considerar el diagnostico de enfermedad relacionada con IgG4 en casos de paquimeningitis hipertrofica e hipofisitis, incluso sin que se acompañen de otras manifestaciones sistemicas, siempre que se hayan descartado otras causas mas frecuentes. El tratamiento de eleccion son los glucocorticoides, y puede ser necesario añadir otro inmunosupresor como ahorrador de esteroides y para evitar las recaidas. Se necesitan estudios prospectivos para evaluar las diferentes manifestaciones clinicas y paraclinicas y establecer los resultados del tratamiento a largo plazo.

  8. [Analysis of maternal deaths in Mexico occurred during 2009].

    PubMed

    Fajardo-Dolci, Germán; Meljem-Moctezuma, José; Vicente-González, Esther; Venegas-Páez, Francisco Vicente; Villalba-Espinoza, Ignacio; Pérez-Cardoso, Ana Luisa; Barrón-Saldaña, Dante Adrián; Montesinos-Gómez, Gabriela; Aguirre Güemez, Ana Valeria; Novoa-Boldo, Alejandro; Mendoza-Larios, Laura Alejandra; López-González, Rosa; Mazón-González, Betania; Aguirre-Gas, Héctor Gerardo

    2013-01-01

    Introducción: en 2011 ocurrieron 955 defunciones maternas en México, 49.9 por 100 000 nacidos vivos. La meta de la Organización Mundial de la Salud para 2015 es reducir la tasa a 22.5: 560 defunciones anuales. Métodos: estudio descriptivo y retrospectivo de 1257 muertes maternas ocurridas en México durante 2009, con una muestra representativa de 173 expedientes. Se calcularon frecuencias simples y porcentajes. Resultados: las muertes maternas ocurrieron por causas directas como preeclampsia-eclampsia, infección y hemorragia obstétrica secundaria a atonía uterina, acretismo placentario y placenta previa. Quince mujeres tuvieron complicaciones por abortos. Cuatro murieron por embarazo extrauterino debido a diagnóstico y tratamiento tardíos. Las causas indirectas de la muerte materna fueron neoplasias, sepsis abdominal, eventos vasculares, problemas metabólicos y cardiopatías. Veinticinco pacientes fallecieron por neumonía atípica y 11 por influenza A H1N1. Conclusiones: es factible disminuir la mortalidad materna mediante suficientes consultas prenatales de calidad y evitar embarazos con riesgo alto por los antecedentes obstétricos y los padecimientos asociados. La influenza A H1N1 interrumpió la tendencia descendente de la mortalidad materna.

  9. [Effectiveness and adequacy of tolvaptan prescription in hospitalized patients].

    PubMed

    Edo Solsona, Ma D; Ruiz Ramos, J; Montero Hernández, M; Font Noguera, I; Poveda Andrés, J L

    2013-01-01

    Objetivo: Analizar la efectividad del uso de tolvaptán y la adecuación de su prescripción en un hospital de tercer nivel. Método: Estudio observacional prospectivo de las prescripciones de tolvaptán desde octubre de 2010 hasta diciembre de 2011. Resultados: Se incluyeron 30 pacientes (60,0% varones), 50,0% diagnosticados de insuficiencia cardíaca y 30,0% de SIADH. Tolvaptán permitió alcanzar niveles de sodio superiores a 135 mEq/L en el 53,3% de los pacientes que partían con una media de 125,3±7,3 mEq/L. La mediana de días de tratamiento fue de 5,0 (rango intercuartílico = 3-45). Se observó un incremento significativo de los niveles de ácido úrico asociado al tratamiento con tolvaptán. La prescripción se adecuó a lo establecido en la GFT en el 63,3% de los casos. Conclusiones: Tolvaptán incrementa un 7,5 mEq/L los niveles de sodio tanto en hiponatremia secundaria al SIADH como en insuficiencia cardiaca.

  10. [Usage, effectiveness and safety of abiraterone in prostate cancer].

    PubMed

    Caro Teller, J M; Cortijo Cascajares, S; Escribano Valenciano, I; Serrano Garrote, O; Ferrari Piquero, J M

    2014-04-01

    Fundamento y objetivo: Tras la comercialización de abiraterona, inhibidor de la síntesis de andrógenos, el objetivo del estudio fue analizar el uso, la respuesta y la seguridad de abiraterona en la población de un hospital de tercer nivel. Material y métodos: Se realizó un estudio observacional retrospectivo en el que se incluyeron todos los pacientes que iniciaron tratamiento con abiraterona en un periodo de 21 meses. Se recogieron variables demográficas, diagnósticas, terapéuticas y clínicas. La respuesta se evaluó de acuerdo con la reducción del PSA con respecto al basal. Para evaluar la seguridad se registraron todas las reacciones adversas secundarias al tratamiento. Resultados: Se incluyó un total de 45 pacientes de los que, fueron evaluables con respecto a la efectividad del fármaco el 88,89%. La mediana de PSA basal era de 457,31 (rango 9032- 2,81). La reducción de PSA fue ≥50%, ≥90% y.

  11. PubMed

    Goñi Esarte, S; Zozaya Urmeneta, J M; Goñi Esarte, M; Uriz Otano, J I; Idoate Santesteban, I; Beunza Puyol, M T

    2016-12-30

    La hepatitis isquémica es una entidad poco frecuente. Se asocia a una hipoperfusión hepática debida en primer lugar a un bajo gasto cardíaco (insuficiencia cardiaca congestiva, infarto agudo de miocardio o miocardiopatía dilatada). De forma menos frecuente puede ser secundaria a una insuficiencia respiratoria o al aumento de las necesidades de oxígeno en el contexto de una sepsis.Paciente varón de 49 años que acude al servicio de Urgencias por disnea progresiva e hipotensión, objetivándose una importante elevación de transaminasas (aspartato aminotransferasa de 5.550 U/L, alanina aminotransferasa de 3.826 U/L) y de LDH (10.375 U/L). La ecografía Doppler hepática fue normal. El ecocardiograma confirmó la sospecha diagnóstica, visualizándose la presencia de un derrame pericárdico masivo. El taponamiento cardíaco es una causa excepcional de este cuadro clínico. En el caso de nuestro paciente, el rápido diagnóstico y una pericardiocentesis realizada de forma urgente le llevaron a su pronta recuperación.

  12. Parenting intervention effects on parental depressive symptoms: examining the role of parenting and child behavior.

    PubMed

    Wong, Jessie J; Gonzales, Nancy A; Montaño, Zorash; Dumka, Larry; Millsap, Roger E

    2014-06-01

    Parental depression is a major risk factor in child development. Growing research suggests parenting programs can positively impact parental depressive symptoms, although the specific mechanisms that explain these effects are unknown. The current study examined parenting mediated effects of a parenting program on mothers' and fathers' depressive symptoms, as well as the role of child behavior in linking parenting to reductions in depressive symptoms. The study samples included 494 mothers and 288 fathers of Mexican origin adolescents who participated in a randomized trial of the Bridges to High School Program/Proyecto Puentes a la Secundaria, a universal prevention and promotion intervention that included parent training but did not directly target parental depressive symptoms. Parenting mediator models tested program effects on parental depressive symptoms through changes in harsh and supportive parenting. Results showed a significant indirect intervention effect on maternal depressive symptoms through changes in mothers' harsh parenting. Next, child behavior models revealed a partial mediation effect of harsh parenting and a full mediation effect of supportive parenting on maternal depressive symptoms through mothers' reports of child externalizing symptoms. Indirect effects of fathers' harsh and supportive parenting on paternal depressive symptoms were also found through fathers' reports of child behavior.

  13. [ApoE polymorphisms and dopaminergic replacement therapy in Parkinson's disease].

    PubMed

    Cervantes-Arriaga, Amin; Rodríguez-Violante, Mayela; González-Latapí, Paulina; Dávila-Ortiz de Montellano, David José; Yescas, Petra; Alonso-Vilatela, Elisa

    2014-01-01

    INTRODUCCIÓN: se ha propuesto que la expresión de los polimorfismos de la apolipoproteína E (apoE) es un factor predisponente para el desarrollo temprano de psicosis en los pacientes con enfermedad de Parkinson. La relación entre el genotipo de la apoE y el desarrollo de complicaciones motoras es controvertida. El objetivo de esta investigación fue determinar la relación entre los polimorfismos de la apoE y su frecuencia alélica y el desarrollo de complicaciones secundarias al reemplazo dopaminérgico. MÉTODOS: se evaluaron 231 pacientes con diagnóstico de enfermedad de Parkinson. La presencia de complicaciones fue determinada por un neurólogo y se realizó la genotipificación de los polimorfismos de la apoE. Se utilizó la chi cuadrada para determinar la relación entre la presencia o ausencia de las complicaciones estudiadas y el genotipo de la apoE.

  14. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice.

    PubMed

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-08-08

    to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da pr

  15. Breast primary epithelial cells that escape p16-dependent stasis enter a telomere-driven crisis state.

    PubMed

    Feijoo, Purificación; Terradas, Mariona; Soler, David; Domínguez, Daniel; Tusell, Laura; Genescà, Anna

    2016-01-13

    Breast cancer is the most common malignant disease in women, but some basic questions remain in breast cancer biology. To answer these, several cell models were developed. Recently, the use of improved cell-culture conditions has enabled the development of a new primary cell model with certain luminal characteristics. This model is relevant because, after the introduction of a specific set of genetic elements, the transformed cells yielded tumors resembling human adenocarcinomas in mice. The use of improved cell-culture conditions supporting the growth of these breast primary epithelial cells was expected to delay or eliminate stress-induced senescence and lead to the propagation of normal cells. However, no studies have been carried out to investigate these points. Propagation of breast primary epithelial cells was performed in WIT medium on Primaria plates. Immunofluorescence, western blot and qRT-PCR were used to detect molecular markers, and to determine the integrity of DNA damage-response pathways. Promoter methylation of p16 (INK4a) was assessed by pyrosequencing. In order to obtain a dynamic picture of chromosome instability over time in culture, we applied FISH methodologies. To better link chromosome instability with excessive telomere attrition, we introduced the telomerase reverse transcriptase human gene using a lentiviral vector. We report here that breast primary epithelial cells propagated in vitro with WIT medium on Primaria plates express some luminal characteristics, but not a complete luminal lineage phenotype. They undergo a p16-dependent stress-induced senescence (stasis), and the cells that escape stasis finally enter a crisis state with rampant chromosome instability. Chromosome instability in these cells is driven by excessive telomere attrition, as distributions of chromosomes involved in aberrations correlate with the profiles of telomere signal-free ends. Importantly, ectopic expression of the human TERT gene rescued their chromosomal

  16. [Achievement of physical activity healthy guidelines in hypertensive adults].

    PubMed

    Romero Blanco, Cristina; Villalvilla Soria, Diego José; Cabanillas Cruz, Esther; Laguna Nieto, María; Aznar Laín, Susana

    2014-01-01

    Introducción: Parece necesario educar a los pacientes en la importancia de realizar AF para mejorar su salud, y específicamente, sobre las implicaciones que la intensidad de la AF tiene para la salud. Objetivo: El propósito de este estudio fue evaluar si se cumplían las recomendaciones de actividad física (AF) para la salud en un grupo de pacientes hipertensos controlados de dos centros de atención primaria: La Estación y La Algodonera, situados en Talavera de la Reina (Toledo). Métodos: Diseño: Estudio descriptivo transversal. Emplazamiento: Centros de atención primaria “La Estación” y “La Algodonera”, situados en Talavera de la Reina. Participantes: Un total de 80 pacientes hipertensos controlados de 40 a 60 años que cumplían los criterios de inclusión, fueron invitados a formar parte en el estudio, de los cuales fueron analizados los resultados válidos de 52 pacientes. Mediciones principales: Se cuantificó la actividad física diaria con acelerometría, obteniéndose los minutos de AF a intensidad de moderada a vigorosa (AFMV) y de actividad ligera, y el número de pasos. Los datos se presentaron diferenciando los días laborables y los días festivos. Resultados: Sólo un 59,6 % de los sujetos de la muestra cumplía la recomendación de realizar un mínimo de 30 minutos de AF de intensidad de moderada a vigorosa al día para la mejora de la salud. Los hombres realizaron significativamente más minutos de AFMV en los días festivos que las mujeres, y solamente las mujeres, mostraron diferencias significativas en los minutos de AFMV entre en los días laborables respecto a los festivos. Conclusiones: El 59,6% de los pacientes hipertensos controlados de esta muestra cumplían con las recomendaciones mínimas de AF para la salud; el resto debería incrementar su AF para cumplir las recomendaciones y con ello mejorar sus niveles de tensión arterial.

  17. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society].

    PubMed

    Mata-Cases, M; Artola, S; Escalada, J; Ezkurra-Loyola, P; Ferrer-García, J C; Fornos, J A; Girbés, J; Rica, I

    2015-03-01

    In Spain, according to the Di@bet.es study, 13.8% of the adult population suffers from diabetes and 14.8% from some form of prediabetes (impaired glucose tolerance, impaired fasting glucose or both). Since early detection of prediabetes can facilitate the implementation of therapeutic measures to prevent its progression to diabetes, we believe that preventive strategies in primary care and specialized clinical settings should be agreed. Screening for diabetes and prediabetes using a specific questionnaire (FINDRISC) and/or the measurement of fasting plasma glucose in high risk patients leads to detecting patients at risk of developing diabetes and it is necessary to consider how they should be managed. The intervention in lifestyle can reduce the progression to diabetes and reverse a prediabetic state to normal and is a cost-effective intervention. Some drugs, such as metformin, have also been shown effective in reducing the progression to diabetes but are not superior to non-pharmacological interventions. Finally, an improvement in some cardiovascular risk factors has been observed although there is no strong evidence supporting the effectiveness of screening in terms of morbility and mortality. The Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society has issued some recommendations that have been agreed by the Sociedad Española de Endocrinología y Nutrición, Sociedad Española de Endocrinología Pediátrica, Sociedad Española de Farmacia Comunitaria, Sociedad Española de Medicina Familiar y Comunitaria, Sociedad Española de Médicos Generales, Sociedad Española de Médicos de Atención Primaria, Sociedad Española de Medicina Interna, Asociación de Enfermería Comunitaria and Red de Grupos de Estudio de la Diabetes en Atención Primaria. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  18. [Effectiveness of a program for treatment of overweight and nonmorbid obesity in primary healthcare and its influence lifestyle modification].

    PubMed

    Arrebola Vivas, E; Gómez-Candela, C; Fernández Fernández, C; Bermejo López, L; Loria Kohen, V

    2013-01-01

    Introducción y Objetivos: la modificación de conductas no saludables es fundamental para tratar la obesidad. El objetivo de este estudio fue evaluar los efectos de un programa basado en dieta, ejercicio y apoyo psicológico en la modificación conductual de pacientes con sobrepeso y obesidad tratados en Atención Primaria. Métodos: 60 pacientes con sobrepeso grado II y obesidad grado I-II fueron incluidos en este ensayo piloto. Edad entre 18-50 2013s. Los pacientes recibieron un programa que combinaba educación nutricional, actividad física y apoyo psicológico. Formato grupal, periodicidad quincenal. Los principales resultados medidos al inicio y 6 meses fueron parámetros antropométricos (índice de masa corporal, porcentaje de masa grasa, perímetro cintura) y de estilos de vida usando el Cuestionario para la valoración de hábitos de vida relacionados con el sobrepeso y la obesidad. Consta de 5 dimensiones: contenido calórico de la dieta (CC), alimentación saludable (AS), ejercicio físico (EF), comer por bienestar psicológico (BP) y consumo de alcohol (CA). La mayor puntuación indica mejores hábitos para CC, AS y EF y peores para BP y CA. Resultados: al final de la intervención mejoraron las escalas CC (2,60± 0,5 vs 3,49± 0,7, p<0,001), EF (2,19± 0,9 vs 3,17± 1,0, p<0,001) y AS (3,04± 0,4 vs 3,43± 0,4, p<0,05) del cuestionario; CA (3,98± 0,7 vs. 4,25± 0,7, p<0,05) y BP (2,82± 1,0 vs. 3,34± 0,7, p<0,001) empeoraron. Conclusión: el programa basado en moderada restricción de la dieta, aumento de actividad física y apoyo psicológico puede mejorar parámetros antropométricos y estilos de vida en pacientes obesos tratados en un centro de Atención Primaria.

  19. The influence of changes in hospital drug formulary on the prescription of proton pump inhibitors.

    PubMed

    Vázquez-Mourelle, Raquel; Carracedo-Martínez, Eduardo

    2017-01-01

    Objetivo: Analizar el impacto de introducir el omeprazol en el formulario del Hospital de Barbanza sobre las prescripciones intrahospitalarias y extrahospitalarias (consultas externas y atención primaria) de todos los Inhibidores de la Bomba de Protones (IBP). Material y métodos: Estudio descriptivo retrospectivo de 36 meses en un hospital de nivel I. Las unidades básicas de trabajo son las dosis-habitantes-día en el ámbito extrahospitalario y las dosis diarias definidas/estancias-día para hospitalización; como medida de eficiencia se utiliza el porcentaje de DDD de omeprazol sobre el resto de IBP. Para el análisis estadístico construimos un modelo de regresión segmentada. Resultados: En consultas externas sufren cambios estadísticamente significativos el pantoprazol y el rabeprazol; el primero, estacionado antes de la intervención, sufre una disminución inmediata; el rabeprazol, en crecimiento antes de la intervención, presenta una posterior tendencia decreciente. En atención primaria se constata un cambio estadísticamente significativo en el pantoprazol, con tendencia decreciente a largo plazo. En hospitalización se observan cambios estadísticamente significativos para el pantoprazol y el omeprazol; el primero con disminución inmediata y tendencia al decrecimiento a largo plazo; el segundo experimenta un aumento inmediato y crecimiento a largo plazo. La evolución del % de omeprazol respecto al total de IBP mostró aumentos en los tres escenarios. Conclusiones: Se observa un cambio hacia una prescripción de IBP más eficiente en todos los ámbitos asistenciales tras la introducción del omeprazol en la guía farmacoterapéutica del hospital. La inclusión de medicamentos eficientes, o la retirada de ineficientes, puede ser una herramienta potencialmente útil para mejorar los perfiles de prescripción.

  20. Our experience in the management of obstructing colorectal cancer.

    PubMed

    Formisano, Vincenzo; Di Muria, Antonio; Connola, Giorgio; Cione, Gianpiero; Falco, Luigina; De Angelis, Carlo Paolo; Angrisani, Luigi

    2014-01-01

    Riportiamo la nostra esperienza retrospettiva sulle occlusioni intestinali da cancro colorettale. Negli ultimi 6 anni, abbiamo operato 238 pazienti affetti da cancro colorettale. I tumori complicati sono stati 136 (56%), 115 dei quali stenosanti (86%) e 19 perforati (14%). In 23 pazienti (20%) il tumore stenosante del colon era a destra ed in 92 (80%) a sinistra. Questi ultimi sono stati suddivisi retrospettivamente in 4 gruppi, in relazione all’intervento chirurgico eseguito: 18 (19%) colostomie decompressive; 32 (35%) procedure in due stadi: 25 operazioni di Hartmann e 7 colectomie totali con ileostomia terminale; 7 (8%) procedure in uno stadio, con ileostomia di protezione: 4 colectomie totali e 3 resezioni del colon con wash-out; 35 (38%) procedure in uno stadio con anastomosi primaria + wash-out o milking. I decessi sono stati 8/115, con un tasso di mortalità operatoria globale del 7%. Il tasso di fistola anastomotica è stato del 10%, riguardando 6/58 pazienti con anastomosi, 5 dei quali hanno richiesto un reintervento chirurgico. Complessivamente, circa 2/3 dei decessi perioperatori sono avvenuti per complicanze generali ed un terzo per deiscenza dell’anastomosi. L’occlusione intestinale da cancro colorettale è associata ad un’elevata mortalità operatoria ed una prognosi peggiore, in termini di recidiva e di sopravvivenza. La colostomia decompressiva può essere considerata come un’opzione valida solo nella malattia avanzata o nel paziente in condizioni generali scadute. La resezione anastomosi primaria rappresenta il gold-standard in pazienti selezionati con un basso rischio anestesiologico, sia sotto forma di resezione tipica con washout, sia come colectomia subtotale. Una colostomia o ileostomia temporanea di protezione può essere proposta per i pazienti con un rischio anestesiologico intermedio. Nei casi ad alto rischio o in avanzato stato occlusivo, oppure in presenza di simultanea perforazione del colon o di malattia metastatica o

  1. [Malignancies in adult patients with common variable immunodeficiency].

    PubMed

    López-Rocha, Eunice; Rodríguez-Mireles, Karen; Segura-Méndez, Nora Hilda; Yamazaki-Nakashimada, Marco Antonio

    2015-01-01

    Antecedentes: los pacientes con inmunodeficiencia común variable tienen riesgo elevado de padecer enfermedades neoplásicas, con incidencia de 11 a 13%, especialmente durante la quinta y sexta décadas de la vida. Los linfomas de tipo celular B son los más frecuentes, además del linfoma no Hodgkin y tumores epiteliales (carcinomas de estómago, mama, vejiga y cuello uterino). Objetivo: conocer el tipo de enfermedades neoplásicas en una cohorte de pacientes adultos con inmunodeficiencia común variable. Material y método: estudio observacional, transversal y descriptivo, en el que se revisaron los expedientes con diagnóstico de inmunodeficiencia común variable de la Clínica de Inmunodeficiencias Primarias del servicio de Alergia e Inmunología Clínica del Hospital de Especialidades del Centro Médico Nacional Siglo XXI del IMSS. Resultados: se incluyeron 23 pacientes con diagnóstico de inmunodeficiencia común variable; de éstos, 13 (56%) eran mujeres, el promedio de edad fue de 36.7 años. Se encontraron neoplasias en cuatro pacientes de este grupo (dos mujeres y dos hombres), la prevalencia de cáncer fue de 17.3%. Los tipos de cáncer reportados fueron: linfoma Hodgkin de células B (1/23), carcinoma neuroendocrino de la cabeza del páncreas (1/23), leucemia mieloide crónica (1/23) y cáncer papilar de tiroides (1/23). En dos de los pacientes, el diagnóstico de cáncer fue previo al diagnóstico de la inmunodeficiencia primaria. El promedio de edad al momento del diagnóstico de cáncer fue de 27 años (límites: 19-34 años). Conclusión: la frecuencia de cáncer en nuestra población fue similar a lo reportado en la bibliografía. Sin embargo, los tipos de cáncer fueron distintos a lo publicado. Consideramos que es necesario realizar un protocolo de escrutinio en estos pacientes para diagnosticar de manera oportuna cualquier tipo de neoplasia, debido al mayor riesgo que tienen estos pacientes.

  2. Regular Motions of Resonant Asteroids

    NASA Astrophysics Data System (ADS)

    Ferraz-Mello, S.

    1990-11-01

    RESUMEN. Se revisan resultados analiticos relativos a soluciones regulares del problema asteroidal eliptico promediados en la vecindad de una resonancia con jupiten Mencionamos Ia ley de estructura para libradores de alta excentricidad, la estabilidad de los centros de liberaci6n, las perturbaciones forzadas por la excentricidad de jupiter y las 6rbitas de corotaci6n. ABSTRAC This paper reviews analytical results concerning the regular solutions of the elliptic asteroidal problem averaged in the neighbourhood of a resonance with jupiter. We mention the law of structure for high-eccentricity librators, the stability of the libration centers, the perturbations forced by the eccentricity ofjupiter and the corotation orbits. Key words: ASThROIDS

  3. Evaluation of the shrinkage and creep of medium strength self compacting concrete

    NASA Astrophysics Data System (ADS)

    De La Cruz, C. J.; Ramos, G.; Hurtado, W. A.

    2017-02-01

    The difference between self compacting concrete (SCC) and conventional concrete (CC) is in fresh state, is the high fluidity at first and the need for vibration at second, but in hardened state, both concretes must comply with the resistance specified, in addition to securing the safety and functionality for which it was designed. This article describes the tests and results for shrinkage and creep at some medium strength Self Compacting Concrete with added sand (SCC-MSs) and two types of cement. The research was conducted at the Laboratorio de Tecnología de Estructuras (LTE) of the Universitat Politécnica de Catalunya (UPC), in dosages of 200 liters; with the idea of evaluating the effectiveness of implementation of these new concretes at elements designed with conventional concrete (CCs).

  4. Estudio multifrecuencia del medio interestelar cercano a HD 192281

    NASA Astrophysics Data System (ADS)

    Arnal, E. M.; Cappa, C.; Cichowolski, S.; Pineault, S.; St-Louis, N.

    Una de las causas que modifica la estructura y dinámica del medio interestelar es la acción que los vientos de las estrellas de gran masa ejercen sobre el mismo. En este trabajo, mediante el uso de datos interferométricos obtenidos en la banda de radio en la transición de 21-cm del Hidrógeno neutro y de imágenes de la emisión de continuo en las bandas de 408 y 1420 MHz, de imágenes HIRES del satélite IRAS en 60 y 100 micrones, y de observaciones de continuo obtenidas con radiotelescopios de disco simple en 2695, 4850 y 8350 MHz se ha realizado un estudio multifrecuencia de los efectos que los vientos estelares de HD 192281, una estrella de tipo espectral O5 Vn((f))p, han tenido sobre el medio interestelar que rodea a la misma.

  5. Estudio de la galaxia peculiar NGC 1487

    NASA Astrophysics Data System (ADS)

    Agüero, E. L.; Paolantonio, S.; Gunthardt, G.

    La galaxia peculiar NGC 1487, cuya morfología sugiere un evento de ``merging" o interacción próxima, es estudiada en base a material observacional espectroscópico y fotométrico obtenido en el CASLEO. Mediante técnicas espectrofotométricas standards se determinan las principales características espectrales, los mecanismos de excitación actuantes, las condiciones físicas y las velocidades radiales de las estructuras conspicuas de la galaxia. Por otra parte, usando imágenes directas en las bandas B, V, R e I, se obtienen distribuciones detalladas de los colores B-V, V-R y R-I y detalles de su morfología.

  6. Infratentorial congenital glioblastoma multiforme. A rare tumour with a still unknown biology.

    PubMed

    Salas, S; Agut, T; Rovira, C; Canizo, D; Lavarino, C; Garcia-Alix, A

    2016-11-01

    Introduccion. El glioblastoma multiforme congenito representa solo el 3% de los tumores congenitos del sistema nervioso central, y su ubicacion infrantentorial es excepcional. Caso clinico. Recien nacido con un glioblastoma multiforme congenito sin mutacion en el gen TP53 ni inmunorreactividad nuclear p53, que infiltraba practicamente todo el tronco cerebral e invadia tambien estructuras supratentoriales. Conclusiones. Hasta donde sabemos, solo se han referido previamente cuatro casos de localizacion infratentorial, tres en el cerebelo y uno en el tronco del encefalo. La biologia del glioblastoma multiforme congenito no se conoce bien y, a diferencia del glioblastoma multiforme en la edad adulta, las mutaciones en el gen TP53 son poco frecuentes, sin que eso parezca implicar un mejor pronostico. Estas observaciones sugieren que el glioblastoma multiforme con origen en la vida fetal tiene una biologia diferente del que se presenta en otras etapas de la vida.

  7. Primeros resultados sobre el estudio de oscilaciones no radiales

    NASA Astrophysics Data System (ADS)

    Córsico, A.; Benvenuto, O. G.

    En el Observatorio de La Plata se ha comenzado a elaborar un código de pulsaciones el cual resuelve el problema de las oscilaciones no radiales en el caso adiabático. Dicho código está basado en la técnica de diferencias finitas ampliamente usado en cálculos de estructura y evolución estelar. En este trabajo se presentan los primeros resultados encontrados aplicando el código mencionado al caso de una polítropa de índice n=3. Se presentan los valores de las autofrecuencias y las autofunciones para diferentes modos de pulsación de dicha configuración politrópica. En un futuro próximo, se aplicará este programa al estudio de las pulsaciones no radiales de estrellas enanas blancas.

  8. Regiones de formación de la línea de He II λ 1640 en una atmósfera en expansión

    NASA Astrophysics Data System (ADS)

    Venero, R.; Cidale, L.; Ringuelet, A.

    Se calculan perfiles de la línea del He II λ1640 empleando un modelo de atmósfera en expansión con una estructura cromosférica para determinar la región de formación de la línea. El problema se trata en geometría esférica, fuera de equilibrio termodinámico. La ecuación de transporte radiativo se resuelve rigurosamente en el marco de referencia del fluído para distintas leyes de velocidad, monótonamente crecientes, y diferentes leyes de temperatura. Se buscan relaciones globales entre las características del perfil y los parámetros físicos atribuídos a la atmósfera estelar, con la finalidad de definir una herramienta de diagnóstico de las propiedades del medio.

  9. Estudio polarimétrico de NGC 104 (47 Tucanae)

    NASA Astrophysics Data System (ADS)

    Forte, J. C.; Bassino, L. P.; Vega, E. I.; Cellone, S.; Pellizza, L.; Méndez, M.

    Se presentan observaciones polarimétricas en el Visual y sin filtro para 72 estrellas, 14 zonas de referencia y el núcleo del cúmulo globular NGC 104. Las medidas, hechas en el CASLEO con el nuevo polarimétro CASPROF, muestran un comportamiento complejo que incluye: a) dos componentes de polarización a lo largo de la visual; b) signos de envolturas polvorientas en 8 de 10 estrellas variables de largo período pertenecientes al cúmulo c) media docena de estrellas con alta polarización residual (P> 0.20 %) originada probablemente en scattering. Estas estrellas se encuentran próximas a una estructura extendida, coincidente con la región central del cúmulo, detectada en observaciones IRAS. Las observaciones son consistentes con la presencia de pequeñas cantidades de polvo originada en procesos de pérdida de masa.

  10. [Complications of endoscopic nasal and sinus surgery: experience in 150 patients].

    PubMed

    Vargas-Aguayo, Alejandro Martín; Copado-Ceballos, Rosalba Elizabeth; Vivar-Acevedo, Eulalio; Waizel-Haiat, Salomón; Contreras-Herrera, Roxana; Desentis-Vargas, Eduardo

    2014-01-01

    INTRODUCCIÓN: la cirugía endoscópica de la nariz y senos paranasales ha tenido un gran auge para tratar la patología inflamatoria y tumoral, y para abordar estructuras extrasinusales. Aunque ha demostrado ser un método muy exitoso, no deja de ser motivo de complicaciones. El objetivo de esta investigación fue identificar la frecuencia de complicaciones en los pacientes con patología nasosinusal sometidos a cirugía endoscópica de nariz y senos paranasales. MÉTODOS: se evaluaron 150 pacientes operados por vía endoscópica, 75 mujeres y 75 hombres, en un hospital de especialidades del Instituto Mexicano del Seguro Social. Se registró tipo de patología, tipo de cirugía endoscópica realizada y sus complicaciones mayores y menores.

  11. Fotometría CCD en el campo del cúmulo abierto Ruprecht 58

    NASA Astrophysics Data System (ADS)

    Giorgi, E. E.; Vázquez, R. A.; Seggewiss, W.; Ostrov, P.; Solivella, G. R.

    La región de Vela-Puppis contiene varios cúmulos cuyo estudio puede brindarnos información acerca de la cinemática y el estado evolutivo de la población estelar en las zonas externas del disco galáctico. A través de observaciones CCD en los filtros UBV en el campo del cúmulo abierto Ruprecht 58 (α2000= 8h 14m 41s, δ2000=-31o 57'), se han determinado por primera vez los parámetros fundamentales de este cúmulo tales como distancia, enrojecimiento y edad. Se analiza también la estructura de su secuencia principal y la presencia de gigantes y binarias.

  12. Investigación del USGS sobre el ecosistema de arrecifes de coral en el Atlántico

    USGS Publications Warehouse

    Kuffner, Ilsa B.; Yates, Kimberly K.; Zawada, David G.; Richey, Julie N.; Kellogg, Christina A.; Toth, Lauren T.; Torres-Garcia, Legna M.

    2015-10-23

    Los arrecifes de coral son estructuras sólidas, biomineralizadas que protegen comunidades costeras actuando como barreras protectoras de peligros tales como los huracanes y los tsunamis. Estos proveen arena a las playas a través de procesos naturales de erosión, fomentan la industria del turismo, las actividades recreacionales y proveen hábitats pesqueros esenciales. La conti-nua degradación mundial de ecosistemas de arrecifes de coral está bien documentada. Existe la necesidad de enfoque y organización de la ciencia para entender los procesos complejos físicos y biológicos e interacciones que están afectando el estado de los arrecifes coralinos y su capacidad para responder a un entorno cambiante.

  13. El Proyecto Sismico "LARSE" - Trabajando Hacia un Futuro con Mas Seguridad para Los Angeles

    USGS Publications Warehouse

    Henyey, Thomas L.; Fuis, Gary S.; Benthien, Mark L.; Burdette, Thomas R.; Christofferson, Shari A.; Clayton, Robert W.; Criley, Edward E.; Davis, Paul M.; Hendley, James W.; Kohler, Monica D.; Lutter, William J.; McRaney, John K.; Murphy, Janice M.; Okaya, David A.; Ryberg, Trond; Simila, Gerald W.; Stauffer, Peter H.

    1999-01-01

    La region de Los Angeles contiene una red de fallas activas, incluyendo muchas fallas por empuje que son profundas y no rompen la superficie de la tierra. Estas fallas ocultas incluyen la falla anteriormente desconocida que fue responsable por la devastacion que ocurrio durante el terremoto de Northridge en enero de 1994, el terremoto mas costoso en la historia de los Estados Unidos. El Experimento Sismico en la Region de Los Angeles (Los Angeles Region Seismic Experiment, LARSE), esta localizando los peligros ocultos de los terremotos debajo de la region de Los Angeles para mejorar la construccion de las estructuras que pueden apoyar terremotos que son inevitables en el futuro, y que ayudaran a los cientificos determinar donde occurira el sacudimento mas fuerte y poderoso.

  14. [The validity and reliability of the Spanish version of the Severe Cognitive Impairment Profile (SCIP) for the cognitive assessment of persons with advanced stages of Alzheimer's disease].

    PubMed

    Buiza, C; Montorio-Cerrato, I; Yanguas, J

    2015-10-16

    Introduccion. Existen pocas herramientas validadas al castellano para realizar una evaluacion precisa del funcionamiento cognitivo de personas con demencias avanzadas. Esta poblacion supone un reto por el elevado numero de personas que alcanzan estos estadios y por la complejidad de cuidados que requieren. Este trabajo presenta la validacion al castellano de un instrumento, la escala 'perfil de deterioro cognitivo grave' (SCIP), que permite la evaluacion del funcionamiento cognitivo de personas con enfermedad de Alzheimer avanzada. Pacientes y metodos. Estudio transversal con 133 sujetos (29 hombres y 104 mujeres; edad media: 81,61 ± 7,41 años) con diagnostico de enfermedad de Alzheimer en estadios de moderado a muy grave, segun la escala de deterioro global (GDS 5-7). Se realizaron analisis de discriminacion de los items, estudio de la consistencia interna y fiabilidad interjueces y test-retest, y se contrasto la estructura factorial y la validez del instrumento. Resultados. Solo el 1% de los 160 items de la escala resulto no discriminativo. La consistencia interna de la escala es adecuada, asi como la fiabilidad interjueces y test-retest. Respecto a la validez de constructo, la correlacion con el miniexamen cognitivo es 0,74 (p < 0,01), y se encuentran diferencias significativas entre la escala SCIP y los tres niveles de la GDS analizados. La estructura factorial de la escala muestra la existencia de un solo factor que explica el 66,12% de la varianza. Conclusion. La escala SCIP es un instrumento util, fiable y valido para la evaluacion exhaustiva en castellano de las funciones cognitivas en personas con demencia en estadios de moderado a muy grave.

  15. [Use of topical non-steroidal anti-inflammatory agents in an urban health center. Comparison with the current evidence].

    PubMed

    Yagüe-Sebastián, M M; Coscollar-Escartín, I; Muñoz-Albadalejo, P; López-Canales, M C; Villaverde-Royo, M V; Gutiérrez-Moreno, F

    2013-09-01

    To describe the prescribing of topical non-steroidal anti-inflammatory drugs (NSAIDs) in an urban health center (Zaragoza, Spain). A cross-sectional descriptive study was conducted on subjects who belonged to an urban center and were studied during the year 2010. The sample size with a confidence level of 95%, was calculated, a total of 843 prescriptions were analyzed. The sample was single random, and 150 cases were selected. The prevalence and confidence intervals were calculated. The statistical package STATA 9.1 was used for the calculations. The most used drug was diclofenac, in 27.33% (95% CI: 20.65-34.88). NSAIDs were most used in females. In 18% of the cases the area of application was the knee, followed by the 15% in the lower back area (95% CI: 10,22-21,78). There were no adverse reactions. Frequent use is made of topical NSAIDs in a basic health area. Current recommendations support the use in the knee and in the hand, but not in the back, where its use is common. The use of topical NSAIDs decreases side effects and drug interactions, therefore their use is recommended in patients on multiple drug therapy and in the elderly. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. [Takayasu arteritis and cerebral venous thrombosis: report of a case].

    PubMed

    Rodríguez de Mingo, E; Riofrío Cabeza, S; Villa Albuger, T; Velasco Blanco, M J

    2014-01-01

    Palpitations, paresthesias and anxiety are very common reasons of consultation in primary care. We report the case of a 40 year-old Caucasian woman who came to the clinic due to these symptoms, and was finally diagnosed with Takayasu arteritis. Later, she had an episode of headache, as the initial manifestation of cerebral venous thrombosis. Takayasu arteritis is a systemic vasculitis affecting medium and large arteries, mainly leacausing stenosis of the aorta and its branches. It most frequently affects Asian women, being much rarer in Europe. The primary care doctor plays a key role in the initial diagnosis and monitoring of patients with rare diseases, such as Takayasu arteritis, and must be a basic support for the patient and family, providing information and advice, and contributing with his work to reduce the vulnerability of this group. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  17. [Urine incontinence referral criteria for primary care].

    PubMed

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-01-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.

  18. The application of atherogenic dyslipidaemia consensus recommendations in the primary care setting. DAT-AP study.

    PubMed

    Rodríguez, Angel Díaz; Cumplido, Adalberto Serrano; Nuñez-Cortés, Jesús Millán; Rodríguez de Miguel, Marta; Orera-Peña, Mª Luisa

    The "DAT-AP" (from the Spanish, "Dislipemia ATerogénica en Atención Primaria", for Atherogenic Dyslipidaemia in Primary Care) study objective is to determine to what extent published consensus guidelines for the diagnostic and therapeutic management of AD are used in the primary care setting, and to evaluate the approach of the participating physicians towards the detection, diagnosis, and treatment of AD. This is descriptive, cross-sectional, multicentre study performed between January and May 2015 in primary care centres throughout Spain. Study data were collected in 2 independent blocks, the first addressing theoretical aspects of AD and the second, practical aspects (clinical cases) RESULTS: The theoretical part is in the process of publication. This manuscript depicts the clinical cases block. Although study participants showed good knowledge of the subject, the high prevalence of this disease requires an additional effort to optimise detection and treatment, with the implementation of appropriate lifestyle interventions and the prescription of the best treatment. Copyright © 2017 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Improvement of clinical parameters in a patient with metabolic syndrome through intervention in nutrition education and improvement of lifestyle].

    PubMed

    Martinez, María Isabel; Ferri, Araceli; Mateos, Ana María; Alegre, Antoni

    2014-01-01

    Objetivos: El objetivo general es la disminución de la morbilidad y mortalidad prematuras asociadas al síndrome metabólico (SM). Métodos: Se realiza un recuento de ingestas de 24h para 3 días y se realiza una historia clínica y dietética. Se realiza un seguimiento de 19 consultas para seguir la evolución. Resultados: Tras la pérdida de peso, la medición de glucemia capilar fue de 59 mg/dl retirándole el tratamiento con metformina y al cabo de 7 días sin tratamiento con metformina fue de 64 mg/dl. Conclusiones: La intervención en educación nutricional y del estilo de vida contribuyó a la disminución de casi un 10% del peso corporal, el paciente pasó de estar en el intervalo de IMC correspondiente a obesidad al de sobrepeso además mejoró la resistencia periférica a la insulina y en consecuencia ocasionó la retirada por parte del médico de Atención Primaria de la metformina pautada.

  20. [Takotsubo syndrome. Transient left ventricular dyskinesia].

    PubMed

    Pérez Pérez, F M; Sánchez Salado, J

    2014-03-01

    The Takotsubo syndrome, also called transient apical dyskinesia syndrome, was first described in Japan in the 1990s. It is a rare entity found in almost 1% of all patients with suspicion of acute coronary syndrome. It usually affects postmenopausal women with a few cardiovascular risk factors. It is characterized by angina-type chest pain, electrocardiographic changes, elevation of the enzymes of myocardial injury, absence of coronary obstruction on angiography, and a characteristic left ventricular anteroapical dyskinesia, which returns to normal within a few days. Severe emotional stress is the most common trigger for this syndrome. The aetiopathogenesis of this syndrome remains to be defined. This syndrome has been considered a clinical condition since 2001, when a series of 88 cases was published. It is a disease with a partially known mechanism, characterised by the morphology adopted by the left ventricle secondary to hypokinesis or dyskinesia of the apical segments, and hypercontractility of basal segments. Unlike acute coronary syndrome, patients with left ventricle dysfunction do not have atherothrombotic disease in the coronary arteries. In addition, the alterations described are reversible. Some clinical diagnostic criteria have been proposed, although they are still controversial, as well as in the complementary examinations required for diagnosis. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  1. [Use of emergency departments in rural and urban areas in Spain].

    PubMed

    Sarría-Santamera, A; Prado-Galbarro, J; Ramallo-Farina, Y; Quintana-Díaz, M; Martínez-Virto, A; Serrano-Aguilar, P

    2015-03-01

    Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence. A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas. There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. [Breast cancer update in primary care: (V/V)].

    PubMed

    Díaz García, Noiva; Cuadrado Rouco, Carmen; Vich, Pilar; Alvarez-Hernandez, Cristina; Brusint, Begoña; Redondo Margüello, Esther

    2015-03-01

    Breast cancer is a prevalent disease affecting all areas of patients' lives. Therefore, family physicians ought to know thoroughly this pathology to optimize the health care services for these patients making the best use of available resources. A series of five articles on breast cancer is presented below. It is based on a review of the scientific literature over the last ten years. In this final section, the social, psychological, occupational and family issues related to the disease will be reviewed, as well as presenting some special situations of breast cancer, including breast cancer in men, during pregnancy and last stages of life. This summary report aims to provide a current and practical review about this disease, providing answers to family doctors and helping them to be by the patients for their benefit throughout their illness. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. [Update in family medicine: Periodontal disease].

    PubMed

    López Silva, M C; Diz-Iglesias, P; Seoane-Romero, J M; Quintas, V; Méndez-Brea, F; Varela-Centelles, P

    2017-03-01

    About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Food neophobia: impact on food habits and acceptance of healthy foods in schoolchildren].

    PubMed

    Rodríguez-Tadeo, Alejandra; Patiño Villena, Begoña; Urquidez-Romero, Rene; Vidaña-Gaytán, María Elena; Periago Caston, María Jesús; Ros Berruezo, Gaspar; González Martinez-Lacuesta, Eduardo

    2014-09-21

    Introducción: En los niños la neofobia puede afectar las elecciones alimentarias y limitar la variedad de la dieta así como afectar la aceptación sensorial de nuevos alimentos. Objetivo: Identificar el impacto de la neofobia alimentaria en los hábitos alimentarios y preferencias de alimentos saludables en usuarios de comedores escolares en la ciudad de Murcia. Materiales y Métodos: Participaron 242 escolares de segundo y tercer ciclo de educación primaria, de 8-12 años, con estratificación por sexo y ciclo escolar. Se aplicó una encuesta de hábitos y preferencias alimentarias, neofobia alimentaria y aceptación de alimentos de consumo habitual en el comedor. Además se realizó una prueba sensorial y se midió el consumo de ensaladas y frutas en el comedor, mediante el método de pesada. Resultados: La prevalencia de neofobia fue de 16%, sin diferencia entre sexos, ciclo escolar, tiempo del uso del comedor, origen de los padres y tener sobrepeso o bajo peso. La neofobia se asoció a un detrimento en el consumo de verduras y frutas, el gusto por las legumbres y menor consumo de cereales y sus derivados en el desayuno y a menor preferencia de frutas, verduras y hortalizas (p.

  5. [Importance of selective immunoglobulin A deficiency].

    PubMed

    Rojas-Torres, D S; Bastidas-Yaguana, D K; Sierra-Santos, L; Aguilar-Shea, A L

    2014-04-01

    Selective IgA deficiency is the most common primary immunodeficiency. Little is known about the pathogenetic mechanisms leading to this disease. It is estimated that the incidence of this disease in Spain is 1:163. We report 3 cases diagnosed in Primary Care. Most people with selective IgA deficiency are usually asymptomatic and are diagnosed by chance, but patients with recurrent respiratory infections; gastrointestinal, allergic and autoimmune diseases can be associated with this disease. Although there is no treatment at present, its importance lies in the association with different diseases, such as coeliac disease or idiopathic thrombocytopenic purpura. Another important feature is the risk of anaphylaxis after transfusion, and the possible progression to Common Variable Immunodeficiency. It is important to know the vaccines that we can use due to the risk of disease. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. Spanish consensus on the physical health of patients with depressive disorders.

    PubMed

    Giner, José; Saiz Ruiz, Jerónimo; Bobes, Julio; Zamorano, Enric; López, Francisco; Hernando, Teresa; Rico-Villademoros, Fernando; Álamo, Cecilio; Cervilla, Jorge A; Ibáñez Cuadrado, Ángela; Ibáñez Guerra, Elena; López, Silvia; Morán, Pedro; Palao, Diego J; Romacho, Montserrat

    2014-01-01

    Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. [Postpartum thyroiditis. A review].

    PubMed

    Hurtado-Hernández, Z; Segura-Domínguez, A

    2013-01-01

    Postpartum thyroiditis (PPT) is a transient thyroid dysfunction of autoimmune origin that can occur in the first year postpartum in women who have not been previously diagnosed with thyroid disease. It may start with clinical thyrotoxicosis followed by hypothyroidism and the subsequent recovery of thyroid function, or may just appear as isolated thyrotoxicosis or hypothyroidism. PPT recurs in high percentage of patients after subsequent pregnancies. Many women develop permanent hypothyroidism sometime during the 3 to 10 year period after an episode of PPT. It is important for family physicians to be familiar with this disease, due to its high prevalence in order to make a correct diagnosis and therapeutic intervention. Family doctors also play a crucial role in the monitoring of these patients, given the negative implications of established hypothyroidism on reproduction in the female population during their reproductive years. This article reviews the principle characteristics of PPT along with its diagnosis and treatment. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. [What medication should be prescribed to a patient with coeliac disease?

    PubMed

    Pérez-Diez, C; Guillén-Lorente, S; Palomo-Palomo, P

    2017-05-13

    Coeliac disease is a permanent intolerance to gluten proteins from wheat, rye, barley and triticale. Although strict adherence is complicated, the only effective treatment is a gluten-free diet throughout life. Some drugs contain starch as an excipient, and there is a risk related to the gluten content, which must be avoided in these patients. Current legislation requires the analysis of the protein content of wheat starch, or the absence of starches from another source where rice, maize, or potato starches are used as excipients. But, it does not specify that reference should be made to traces of gluten that are residues of the process of production of the active ingredient. As regards the case described, there needs to be awareness of the importance of adequately informing patients and reviewing/updating current legislation to ensure the safe use of drugs. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Abdominal ultrasound course an introduction to the ultrasound technique. Physical basis. Ultrasound language].

    PubMed

    Segura-Grau, A; Sáez-Fernández, A; Rodríguez-Lorenzo, A; Díaz-Rodríguez, N

    2014-01-01

    Ultrasound is a non-invasive, accessible, and versatile diagnostic technique that uses high frequency ultrasound waves to define outline the organs of the human body, with no ionising radiation, in real time and with the capacity to visual several planes. The high diagnostic yield of the technique, together with its ease of uses plus the previously mentioned characteristics, has currently made it a routine method in daily medical practice. It is for this reason that the multidisciplinary character of this technique is being strengthened every day. To be able to perform the technique correctly requires knowledge of the physical basis of ultrasound, the method and the equipment, as well as of the human anatomy, in order to have the maximum information possible to avoid diagnostic errors due to poor interpretation or lack of information. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. Descriptions of three new species of the genus Cheilosia Meigen from China (Diptera, Syrphidae).

    PubMed

    Barkalov, Anatolij V; Ståhls, Gunilla

    2015-06-11

    Three species of genus Cheilosia (Diptera, Syrphidae: Eristalinae) from China are described as new to science, Cheilosia bullabucca Barkalov & Ståhls sp. n., C. lamproptera Barkalov & Ståhls sp. n. and C. yunnanensis Barkalov & Ståhls sp. n. We provide species descriptions and keys for their identification. The phylogenetic placements of the taxa was estimated based on their morphological characteristics and by analysing the taxa under parsimony using a mtDNA COI sequence dataset including a comprehensive set of Palaearctic previously generated Cheilosia spp. sequences representing all major subgenera. Based on both their morphological affinities and the molecular data. The Chinese taxa were placed in the subgenera Eucartosyrphus (C. bullabucca), Cheilosia s. str. (C. oblonga), Floccocheila (C. versicolor) while C. yunnanensis was not resolved as member of Cheilosia s. str. based on DNA despite sharing morphological characteristics with the subgenus. As the name Cheilosia (Nephocheila) prima Barkalov & Cheng from China is a junior homonym of Cheilosia (Cartosyrphus) prima Hunter, 1896 from the Nearctic region, for the Chinese species the new name Cheilosia (Nephocheila) primaria Barkalov & Ståhls nomen nov. is proposed.

  11. [The dementia of King Ferdinand VI and the year with no king].

    PubMed

    Fernandez-Menendez, S; Gonzalez-Gonzalez, J M; Alvarez-Antuna, V; Bobes, J

    2016-06-01

    Introduccion. Fernando VI fue rey de España entre 1746 y 1759. Su ultimo año de reinado se conoce como el año sin rey. Durante ese año, el monarca sufrio un rapido empeoramiento de sus condiciones mentales. La enfermedad generalmente ha sido atribuida a una condicion psiquiatrica primaria, generalmente por un trastorno bipolar. Desarrollo. Se realiza un estudio de investigacion en los archivos documentales españoles y bibliotecas en busca de informacion clinica sobre la enfermedad de Fernando VI. Se realiza una evaluacion y discusion clinica de la enfermedad del rey sobre la base de la informacion obtenida. Conclusiones. El inicio del empeoramiento clinico del ultimo año de Fernando VI empezo tras la muerte de su amada esposa. Los sintomas iniciales descritos pueden ser similares a los de un episodio depresivo mayor, sin embargo, el monarca sufrio un empeoramiento rapidamente progresivo con alteraciones de la personalidad, conductuales, encamamiento, perdida de control de esfinteres y crisis epilepticas. Los ultimos meses de su vida estuvo en un estado de postracion con un estado cognitivo compatible con una demencia grave. Por todo ello, aunque es posible que Fernando VI pudiera padecer previamente algun tipo de trastorno psiquiatrico, la enfermedad que le llevo a su muerte precoz seria compatible con lo que hoy conocemos como una demencia rapidamente progresiva.

  12. [Electronic prescription for Primary Care: a reliable tool to conceal medication at hospital admission?].

    PubMed

    Martín González, A; Abajo Del Álamo, C

    2013-01-01

    Objetivo: Analizar la fiabilidad de un programa de prescripción electrónica en receta de atención primaria (Medoracyl®) para conciliar la medicación al ingreso hospitalario. Método: Estudio prospectivo comparativo del tratamiento domiciliario validado de pacientes al ingreso, con el prescrito en Medoracyl®. La medicación al ingreso se obtuvo mediante entrevista clínica, informes médicos y revisión de la medicación aportada; la medicación activa en Medoracyl®, mediante consulta a la aplicación el día del ingreso. Se analizaron las discrepancias entre ambos tratamientos. Resultados Se incluyeron 47 pacientes con 273 líneas de tratamiento domiciliario validado y 274 líneas de tratamiento Medoracyl ®. Resultaron 48/273 líneas discrepantes (17,6% [IC95%: 13,1-21,6]). Se consideraron justificadas 27/48, resultando un riesgo final de no concordancia del 7,8% [IC95%: 4,6-11,0]. Conclusiones: Medoracyl® es una herramienta útil y de fácil acceso que permite conocer más del 90% de la medicación domiciliaria de los pacientes.

  13. [Involuntary commitment of the psychiatric patient: legal regulations and critical aspects].

    PubMed

    Ibáñez Bernáldez, M; Casado Blanco, M

    2017-06-19

    Traditionally, medical care received by psychiatric patients involved their separation from the society through their isolation in closed institutions, thereby setting a stigmatising trend on the sick, and by extension on mental illness, a practice that somehow has remained until now. The profound changes in the field of psychiatry have been important and are reflected in the therapeutic field, as well as in the legislative one, and have contributed to establish changes concerning the social opinion about psychiatric patients. The purpose of this article is to review, from the critical perspective, the current legislative framework concerning the situation of involuntary psychiatric commitment as a therapeutic measure in the psychiatric patient, as well as the legal medical practice which indicates the lack of legal skills and ethical and professional conduct arising in the field of primary care. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Self-assessment of opinions, habits and oral health status by pregnant women in the south of Galicia, Spain].

    PubMed

    Lorenzo-Pouso, A I; Pérez-Sayáns, M; Suárez-Quintanilla, J A; González-Palanca, S

    2017-05-25

    An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Vitamin B12 levels in the patient population attending an urban health centre in Madrid].

    PubMed

    Camarero-Shelly, M

    2017-04-27

    Vitamin B12 levels are usually measured in Primary Care when the patients have symptoms or risk factors associated with its deficiency, mostly in the elderly. However, no evidence has been found to support the recommendation of screening in the general population. The aim of this study is to assess the relevance of having extended the screening of vitamin B12 deficiency to a younger population, after observing an increase in the prescription of this injected vitamin in a population under 65 years, by analysing the vitamin B12 values obtained. A descriptive, retrospective, observational study was conducted on a sample consisting of 5,531 patients from Barajas Health Primary Centre, Madrid, between 2008 and 2012, and on whom a blood test was performed for any reason, with values of vitamin B12. A deficiency was found in 9.1% (SD 2.3) of the patients, of whom 49.4% were less than 65 years. The deficiencies were associated (P<.001, 95% CI) with age, dementia, changes in blood red cell counts, memory, and with the taking of metformin and proton pump inhibitors (P=.007). The prevalence of vitamin B12 deficiency in our served population is similar in patients older and younger than 65 years. The extended screening was relevant. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Differential perception of gender violence by Romanian immigrants resident in the metropolitan area of Madrid].

    PubMed

    Rabito-Alcón, M F; Puente-García, R; Cámara-Blanco, L; De Frutos-Moneo, E; García-Jorge, S; Correas-Lauffer, J

    2013-01-01

    Battered women have poorer health. Immigrant women have a higher risk of suffering abuse by their partner, with the most frequent type being psychological abuse. A large percentage of the population living in the health district of Coslada are of Romanian origin, therefore we designed a study aimed at determining whether there are differences between Spanish and Romanian women regarding the perception of different types of violence, expecting to find significant differences. A total of 93 people (61.26% Romanian) were included in the study, and who were given a questionnaire with sociodemographic variables, family APGAR, and a questionnaire on perceptions of behaviors related to gender violence. Descriptive statistics and a hierarchical multiple regression analysis was performed on the results. Nearly 30% of women from Romania and 10% of Spanish respondents were considering or had considered being victims of abuse. According to the data, the Romanian-born women in the sample identified easier those behaviours involving physical or sexual violence easier; while, like Spanish women had more difficulty recognizing psychological violence. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  17. [Occupational disability in epilepsy. The assessment criteria].

    PubMed

    Vicente-Herrero, M T; Terradillos García, M J; Capdevila García, L; Ramírez Iñiguez de la Torre, M V; López-González, Á A; Aguilar Jiménez, E

    2016-03-01

    Epilepsy is a chronic disease cursing with recurrent and paroxysmal crises due to anomalies in the electrical activity of brain, and is controllable in most of the patients by using antiepileptic drugs, in single or combination therapy. Probably one of the most complex aspects of epilepsy is the assessment of disability for work of the affected person. For this purpose, multiple factors need to be taken into account for homogeneous decision-making, and according to criteria of approval and within the principle of equity inherent in the granting of Social Security disability benefits. This requires the cooperation of all professionals involved in the different specialties, with reports using common criteria and taking into account the disease itself, as well as the effects of the prescribed treatments, the effects of which can contribute to the limitations in the performance of certain professions of risk. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. [Mental disorders and their underdiagnosis in primary care].

    PubMed

    Cabrera Mateos, J L; Touriño González, R; Núñez González, E

    2017-05-12

    Despite its high prevalence, mental disorders are often underdiagnosed. To determine the magnitude of the underdiagnosis mental disorders and its associated characteristics. A descriptive cross-sectional study performed in Lanzarote (2011) on 310 patients selected by cluster random sampling. A self-completed questionnaire was used that contained the General Health Questionnaire-28, as well as structured interview using the Mini International Neuropsychiatric Interview to confirm the diagnosis of mental disorder. The current diagnosis registered in the DRAGO-AP electronic medical record was also recorded. Of the 75 patients detected with the interview, 14 (18.67%) had a diagnosis recorded in the medical record (sensitivity=0.19; IC 95% CI; 0.09-28). The positive predictive value of being in the medical record was 0.56. With respect to sensitivity, only the "number of visits made to the health centre in the last 3 months" was significantly higher in the group of patients also with a diagnosis of any mental disorder in the medical record (5 vs. 2.77; p=.002). There is an important underdiagnosis of the mental disorders in our environment. More visits to the health centre are associated with this diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Human papillomavirus nonavalent vaccine. Update 2017].

    PubMed

    Bosch, F X; Moreno, D; Redondo, E; Torné, A

    Human papillomavirus (HPV) is the causative agent of 5% of human cancers. HPV infection is necessary for the development of cervical cancer and is responsible of a variable percentage of cancers of anus, vulva, vagina, penis, and oropharynx. Since 2007, 2 vaccines against HPV have been commercially available in Spain: bivalent (HPV types 16/18), and tetravalent (HPV types 6/11/16/18). In order to extend the protection afforded by HPV vaccines, a clinical program was launched in 2006 for the new nonavalent vaccine, including 9 HPV types (6/11/16/18/31/33/45/52/58). These types are responsible for 90% of cervical cancers, 82% of high-grade ano-genital pre-cancerous lesions, and 90% of genital warts. The purpose of this publication is to provide healthcare professionals with the scientific evidence that supports the new vaccine, as well as the clinical value that it offers in our environment. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Dyslipidaemia and vascular risk. A new evidence based review].

    PubMed

    Pallarés-Carratalá, V; Pascual-Fuster, V; Godoy-Rocatí, D

    2015-01-01

    Dyslipidaemia is one of the major risk factors for ischaemic heart disease, the leading cause of death worldwide. Early detection and therapeutic intervention are key elements in the adequate prevention of cardiovascular disease. It is essential to have knowledge of the therapeutic arsenal available for their appropriate use in each of the clinical situations that might be presented in our patients. In the past 3 years, there has been a proliferation of multiple guidelines for the clinical management of patients with dyslipidaemia, with apparent contradictory messages regarding the achievement of the control objectives, which are confusing clinicians. This review aims to provide an updated overview of the situation as regards dyslipidaemia, based on the positioning of both European and American guidelines, through different risk situations and ending with the concept of atherogenic dyslipidaemia as a recognized cardiovascular risk factor. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Enhancement of motor relearning and functional recovery in stroke patients: non-invasive strategies for modulating the central nervous system].

    PubMed

    Bravo-Esteban, Elisabeth; López-Larraz, Eduardo

    2016-03-16

    Introduccion. La mayoria de los pacientes que han sufrido un ictus no recuperan el estado funcional basal de la extremidad superior afecta y sufren una grave limitacion que permanece en la fase cronica de la enfermedad y que repercute de manera devastadora en su calidad de vida. Por ello, las estrategias de neurorrehabilitacion tratan de evitar o minimizar las posibles disfunciones sensitivomotoras asociadas al ictus mediante la promocion de cambios plasticos en el sistema nervioso central. Desarrollo. La reorganizacion cerebral que tiene lugar tras el ictus puede promover la recuperacion motora y funcional de los sujetos con ictus. No obstante, tras la lesion, tambien se pueden iniciar cambios neuroplasticos maladaptativos responsables del desarrollo de trastornos sensitivomotores, como el sindrome de espasticidad. Las estrategias no invasivas de estimulacion cerebral, como la estimulacion con corriente directa y la estimulacion magnetica transcraneal, son unas tecnicas ampliamente utilizadas que, aplicadas sobre la corteza motora primaria, pueden modificar la excitabilidad de los circuitos neuronales y las funciones cognitivas, tanto en las personas sanas como en los pacientes con afectacion neurologica. Asimismo, los sistemas de interfaces cerebro-maquina tambien son capaces de generar esa reorganizacion por medio de la asociacion contingente y simultanea entre la activacion cerebral y la estimulacion periferica. Conclusiones. Se evidencian los efectos positivos de las estrategias de neurorrehabilitacion citadas previamente en la potenciacion de la reorganizacion cortical despues del ictus, asi como en la paliacion de los efectos adversos asociados al desarrollo de la espasticidad.

  2. [We are a band: An anthropological vision of the medical community].

    PubMed

    Serrano Morón, P; Delgado Galán, M

    2017-06-27

    In this paper we try to explain, using an anthropological point of view, how the medical community behaves like a tribe like those who inhabit the Amazon forests or the African Savanna. The Family as fundamental unit of a band of hunter-gatherers also defines the Primary Care Centre and the professionals who work there, as an egalitarian group in which every member works for the good of the tribe. The leaders of the tribe, also called "Health Centre Managers", are also comparable to the "big men" of Polynesia or the aborigines, who leads hunting parties. Even the clashes between physicians about the responsibilities as regards patients have been described throughout history in the anthropological literature, and they repeat the patterns of the segmental groups. We finish by concluding that this vision of warring tribes has to be overcome in order to advance towards the improvement of our community's health. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Spanish consensus on sexual health in men and women over 50.

    PubMed

    Sanchez-Borrego, Rafael; Molero, Francisca; Castaño, Rosario; Castelo-Branco, Camil; Honrado, Manel; Jurado, Ana Rosa; Laforet, Encarna; Prieto, Rafael; Cabello, Francisco; Larrazabal, Miren; Sánchez, Froilán; Florido, Jesús; Mendoza, Nicolas

    2014-06-01

    Sexual health has been defined as "the state of physical, emotional and social wellbeing related to sexuality. However, there are medical, psychological and social reasons that complicate full sexual health that are frequently not attended to sufficiently. The objective of this guide will be to analyze the factors that impact the sexual health of men and women over 50 and to provide recommendations for the most appropriate diagnostic and therapeutic measures for this age group. A panel of experts from various Spanish scientific societies related to sexual health (Spanish Menopause Society, SMS; Asociación Española de Andrología, Medicina Sexual y Reproductiva, ASESA; Federación Española de Sociedades de Sexología, FESS; and Sociedad Española de Médicos de Atención Primaria SEMERGEN) met to reach a consensus on these issues and to decide the optimal timing and methods based on the best evidence available.

  4. [Klippel-Feil syndrome, a rare cervicalgia].

    PubMed

    Palacios Martínez, D; Díaz Alonso, R A; Gutiérrez López, M; Gordillo López, F J

    2013-01-01

    Cervicalgia is defined as the presence of pain in the neck region, and can radiate to the shoulders, upper limbs or back. It is a source of frequent visits to Primary Care, and more than half of the general population will suffer neck pain at some point in their life. Klippel-Feil syndrome is an exceptional cause of cervicalgia. It belongs to the group of so-called malformations of the hold-down skull-cervical congenital disease. Klippel-Feil syndrome is a complex disease entity characterized by the fusion of two or more vertebrae, and may also be associated with other bone and visceral disorders. The characteristic clinical triad consists of short-neck, implantation below the hair in the occipital region, and limitation of cervical mobility. However, this clinical picture is present in less than 50% of these patients. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  5. [Lifestyles of primary care physicians: perception and implications on cardiovascular prevention].

    PubMed

    Fonseca, M; Fleitas, G; Tamborero, G; Benejam, M; Leiva, A

    2013-01-01

    To analyze the lifestyles of family physicians, their influence on cardiovascular prevention activities carried out on their patients and the difficulties in carrying them out. Design cross-sectional study, using as an anonymous ad hoc questionnaire, implemented in 2010. Primary care of Mallorca. Representative sample of 185 primary care medical professionals of Mallorca. There was a response rate of 78.9% (146/185). Characteristics of physicians surveyed: the mean age was 43.6 years, 24.6% following a healthy diet, 18.6% were smokers, 32.7% did not consume alcohol, and 80.8% performed physical exercise. The most frequent prevention activity on their patients was anti-smoking advice (52.3%), followed by those related to cardiovascular risk factors, hypertension, diabetes, dyslipidemia (22.7%), dietary advice (14.4%), advice about exercise (5.3%), and alcohol consumption (0.8%). Doctors who smoked and drank more alcohol offered less preventive activities to their patients (P<.05). Lack of time was the main limiting factor to properly perform prevention activities. There is a relationship between lifestyle habits of primary care physicians and preventive activities carried out with their patients. Family physicians have relatively healthy lifestyles and promote preventive activities among their patients. The limited investigation into alcohol consumption should be noted. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. [Previous abstinence time as a predictive factor at 12 months follow-up in a multi-component smoking cessation program].

    PubMed

    Moreno-Arnedillo, J J; Morante-Benadero, M E; Sánchez-Vegazo-Sánchez, E

    2014-01-01

    The objective of this study is to analyze the length of the longest period of previous abstinence time as a predictor of the results of a smoking cessation program at 12 months follow-up. A cross-sectional study was conducted on a sample of 475 smokers who had participated in a multi-component smoking cessation group therapy program. The independent variable is the longest abstinence time passed, measured in weeks, before the current treatment. Success was defined as self-reported abstinence. Bivariate analyses were applied to the independent variable and to other variables in order to determine the factors that would be part of a logistic regression model using contrasts Student t or χ(2) comparisons, as appropriate. Those that showed statistical significance were entered into a multivariate logistic regression model. Within the studied variables, previous abstinence time and sex were the only predictive variables of success at 12 month follow-up. The probability of being abstinent at 12 months follow-up was significantly associated with the length of the previous longest period of abstinence, and this is the best of the predictors considered. Successful cessation programs depend more on the relationship with the consumer biographical aspects than with biological factors. The history of previous attempts is a more valuable source of information for designing treatments than others traditionally considered. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. [The medical history taking in sexual health: skills and attitudes].

    PubMed

    Sánchez-Sánchez, F; González-Correales, R; Jurado-López, A R; San Martín-Blanco, C; Montaña-Hernández, R M; Tijeras-Úbeda, M J; Benitez-Moreno, J M; Brenes-Bermúdez, F; Mir Pizà, J; Villalba-Quintana, E

    2013-01-01

    A sexual satisfactory life favourably affects quality of life, there being evidence that shows there are multiple organic processes of which sexual dysfunction is often a precocious sign of underlying organic disease (cardiovascular, endocrinological or neurological). Difficulties exist in recording the sexual anamnesis on the part of the professional, the patient, or by the health system. Nevertheless, given its importance, it is necessary for the doctor to adopt an attitude of active search, especially among the population of risk. To do this, it is necessary that the situation is propitious (sense of the opportunity), preserving the confidentiality of the meeting, and it will be carried out naturally and with empathy, adopting a listening attitude, taking into account the non-verbal language, without issuing valued judgments, and resorting to assertivity to overcome the resistances. This article proposes guidelines to perform an anamnesis adequately. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. [Use of probiotics in bacterial vaginosis].

    PubMed

    Mur Pérez, A M; Mateo Segura, Z; Ramírez Domínguez, N; Vela Condón, P

    Bacterial vaginosis (BV) is a change in the vaginal microbiota due to bacterial overgrowth of normal microorganisms, which produces symptoms of vaginal discomfort, increased malodorous vaginal discharge, etc. Although they been seen to improve recurrence rates in clinical practice, the role of probiotics is questioned in these situations. A literature review on BV is presented in order to evaluate the effectiveness of using probiotics as adjuvant therapy in BV. PubMed, Cochrane and SCOPUS review of the last 5 years publications using probiotics to treat women diagnosed with BV. An analysis was performed on the 10 items that refer to the use of probiotics in addition to antibiotic treatments. All items conclude that the use of probiotics is beneficial in cases of BV in addition to conventional treatments. However, the conclusions are not categorical due to there being a wide variety of studies and probiotics used. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Narcolepsy and odor: preliminary report.

    PubMed

    Dominguez-Ortega, L; Díaz-Gállego, E; Pozo, F; Cabrera García-Armenter, S; Serrano Comino, M; Dominguez-Sanchez, E

    2013-10-01

    This study has been carried out to test the clinical hypothesis of personal smell as a hint to the diagnosis of narcoleptic patients. Sweat samples from narcoleptic and healthy controls were tested independently by two trained dogs and their positive or negative detection compared to the gold standard diagnosis for narcolepsy. Neither trainer nor dog knew the source of the sample selected or its placement in the search device. Twelve narcoleptic patients, both sexes and various ages, recruited from April 2011 to June 2012 and diagnosed according to standard criteria, through their clinical records and nocturnal polysomnography plus multiple sleep latency test, made up the patient group. The control group was made up of 22 healthy volunteer without sleep disorders, both sexes and various ages. Sweat samples from both patients and controls were collected following the same protocol to avoid contamination, and tested independently by two trained dogs. Eleven narcoleptic were detected positive by the dogs while only three controls. It seems that narcoleptic patients have a distinct typical odor that trained dogs can detect. The development of olfactory test could be a useful method in the screening of narcolepsy while opens a new research area. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. [RS3PE syndrome: An update on its treatment using the presentation of a case].

    PubMed

    Amodeo, M C; Poyato, M; Rodríguez, M

    2015-01-01

    The present study was undertaken in order to try to clarify certain aspects of RS3PE syndrome, for which there is no unanimity of opinion in the current literature. An attempt will be made to clarify the best and most suitable drug for treatment, and the dosage duration. In order to do this, a literature search was performed, and a review is presented of the 108 cases collected. In 95% cases glucocorticoids were the most used, with prednisone in being used in 68.5% of cases. Although there is no unanimity criteria regarding the dosage and duration, 73.8% cases were treated with a prednisone dose from 15 to 20 mg/day (median 18.2 mg/day, SD 8.9). Two-thirds (66.1%) of cases were treated for 3 to 6 months (median 5.3 months, SD 3.8). A case is presented that serves as a common thread of these observations. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. [Descriptive study of alcohol consumption in adolescents of Gandia].

    PubMed

    Martínez-Sabater, A; Llorca-Tauste, J; Blasco-Roque, M; Escrivá-Aznar, G; Martínez-Puig, C; Marzá Gascó, A

    2014-01-01

    The morbidity and mortality in developed countries is related to habits acquired in adolescence. Alcohol is the drug most consumed by Spanish adolescents, making its abuse a concern for public health. To evaluate the pattern of alcohol consumption of 4th year secondary school pupils in the city of Gandia, the defining characteristics of this population and the environment in which this takes place. This is a descriptive study of alcohol use in adolescents aged 15 to 18 years of Gandia, which was carried out through a survey of different issues related to health habits, nine of which relate to consumption alcohol. Of the 346 adolescents surveyed, 98% were minors, 93.3% had tried an alcoholic drink. Just under half (48.5%) took part in street binge-drinking, and 45.5% had got drunk at least once. Consumption was mainly during the weekend. More than three-quarters (76.6%) had their first contact with alcohol in the family. Alcohol use among adolescents is high, with consumption is mostly at weekends and with a high prevalence of alcohol intoxication, drinking in public places, and with friends. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  12. Epidemiological multicentre study on the education provided to patients with type 2 diabetes mellitus in the Spanish Health Care System. The Forma2 study.

    PubMed

    García-Donaire, J A; Franch-Nadal, J; Rodríguez-Fortúnez, P; Labrador-Barba, E; Orera-Peña, M L; Rodríguez de Miguel, M

    2017-05-13

    The purpose of the present study was to characterize the education that patients with type 2 diabetes mellitus receive, and to identify differences as regards the presence of insulin therapy or not. This crossover, multicentre and descriptive study involved 1066 Spanish physicians who completed a questionnaire on Internet. The physicians that responded had a mean of 26.0 years of experience in healthcare, and mainly worked in a walk-in clinic in an urban area. Physicians rated the level of patient knowledge about their disease on a 5.0 point-scale. Fifty percent of them indicated that they spent between 15 and 30min in educating patients at the time of diagnosis. Previous control with HbA1c>9%, presence of microvascular complications, and a low socio-cultural level, were factors associated with spending more time in education. This is the first study designed to evaluate the education provided to patients with type 2 diabetes mellitus from Spain. The time spent and the individualization of the education are important factors associated with better long-term control of the disease, and thus with the effectiveness of the clinical management. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. [Survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain)].

    PubMed

    Barbosa, I R; Bernal Pérez, M M; Costa, Í C C; Jerez-Roig, J; Souza, D L B de

    2016-09-01

    The aim of this work is to study the survival of lung cancer patients treated at a referral hospital in Zaragoza (Spain). The Kaplan-Meier test was used to calculate observed survival. The automatic calculation of the Catalan Institute of Oncology was used to analyse relative survival. Mean survival time was 25.74 months. There was no difference when comparing age groups (P=.151), gender (P=.369), and histological type of tumour (P=.086). Survival by stage of the disease at diagnosis revealed statistically significant differences (P<.001). Relative survival 5 years after diagnosis for the group analysed was 14%. Survival was higher for men (15.5%), in patients under 60 (16.7%) and squamous tumours (18.7%). Survival by tumour stage was in line with the TNM Staging System for Lung Cancer. These results suggest that overall survival rate for lung cancer in Zaragoza remains very low in the long term, and this depends on the stage of the disease at diagnosis. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Electronic medical records: Evolution of physician-patient relationship in the Primary Care clinic].

    PubMed

    Pérez-Santonja, T; Gómez-Paredes, L; Álvarez-Montero, S; Cabello-Ballesteros, L; Mombiela-Muruzabal, M T

    2017-04-01

    The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Bisphosphonate-related osteonecrosis of the jaw].

    PubMed

    Atanes-Bonome, P; Atanes-Bonome, A; Ríos-Lage, P; Atanes-Sandoval, A D

    2014-04-01

    The bisphosphonates are stable inorganic pyrophosphate analogs that have demonstrated their efficacy in treatment of osteolytic lesions associated with bony metastases, and multiple myeloma, malignant hypercalcemia, Paget's disease, and osteoporosis. Several publications within the last few years have suggested that osteonecrosis of the jaw is associated with bisphosphonate therapy. The diagnosis and management strategies of the patients with bisphosphonate-related osteonecrosis of the jaw is very difficult. It is important for patients to be informed of the risk of this complication, so that they have the opportunity to assess the need for dental treatment before starting therapy. Preventive measures must be taken before, during, and after treatment with bisphosphonates. If osteonecrosis of the jaw is present, management should be conservative: oral chlorhexidine and antibiotics. Surgical treatment should be reserved for those patients who are symptomatic. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. [Reliability study on the interpretation of electrocardiograms by general practitioners and trainees].

    PubMed

    Alonso Moreno, F J; Orueta Sánchez, R; Segura Fragoso, A; Rabadán Velasco, A I; Luna Del Pozo, L; Villarín Castro, A; Baquero Alonso, M; Rodríguez Padial, L

    2017-02-27

    To determine the reliability of the interpretation of electrocardiograms (ECG) by general practitioners and those in training by making a comparison with the interpretation made by the cardiologist. An observational study was conducted that included general practitioners working in the Toledo Health Area, physicians during their training in Family and Community Medicine, and cardiologists in their first 3 years of specialist training (R1-R3). A questionnaire was used that included 13 ECGs with no clinical details of the patient. The 13 ECGs were selected and their diagnoses made by consensus by 2 cardiologists from the Toledo Hospital Complex. The highest percentage of correct answers (82.3%) was obtained for ECG 5 (atrial fibrillation), and the lowest (26.5%) for ECG 11 (junctional rhythm). The highest diagnostic skill was achieved by the resident cardiologists, general practitioners, medical tutors, and doctors who had worked in hospital emergency departments. The highest odds ratio for a higher diagnostic skill was to work in an emergency department and be a practising general practitioner, both with almost significant results (P<.10). Family physicians and those in training have a medium level of reliability in the interpretation of an ECG compared to the cardiologist. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Chronic obstructive pulmonary disease: Morbimortality and healthcare burden].

    PubMed

    Gómez Sáenz, J T; Quintano Jiménez, J A; Hidalgo Requena, A; González Béjar, M; Gérez Callejas, M J; Zangróniz Uruñuela, M R; Moreno Vilaseca, A; Hernández García, R

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is an enormous public health problem and of growing importance due to its high prevalence, elevated morbimortality, and socioeconomic costs. Many Spanish epidemiological studies report a prevalence of 10% of the adult population, with its growth appearing to have stabilised. Nevertheless, over 75% of cases are still underdiagnosed. The diagnosis of mild and moderate obstruction is associated with a higher survival and lower costs (14 years and €9,730) compared to 10 years survival and €43,785 of patients diagnosed in the severe obstruction phase. COPD was the fourth cause of death in Spain in 2011, although the adjusted mortality rates have decreased more than 20% in the last decade, particularly in males. Patients with advanced COPD die from it, but patients with mild or moderate COPD die due to cardiovascular diseases or cancer (mainly of the lung). It is estimated that the annual cost of the disease is around 3,000 million Euros. These increase with the spirometric severity, and is mainly associated with exacerbations (almost 60% of the direct costs). Comorbidity, that is the presence of diseases that coexist with the studied disease, is higher in patients with COPD than in the general population and affects health results. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. [The tired adolescent: Evaluation and management in the family practice].

    PubMed

    Cárdenas Villamil, J P; Cavanzo Ramírez, A I; García Manrique, J G

    2017-05-13

    The narrative review is used as a methodological tool for the presentation of this article. A search was made in the PubMed, Elsevier, Ebsco, and Medline databases using temporal limits (publications from 2005 to 2016), in the Spanish, English, and Portuguese language, and by the type of persons analysed in the study (adolescents), along with the keywords in English: Adolescent/teen, tiredness, fatigue, sleepiness, drowsiness. A total of 33 articles of relevance were obtained for the diagnostic and therapeutic approach of the tired adolescent in Primary Care. It was found that the main cause of excessive daytime sleepiness and drowsiness in adolescents is insufficient or inadequate sleep. For this reason, a sleep assessment should be a routine component of the clinical evaluation of adolescents, and as the initial approach to dismiss secondary causes. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Rapid headache guidelines. Neurology consensus between Neurology (SAN) and Primary Care (SEMERGEN Andalucía). Referral criteria].

    PubMed

    Gil Campoy, J A; González Oria, C; Fernández Recio, M; Gómez Aranda, F; Jurado Cobo, C M; Heras Pérez, J A

    2012-01-01

    Headache is one of the most frequent reasons for consultation in our health centers, something which should not be surprising if we consider that is one of the most common symptoms experienced by the population. The main concern of the family physician and emergency physician is to reach a correct diagnosis by clinical history and a basic neurological examination and adapted to the time and means at its disposal. In case of diagnostic doubts or suspected secondary headache, the primary care physician or emergency medical have to refer the patient to be studied and/or treated for Neurology services, such referral shall be made with varying degrees of urgency depending on the presence, or not, of symptoms or signs of alarm. A working group consisting of Neurologists of Sociedad Andaluza de Neurología (SAN) to provide services in different hospitals in Andalucía and Family Physicians representatives of the Sociedad Andaluza de Medicina Familiar y Comunitaria (SAMFyC) and the Sociedad Española de Médicos de Atención Primaria (SEMERGEN Andalucía), has developed a Quick Guide headache, which addresses the more practical aspects for the diagnosis, treatment and monitoring of patients with headache. We show you in this paper, the chapter that deals the alarm criteria and referral. Copyright © 2012. Published by Elsevier Espana.

  20. [Analysis of the quality of life in patients affected by scoliosis].

    PubMed

    Leal-Hernández, M; Martínez-Monje, F; Pérez-Valencia, M; García-Romero, R; Mena-Poveda, R; Caballero-Cánovas, J

    2017-05-11

    To assess the quality of life using the SRS 22 test in patients with scoliosis of 20 or more degrees Cobb. A prospective descriptive study was conducted between April and May 2016 on patients with scoliosis of at least 20 degrees Cobb and aged between 10 and 20 years. A record was made of weight, height, body mass index, and the SR 22 specific quality of life questionnaire for patients with scoliosis was completed. Patients were divided into two groups for analysis: a) scoliosis between 20 and 29 degrees Cobb (n=44); and b) scoliosis with a Cobb of 30 degrees or greater (n=32). There were significant differences in the dimensions that assess pain, image self-perception, and satisfaction with treatment, being valued worse when the degree of scoliosis Cobb is 30 degrees or higher. There were no significant differences in function/activity or mental health. The overall score of the questionnaire was also worse in the group with the highest degree of scoliosis. The weight, height, and BMI showed no significant differences due to the varying degrees of scoliosis. Scoliosis significantly affects the quality of life of people who suffer it, and there is a negative correlation between the severity of scoliosis measured by degrees Cobb and quality of life. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Neurological manifestations in patients with cancer: more than 17,000 reasons for consultation].

    PubMed

    Cacho-Diaz, B; Reyes-Soto, G; Monroy-Sosa, A; Lorenzana-Mendoza, N A; Olvera-Manzanilla, E; Rodriguez-Orozco, J; Xolio-Villanueva, A; Herrera-Gomez, A; Granados-Garcia, M

    2016-05-16

    Introduccion. El cancer es una de las primeras causas de muerte en nuestra poblacion. Las complicaciones neurologicas asociadas son frecuentes e incrementan significativamente la morbilidad y la mortalidad de estos pacientes. Objetivo. Describir las manifestaciones neurologicas en pacientes con cancer. Pacientes y metodos. Desde enero de 2010 hasta diciembre de 2014 se creo una base de datos de pacientes con cancer que merecian una valoracion por neurooncologia en un centro de referencia. Resultados. Se describen 17.092 motivos de consulta de neurooncologia. Las neoplasias que mas se relacionaron con manifestaciones neurologicas fueron: cancer de mama, neoplasias hematologicas, tumores primarios del sistema nervioso central, cancer de pulmon y neoplasias ginecologicas. Las manifestaciones neurologicas mas frecuentes fueron: afeccion neuromuscular, actividad tumoral en el sistema nervioso central, cefalea primaria, crisis convulsivas, enfermedad vascular cerebral y tumores neurologicos primarios. Conclusiones. Es importante que los neurologos, medicos de distintas areas de la medicina y personal paramedico, involucrados en el manejo de estos pacientes, reconozcan las complicaciones neurologicas de manera temprana.

  2. [Burnout syndrome in general practitioners of Avila].

    PubMed

    Frutos-Llanes, R; Jiménez-Blanco, S; Blanco-Montagut, L E

    2014-10-01

    To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. A response rate of 51.8% was obtained. The mean age was 48.55±8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P=.012), do not guards (P<.0001), working in rural areas (P=.008), and to be an area doctor (p=.03), predisposes to suffer burnout in severe or moderate/severe burnout. A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. [Characteristics and factors associated with dementia caregivers burden].

    PubMed

    Delgado Parada, Eduardo; Suárez Alvarez, Óscar; de Dios del Valle, Ricardo; Valdespino Páez, Ineyvis; Sousa Ávila, Yolanda; Braña Fernández, Gerardo

    2014-03-01

    To describe the characteristics and determining factors of carer stress in a group of elderly home care patients with dementia evaluated in a Geriatric Assessment Unit. An observational descriptive cross-sectional study was conducted using an assessment of baseline characteristics of patients and carers. Estimation of caregiver burden was registered by validated scales: Goldberg Anxiety Scale (GAS), Goldberg Depression Scales (GDS), and Zarit Burden Scale (ZS). A total of 130 patients were included. No item related to dementia patients was associated with caregiver burden. A poor perception of health and quality of life by the caregivers were associated with anxiety risk, depression and burden. Attendance rates for primary care and lack of paid work outside the home were associated with both, depression (GDS>2) and anxiety (GAS>4). Carer age and a lower education were related to depression. Anti-inflammatory, anxiolytics and antidepressants consumption was associated with anxiety, and anti-inflammatory consumption with caregiver burden (ZS >47). The profile of carers in our sample is comparable to that described in other national studies, but care time is longer. The target population is difficult to identify and in need of help. Although there is not a formal demand for help, we should be encouraged to develop new healthcare methods. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. [Research on drug utilization in primary health care in national journals].

    PubMed

    Arnau, J M; Vallano, A; Artigas, R; Vallés, J A; Agustí, A; Colomé, E; Pontes, C; Diogene, E

    1991-12-01

    In order to discover the present state of research into the use of medication (UM) in primary care, articles published in the "Original Articles" sections of Medicina Clínica (MC) (Clinical Medicine) and Atención Primaria (AP) (Primary Care) between 1983 and 1990, were studied. A total of 130 articles that meet the definition of the WHO for studies into the use of Medications (SUM) were identified. The instigator and organiser of the research, the drugs included, the kind of study, the source of the data, the main variables used and the qualitative analysis made, were all studied. In conclusion we were able to point out that the characteristics of UM were met in the majority of the studies; although they are the main objective of the study in only a minority of cases. The people who undertook most of the research were those who themselves prescribed the drugs or dealt with very common pathologies. In general, the studies are only descriptive and have a poor level of assessment of the results.

  5. [Current aspects of prostate cancer screening].

    PubMed

    Jalón Monzón, A; Escaf Barmadah, S; Viña Alonso, L M; Jalón Monzón, M

    Screening programs for prostate cancer based on the determination of serum prostate specific antigen has led to overdiagnosis, and consequently overtreatment. A percentage of men diagnosed with prostate cancer have a tumour that will not progress, or do so slowly (overdiagnosis or pseudo-disease). This overdiagnosis rate ranges from 17-50%. Mass screening is defined as the systematic examination of asymptomatic men. Early detection or opportunistic screening involves the pursuit of individual cases being initiated by the doctor or the patient. In the case of a patient who requests a prostate specific antigen from their general practitioner, a number of issues on overdiagnosis, over-treatment and possible damage from the biopsy, should be explained to him. With data from randomised studies on prostate specific antigen and prostate cancer screening, population screening is not recommended by any urological society. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [A review of multiple sclerosis (2). Diagnosis and treatment].

    PubMed

    Martinez-Altarriba, M C; Ramos-Campoy, O; Luna-Calcaño, I M; Arrieta-Antón, E

    2015-09-01

    Multiple sclerosis is a major demyelinating disease of the central nervous system. It has a significant economic and social impact. Its etiology is unclear, although there are several hypotheses, such as infections or genetics. In its pathophysiology, it seems that immune activation attacks the myelin sheath, causing a progressive and irreversible axonal degeneration. The disease produces a variety of symptoms, and diagnosis requires fulfilling a number of criteria and the exclusion of other possible causes. The role of neuroimaging is very important, especially Magnetic Resonance Imaging. Despite the availability of disease-modifying drugs, none of them are able to halt its progress, and the most useful drugs are those designed to alleviate the symptoms of outbreaks. Overall, multiple sclerosis requires a significant effort in research to clarify not only why and how it occurs, as well as the development of new measures to improve quality of life of affected patients. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. [A review of multiple sclerosis (1). Presentation of a case].

    PubMed

    Martinez-Altarriba, M C; Ramos-Campoy, O; Luna-Calcaño, I M; Arrieta-Antón, E

    2015-01-01

    Multiple sclerosis is a major demyelinating disease of the central nervous system. It has a significant economic and social impact. Its etiology is unclear, although there are several hypotheses, such as infections or genetics. In its pathophysiology, it seems that immune activation attacks the myelin sheath, causing a progressive and irreversible axonal degeneration. The disease produces a variety of symptoms, and diagnosis requires fulfilling a number of criteria and the exclusion of other possible causes. The role of neuroimaging, especially MRI, is very important. Despite the availability of disease-modifying drugs, none of them are able to halt its progress, and the most useful drugs are those designed to alleviate the symptoms of outbreaks. Overall, multiple sclerosis requires a significant effort in research to clarify not only why and how it occurs, but also to develop of new measures to improve the life of affected patients. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Prevalence of the metabolic syndrome in patients with hypertension treated in general practice in Spain: an assessment of blood pressure and low-density lipoprotein cholesterol control and accuracy of diagnosis.

    PubMed

    Barrios, Vivencio; Escobar, Carlos; Calderón, Alberto; Llisterri, José L; Alegría, Eduardo; Muñiz, Javier; Matalí, Arantxa

    2007-01-01

    This study was designed to evaluate whether primary care physicians in Spain accurately diagnose the metabolic syndrome in hypertensive patients, to define the profile and management of these patients in clinical practice, and to ascertain the level of blood pressure and low-density lipoprotein cholesterol control. Data were analyzed from a cross-sectional survey involving 12,954 patients with hypertension (Prevención Cardiovascular en España en Atención Primaria: Intervención Sobre el Colesterol en Hipertensión [PRESCOT] study), wherein 52% of the cohort fulfilled the National Cholesterol Education Program-Adult Treatment Panel criteria for the metabolic syndrome. The majority of patients (54.6%) had 3 risk factors, 32.4% had 4, and 13% had 5 risk factors. Physician diagnosis of the metabolic syndrome was poor, with 43.7% of physicians missing the diagnosis and 12.9% wrongly diagnosing the metabolic syndrome. Blood pressure and low-density lipoprotein cholesterol control rates were very low, with only 4.7% of metabolic syndrome patients achieving control for both blood pressure and low-density lipoprotein cholesterol vs 13.5% for non-metabolic syndrome patients (P<.0001). These findings demonstrate that the metabolic syndrome is common in patients with hypertension and that it is generally poorly diagnosed and treated by primary care physicians.

  9. [Familial combined hyperlipidemia: consensus document].

    PubMed

    Mata, Pedro; Alonso, Rodrigo; Ruíz-Garcia, Antonio; Díaz-Díaz, Jose L; González, Noemí; Gijón-Conde, Teresa; Martínez-Faedo, Ceferino; Morón, Ignacio; Arranz, Ezequiel; Aguado, Rocío; Argueso, Rosa; Perez de Isla, Leopoldo

    2014-10-01

    Familial combined hyperlipidemia (FCH) is a frequent disorder associated with premature coronary artery disease. It is transmitted in an autosomal dominant manner, although there is not a unique gene involved. The diagnosis is performed using clinical criteria, and variability in lipid phenotype and family history of hyperlipidemia are necessaries. Frequently, the disorder is associated with type2 diabetes mellitus, arterial hypertension and central obesity. Patients with FCH are considered as high cardiovascular risk and the lipid target is an LDL-cholesterol <100mg/dL, and <70mg/dL if cardiovascular disease or type 2 diabetes are present. Patients with FCH require lipid lowering treatment using potent statins and sometimes, combined lipid-lowering treatment. Identification and management of other cardiovascular risk factors as type 2 diabetes and hypertension are fundamental to reduce cardiovascular disease burden. This document gives recommendations for the diagnosis and global treatment of patients with FCH directed to specialists and general practitioners. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  10. [Cluster headache in pediatric population: four case reports and review of the literature].

    PubMed

    Alfaro-Iznaola, C; Natera-de Benito, D; Rodriguez-Diaz, R; Taboas-Pereira, M A; Cuadrado-Martin, M; Ballesteros-Garcia, M M

    2016-07-16

    Introduccion. La cefalea en racimos es una cefalea primaria de origen trigeminoautonomico cuyo inicio en la infancia es infrecuente. Se presentan cuatro casos en los que el inicio de la sintomatologia se produjo entre los 2 y los 13 años. Casos clinicos. Se incluyen tres varones y una niña con inicio a los 2, 7, 13 y 12 años, respectivamente. Los cuatro pacientes cumplen los criterios propuestos por la tercera edicion de la Clasificacion Internacional de las Cefaleas ICHD-III (beta). Conclusiones. A pesar de ser poco frecuente durante la edad pediatrica, la cefalea en racimos debe formar parte del diagnostico diferencial de un niño que consulta por cefalea. Subrayamos la importancia de conocer sus criterios diagnosticos para evitar el retraso diagnostico que se ha descrito con frecuencia. En nuestros pacientes, el tratamiento con verapamilo resulto mas eficaz que el tratamiento con flunaricina. Los tratamientos con mejor respuesta en fase aguda fueron la oxigenoterapia y los triptanes.

  11. [Urine incontinence referral criteria for primary care].

    PubMed

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-05-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. [Intimate partner violence and family dysfunction among Mexican women seen a Primary Care Unit].

    PubMed

    Ambriz-Mora, M I; Zonana-Nacach, A; Anzaldo-Campos, M C

    2015-01-01

    To assess the prevalence and risk factors for intimate-partner violence (IPV) in women who attended a Family Medicine Unit in Tijuana, Mexico. A total of 297 women were interviewed and evaluated using two validated scales: violence and severity index and family APGAR to assess family functioning and IPV respectively. The mean age (± SD) was 40.6±13.8 years, and 120 (40.4%) women had suffered IPV: 47 (15.8%) psychological violence; 31 (10.4%) sexual violence; 77 (25.9%) physical violence, and in 19 (6.4%) there were actions that threatened the lives of women. The most common causes of domestic violence were women who reported that their partner had been jealous, or suspicion from friends (37.4%). Twenty two (7.4%) of the women with domestic violence reported that they had sought help. The prevalence of IPV was high and associated with the education level of the couple and family functioning. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. [A way of helping "Mr. Minotaur" and "Ms. Ariadne" to exit from the multiple morbidity labyrinth: the "master problems"].

    PubMed

    Turabián, J L; Pérez Franco, B

    2016-01-01

    Multiple morbidity seems to be "infinite" and so is not easy to make useful decisions. A new concept is introduced: the "master problems", as a qualitative method to facilitate the exit from this maze of multiple morbidity. Metaphors from the art world have been used to teach this concept. These "master problems" generally remain hidden and can only "unravel" between the interstices of multiple morbidity, when the details of the system that defines the problem are explained. A problem with "energy" or a "master problem" is complex, multiple and dramatic or theatrical--everything in the clinical history history make us look into that particular question. It is what gives us a blow to the stomach, which causes our hearts to beat faster, that moves us on many levels, which has a high "density of emotions", human elements, social symbols, and opens solutions in a patient. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Vaccination against community acquired pneumonia in adult patients. A position paper by Neumoexpertos en Prevención].

    PubMed

    Redondo, E; Rivero, I; Vargas, D A; Mascarós, E; Díaz-Maroto, J L; Linares, M; Valdepérez, J; Gil, A; Molina, J; Jimeno, I; Ocaña, D; Martinón-Torres, F

    2016-10-01

    Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults. The annual incidence of CAP in adults in Spain ranges from 3 to 14 cases per 1,000 inhabitants. Current clinical guidelines primarily focus on the therapeutic approach to CAP rather than its prevention. The aim of this study is to develop and propose a practical guide for CAP prevention through vaccination in Spain according to available vaccines and evidence. A literature review and expert opinion. Pneumococcal and influenza vaccines are the main preventive tools available against CAP. Age, chronic diseases, and immunosuppression are risk factors for pneumonia, so these populations should be a priority for vaccination. In addition, influenza and pneumococcal vaccination is considered advisable in healthy adults under 60 years of age, and anyone with risk condition for CAP, irrespective of age. The influenza vaccine will be administered seasonally, while pneumococcal vaccination can be administered at any time of the year. Vaccination against pneumococcus and influenza in adults can help to reduce the burden of CAP and its associated complications. The available evidence supports the priority indications set out in this guide, and it would be advisable to try to achieve a wide circulation and practical implementation of these recommendations. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Vaccines and preventive activities in patients with inflammatory arthritis].

    PubMed

    Casals-Sánchez, J L; Casals Vázquez, C; Vázquez Sánchez, M Á; Giménez Basallote, S

    2013-10-01

    Patients with inflammatory arthritis and eligible for immunosuppressive therapy account for more than 1% of general population, and represents a significant workload on family doctors. They are prone to other comorbidities, with an increased cardiovascular risk and a higher incidence of infections than the general population, especially skin infections and pneumonitis. This comorbidity can be considered vulnerable to a prevention program-prevention of cardiovascular risk, cancer screening, vaccination schedule for adults. As for prevention through vaccination, importance should be given to pneumococcal infection - significant in adults aged 50 or over, especially amongst immunosuppressed patients. The 13-valent conjugate vaccine, which has been recently approved for adults, must be considered. An attempt has been made to write a simple, applicable document on preventive measures that should be implemented both at primary and secondary care level for those adults. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. [Orofacial alterations and surface electromyography in neurodevelopmental disorders].

    PubMed

    Rosell-Clari, V

    2017-02-24

    Introduccion. La electromiografia de superficie se ha convertido en una tecnica muy utilizada para medir la actividad de distintos grupos musculares. Aunque la fiabilidad y validez de la tecnica se discuten, existe un cuerpo importante de bibliografia cientifica que defiende su uso. Objetivo. Presentar, mediante un estudio de caso, las dos utilidades basicas de la electromiografia de superficie: la medida de la actividad muscular orofacial y su empleo como biofeedback modulador de la propia actividad muscular. Caso clinico. Niña de 10 años con perfil facial dolicocefalico y prognatico, mordida abierta anterior y mordida cruzada bilateral, oclusion clase II de Angle bilateral y deglucion atipica con interposicion lingual. Se utilizo el electromiografo de superficie de ocho canales bipolares MioTool Face, de Miotec Suite 1.0. Se colocaron electrodos de superficie en la musculatura orofacial y los resultados obtenidos se midieron y visualizaron a traves de los programas Miograph y Biotrainer. Conclusiones. Los resultados confirman los obtenidos a traves de la exploracion clinica del paciente y apoyan el uso de estas mediciones para la estimacion y validacion de modelos mecanicos del sistema masticatorio y deglutorio. El biofeedback electromiografico se muestra como una tecnica eficaz para autocontrolar la fuerza que se realiza en grupos musculares claves en actividades primarias como la masticacion y la deglucion.

  17. [Epilepsy in the temporal lobe: déjà vu in Primary Care].

    PubMed

    Miguéns Blanco, I; Rodríguez Acevedo, B

    2013-10-01

    Epilepsy is a common disease in the general population. 10% of the population will present a seizure throughout his life, although only 1% will have an epileptic condition. We can divide the generalized epilepsy and focal. Es in the latter that more diagnostic and management difficulties may arise in clinical practice, for its wide variety of symptoms and their identification difficult. These symptoms may be referred to differently by each patient, often dismissively. In focal epilepsy, the most prevalent epilepsy that originates in the temporal lobe. The identification and study of this pathology is very important because the patient may have episodes of disconnecting means and in one third of cases secondarily generalized crises. Although most patients the culprit lesion is mesial temporal sclerosis, one must rule out other causes such as tumors or infections. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  18. Contralateral botulinum injections in patients with residual facial asymmetry and contralateral hyperkinesis after primary facial palsy surgery.

    PubMed

    Bartoli, Davina; Battisti, Andrea; Cassoni, Andrea; Terenzi, Valentina; Della Monaca, Marco; Pagnoni, Mario; Valentini, Valentino; Priore, Paolo

    2015-01-01

    Ogni trattamento, medico e chirurgico, della paralisi facciale è finalizzato al recupero della simmetria facciale statica e dinamica. La tossina botulinica di tipo A può essere utilizzata nei pazienti affetti da paralisi del nervo facciale, sottoposti in precedenza a chirurgia primaria, al fine di ridurre la residua asimmetria facciale e le progressive ipercinesie controlaterali al lato affetto, che caratterizzano tali soggetti. Sono stati inclusi nel nostro studio sei pazienti (1 maschio e 5 femmine) affetti da paralisi del nervo facciale monolaterale secondaria a diverse cause, classificata secondo la scala di House-Brackmann in grado III e IV. I pazienti inclusi nello studio sono stati sottoposti in precedenza a trattamento chirurgico riabilitativo specifico per la paralisi facciale stessa; successivamente ciascuno di essi è stato trattato con 50 unità di tossina botulinica di tipo A a livello del lato non affetto del volto, al fine di ridurre le ipercinesie muscolari ed aumentare l’asimmetria e l’abilità muscolare del volto. L’età media dei soggetti era di 44,5 anni. I pazienti sono stati esaminati a 7, 14, 30, 60, 90 e 120 giorni dopo il trattamento con tossina botulinica. Lo studio dimostra la riduzione delle ipercinesie controlaterali alla paralisi facciale ed il miglioramento della simmetria del volto nei pazienti sottoposti precedentemente a trattamento chirurgico primario per la riabilitazione del nervo facciale stesso. Tutti i pazienti si sono dimostrati soddisfatti del trattamento con tossina botulinica di tipo A.

  19. [Validity of the 24-h previous day physical activity recall (PDPAR-24) in Spanish adolescents].

    PubMed

    Cancela, José María; Lago, Joaquín; Ouviña, Lara; Ayán, Carlos

    2015-04-01

    Introducción: El control del nivel de práctica de actividad física que realizan los adolescentes, de sus factores determinantes y susceptibilidad al cambio resulta indispensable para intervenir sobre la epidemia de obesidad que afecta a la sociedad española. Sin embargo, el número de cuestionarios validados para valorar la actividad física en adolescentes españoles es escaso. Objetivos: Evaluar la validez del cuestionario24hPrevious Day Physical Activity Recall (PDPAR-24) cuando es aplicado a la población de adolescentes españoles. Método: Participaron en este estudio estudiantes de 14-15 años de dos centros de educación secundaria del norte de Galicia. Como criterio objetivo de la actividad física realizada se utilizó el registro proporcionado por el acelerómetro Actigraph GT3X.Se monitorizó a los sujetos durante un día por medio del acelerómetro y al día siguiente se administró el cuestionario de auto-informe. Resultados: Un total de 79 alumnos (15.16 ± 0.81 años, 39% mujeres) finalizaron el estudio. Se observan correlaciones positivas estadísticamente significativas de tamaño medio a grande en ambos sexos (r=0.50-0.98), para la actividad física ligera y moderada. Las correlaciones observadas son más elevadas a medida que aumenta la intensidad de la actividad física realizada. Conclusiones: El cuestionario de auto-informe PDPAR-24 puede ser considerado como una herramienta válida a la hora de valorar el nivel de actividad física en adolescentes españoles.

  20. [LIFESTYLES AND FACTORS ASSOCIATED TO NUTRITION AND PHYSICAL ACTIVITY AMONG ADOLESCENTS].

    PubMed

    Lima-Serrano, Marta; Guerra-Martín, María Dolores; Lima-Rodríguez, Joaquín Salvador

    2015-12-01

    Introducción y objetivos: los objetivos del estudio han sido conocer los estilos de vida de los adolescentes del sur de España, en áreas de alimentación y actividad física, y analizar la influencia de variables sociodemográficas en los mismos. Métodos: se utilizó un diseño transversal correlacional con 204 estudiantes de educación secundaria. Se realizó análisis descriptivo, bivariante y multivariante usando modelos de regresión (=0,05). Resultados: desayunaba a diario el 67%. Consumían más de seis veces a la semana: lácteos (56,3%), cereales (44,1%), frutas (40,7%) y verduras (28,5%). Hacían actividad física, al menos 60 minutos, 4,34 días a la semana y el índice de masa corporal se situó en normopeso (19,85). Mediante modelos lineales multivariantes se comprobó la influencia de la edad, el sexo/género y el estatus social sobre el índice de masa corporal, el consumo de frutas y verduras y la frecuencia de actividad física de estos adolescentes. Conclusiones: conocer las desigualdades en las áreas de alimentación y actividad física en los adolescentes, así como sus factores de riesgo o determinantes sociales puede ayudar en el diseño de estrategias y políticas de salud pública específicas, teniendo en cuenta estos determinantes sociales, a nivel normativo y mediante intervenciones de promoción de la salud nutricional y la actividad física.

  1. Adherence to dietary recommendations among Spanish and immigrant adolescents living in Spain; the AFINOS study.

    PubMed

    Esteban-Gonzalo, Laura; Veiga, Oscar Luis; Gómez-Martínez, Sonia; Regidor, Enrique; Martínez, David; Marcos, Ascensión; Calle, María Elisa

    2013-11-01

    Objetivos: Este estudio compara la adherencia a las recomendaciones nutricionales de adolescentes inmigrantes y españoles residentes en la Comunidad de Madrid, España. Se comparó el consumo de ocho grupos principales de alimentos (verduras, frutas, pan/cereales, carne, huevos, pescado, legumbres, leche/derivados lácteos) incluyendo el consumo excesivo y deficiente de huevos, carne y pescado. También fue valorado el consumo excesivo de dulces y bebidas azucaradas. Posteriormente se analizó la influencia del tiempo de residencia en España sobre los mencionados hábitos de dieta. Material y método: Se llevó a cabo un estudio transversal en el que fueron recogidos datos auto-reportados durante el periodo comprendido entre Noviembre 2007 y Febrero 2008. Se obtuvo una muestra representativa de adolescentes con edades comprendidas entre 13 y 17 años (n=2081, 1055 mujeres) residentes en la Comunidad de Madrid. Los participantes pertenecían a centros de enseñanza secundaria seleccionados aleatoriamente según la distribución geográfica de los adolescentes en la región. Resultados: Los inmigrantes adolescentes presentaron una mayor probabilidad de no cumplir las recomendaciones nutricionales para el consume de carne, pescado, legumbres, pan/cereales y leche/derivados, de consumir una cantidad insuficiente de pescado y más dulces y bebidas azucaradas que sus compañeros españoles. Los adolescentes españoles mostraron una mayor probabilidad de no cumplir con la recomendación establecida para verduras. El tiempo de residencia afectó débilmente los hábitos de dieta, asociando aspectos tanto positivos como negativos. Conclusiones: La probabilidad de no cumplir las recomendaciones nutricionales fue mayor entre los adolescentes inmigrantes con excepción del consumo de frutas y verduras.

  2. [Giant cystic lymphangioma breast. Report of a case with 20-year follow-up and review of the literature].

    PubMed

    Vargas-Hernández, Víctor Manuel; Tovar-Rodríguez, José María; Moreno-Eutimio, Mario Adán; Acosta-Altamirano, Gustavo

    2014-01-01

    Antecedentes: los linfangiomas son malformaciones congénitas o adquiridas (secundarias a traumatismos, infecciones o neoplasias) de la glándula mamaria sumamente raras. Estas lesiones tienden a infiltrar los tejidos circundantes y la degeneración maligna es excepcional. Su manifestación clínica es en tumores benignos y de crecimiento lento. Se diagnostica clínicamente y por estudios de imagen. El tumor se extirpa por razones estéticas y para establecer el diagnóstico diferencial con otras lesiones más comunes. Caso clínico: paciente femenina de 45 años de edad, con incremento progresivo del tamaño de la mama izquierda, quizá originado por un traumatismo y no tiene otros sintomas. El diagnóstico histológico definitivo fue: linfangioma quístico gigante de la glándula mamaria izquierda. Discusión: los linfangiomas son lesiones extremadamente raras en la glándula mamaria, de comportamiento agresivo local y benignas. El tejido linfático anormal posee cierta capacidad de proliferar y de acumular grandes cantidades de líquido, lo que representa su apariencia quística, como sucedió en el caso aquí reportado. La extirpación quirúrgica local es el tratamiento indicado. Conclusión: este primer caso de linfangioma quístico gigante de mama reportado en México permite corroborar la benignidad de la lesión.

  3. The Intergenerational Transmission of Smoking Across Three Cohabitant Generations: A Count Data Approach.

    PubMed

    Escario, José-Julián; Wilkinson, Anna V

    2015-10-01

    This paper examines the extent to which parent and grandparent smoking influences adolescent smoking and its quantitative implications for tobacco control. It extends similar prior studies by investigating the effects on the probability of becoming a smoker and on the number of cigarettes smoked. Count regressions were used to assess the intergenerational transmission of smoking across three cohabitant generations, simultaneously, using data from the 2010 survey "Encuesta Estatal Sobre Uso De Drogas en Estudiantes de Enseñanzas Secundarias". This survey, of 32,234 students, constitutes a representative sample of Spanish students between 14 and 18 years of age. Living with a mother who smokes, a father who smokes, or a grandparent who smokes reduces the odds of being a non-smoker by 36.1% (OR 0.639), 26.1% (OR 0.739) and 20.3% (OR 0.797), respectively. Parental smoking increases cigarette consumption levels among adolescents. Having a cohabitant mother who smokes increases the number of cigarettes smoked by children by around 18.7% (IRR 1.187), while having a cohabitant father who smokes increases the number by around 12.1% (IRR 1.121). Estimates support the hypothesis that visibility of smoking among parents and grandparents is a strong predictor of smoking among adolescents. Accordingly, quitting smoking by parents and grandparents before children become adolescents appears to be a powerful means to both reduce smoking rates among adolescents and the number of cigarettes smoked by smokers; such decisions appear to exert a stronger influence on the prevalence of smoking and consumption levels than exposure to smoking prevention campaigns at school.

  4. Environmental restoration and waste management: An introduction. Student edition; Restauracion ambiental y administracion de residuos nucleares: Introduccion; Edicion estudiantil

    SciTech Connect

    Not Available

    1993-12-31

    For more than 40 years, the United States has produced nuclear weapons. These production activities generated both radioactive and hazardous waste and often contaminated the environment. For many years, the public was unaware of the problem and unable to do anything about it. All of this has changed. In response to recent public outcry, the former Secretary of Energy, Retired Admiral James D. Watkins, established the Office of Environmental Restoration and Waste Management (EM) in November 1989. The creation of EM was the first step toward correcting contamination problems from the past 40 years In this booklet, we at DOE, through the efforts of the students at Oak Hills High School of Cincinnati, Ohio, will introduce you to EM and encourage your involvement in this major program within the Department of Energy. [Espanol] Durante mas de 40 anos, los Estados Unidos fabricaron armamentos nucleares. Esta produccion genero residuos radiactivos y peligrosos y, en muchos casos, contaminaron el medio ambiente. Durante mucho tiempo, el publico norteamericano no tenia conocimiento de este problema y no pudo hacer nada para solucionarlo. Todo esto ha cambiado. Respondiendo a crecientes protestas publicas, el ex Secretario de Energia Almirante James D. Watkins, establecio en noviembre de 1989 la Subsecretaria de Administracion Ambiental. La creacion de esta Subsecretaria fue el primer paso que dio el Departamento de Energia para corregir los problemas de contaminacion ambiental de los ultimos 40 anos. En esta publicacion, los que trabajamos en el Departamento de Energia con la ayuda de los estudiantes de la Escuela Secundaria de Oak Hills, Cincinnati, Ohio, te introduciermos a la administracion ambiental y alentamos tu participacion en este programa de fundamental importancia en el Departamento de Energia.

  5. [Sexual dysfunction in migraine patients who receive preventive treatment: identification by means of two screening tests].

    PubMed

    Domínguez, Elena; Ruiz, Lara; Hernández, Marta S; Muñoz, Irene; Ruiz-Piñero, Marina; Uribe, Fernando; Guerrero-Peral, Ángel L; Toribio-Díaz, M Elena

    2015-01-01

    Introduccion. Las disfunciones sexuales constituyen uno de los problemas mas importantes que afectan a la salud sexual y se asocian a bajos niveles de calidad de vida. Objetivo. Evaluar la funcion sexual en pacientes migrañosos y la disfuncion sexual atribuible al tratamiento preventivo. Pacientes y metodos. Pacientes atendidos en las consultas de cefaleas de dos hospitales generales que acudian a la primera visita tras prescripcion de un preventivo. Respondieron al cuestionario de funcionamiento sexual del Hospital General de Massachusetts (MGH-SFQ) y al cuestionario de disfuncion sexual secundaria a psicofarmacos (SALSEX). Resultados. Muestra de 79 pacientes (17 varones, 62 mujeres), de 37,6 ± 9,1 años (rango: 19-57 años), 31 (39,2%) de ellos con migraña cronica. Como tratamiento preventivo, 23 (29,1%) recibian betabloqueantes; 42 (53,2%), neuromoduladores; 8 (10,1%), antagonistas del calcio, y 6 (7,6%), antidepresivos. El MGH-SFQ detecto en 24 pacientes (30,4%) disminucion al menos moderada de satisfaccion sexual global. El SALSEX mostro cambio de la funcion sexual atribuible al tratamiento preventivo en 36 casos (45,5%), solo excepcionalmente manifestada de forma espontanea. En pacientes con disfuncion al menos moderada en el MGH-SFQ, eran significativamente mayores la edad media en el momento de la inclusion, el numero de dias de dolor al mes y el uso excesivo de medicacion sintomatica (53,3% frente a 46,7%; p = 0,03). Conclusion. La disfuncion sexual evaluada con sencillos test de cribado detecta con frecuencia disfuncion sexual en pacientes migrañosos en tratamiento preventivo y cambios en su vida sexual atribuibles a estos farmacos.

  6. [Hypertrophic pachymeningitis secondary to IgG4-related disease: case report and review of the literature].

    PubMed

    Rodríguez-Castro, Emilio; Fernández-Lebrero, Aida; López-Dequidt, Iria A; Rodríguez-Osorio, Xiana; López-González, Francisco J; Suárez-Peñaranda, José M; Arias, Manuel

    2015-10-01

    Introduccion. La paquimeningitis hipertrofica es un trastorno infrecuente que produce un engrosamiento focal o difuso de la duramadre. Puede ser idiopatica o secundaria a procesos infecciosos, autoinmunes o neoplasicos. La recientemente descrita 'enfermedad relacionada con IgG4' podria ser la causa de bastantes cuadros considerados criptogenicos. Caso clinico. Mujer de 54 años, con historia de asma bronquial, que consulto por cefalea, vertigo y perdida de audicion por su oido izquierdo. En la resonancia magnetica cerebral con gadolinio se objetivo engrosamiento y realce dural, que se extendia desde la pared lateral del seno cavernoso izquierdo y la parte medial del lobulo temporal al angulo pontocerebeloso y parte del tentorio homolaterales. El liquido cefalorraquideo presentaba 10 leucocitos/µL (90% mononucleares), con 1 g/L de proteinas y sin consumo de glucosa. El estudio anatomopatologico mostro fibrosis y un infiltrado linfoplasmocitario, con 16 celulas plasmaticas IgG4+ por campo de gran aumento. El resto de estudios analiticos y microbiologicos resultaron normales o negativos. La tasa plasmatica de IgG4 estaba dentro de los limites normales. Tratada con esteroides, se produjo mejoria clinica acompañada de la practica desaparicion de las alteraciones detectadas en la neuroimagen. Conclusiones. La paquimeningitis hipertrofica como manifestacion de la enfermedad relacionada con IgG4 puede diagnosticarse basandose en los hallazgos de la resonancia magnetica si la IgG4 plasmatica esta elevada. En casos dudosos, habra que recurrir a la biopsia meningea. La corticoterapia suele ser eficaz y representa la primera linea terapeutica.

  7. [A very slow-growing exophytic hemisphere glioma: a case report].

    PubMed

    Velásquez, Carlos; Caballero, Hugo; Bucheli, Carlos; Berciano, José; Vázquez-Barquero, Alfonso; Martino, Juan

    2016-01-01

    Introduccion. Los gliomas de bajo grado presentan un patron de crecimiento caracteristico a traves de las fibras de la sustancia blanca. El crecimiento exofitico en gliomas de bajo grado hemisfericos no se ha descrito previamente. Se presenta un caso de glioma hemisferico de lenta progresion y con crecimiento exofitico. Caso clinico. Varon de 55 años, con crisis parciales motoras secundarias a un oligodendroglioma de grado II de la Organizacion Mundial de la Salud. El tumor infiltraba la circunvolucion frontal superior con extension exofitica que se extendia por encima de la circunvolucion precentral. Fue seguido con controles clinicorradiologicos durante 23 años. El analisis de la evolucion radiologica del tumor demostraba un crecimiento tumoral lento, con una velocidad de crecimiento de 0,5 mm al año. Durante la exeresis quirurgica se definio un plano subaracnoideo entre el componente exofitico y la circunvolucion precentral, que se encontraba desplazada inferiormente sin infiltracion tumoral. La estimulacion electrica intraoperatoria no evidencio funcion en el componente exofitico, pero si en la circunvolucion precentral. No se observaron deficits neurologicos postoperatorios. Conclusiones. La velocidad de crecimiento en gliomas de bajo grado se ha estimado en 4-6 mm al año. El tumor que se describe aqui tiene una velocidad de crecimiento de 0,5 mm al año, muy por debajo de esta media. La identificacion de la porcion exofitica es un paso importante en la planificacion preoperatoria. Este componente es mas facil de resecar debido al plano de clivaje subaracnoideo y a la ausencia de funcion.

  8. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study.

    PubMed

    García-Navia, Jusset Teresa; Tornero López, Javier; Egea-Guerrero, Juan José; Vilches Arenas, Angel; Vázquez Gutiérrez, Tiburcio

    2016-01-01

    Introducción y objetivos del estudio: existe evidencia de que la administracion perioperatoria de ketamina y lidocaina intravenosa reduce el dolor y el consumo de opioides postoperatorio, acorta la estancia hospitalaria y acelera la recuperacion de la funcion intestinal. Sin embargo, no se han estudiado los efectos beneficiosos en el periodo intraoperatorio. El objetivo de este estudio fue evaluar el efecto de una unica dosis de lidocaina y ketamina sobre el consumo intraoperatorio de opioides en pacientes sometidas a cirugia ginecologica electiva bajo anestesia general. Material y métodos: estudio prospectivo, aleatorizado, doble ciego, controlado con placebo en un solo centro. Se incluyeron 33 pacientes (11 en el grupo ketamina, 11 en el grupo lidocaina y 11 en el grupo placebo). Para la analgesia postoperatoria se utilizo una bomba PCA (Analgesia Controlada por el Paciente ) de morfina. Los pacientes fueron asignados al azar a uno de los tres grupos de estudio: 1,5 mg/kg de lidocaina al 2%, 0,5 mg/kg de ketamina al 5% o solucion salina 0.9%. La variable principal del estudio fue el consumo de opioides durante la cirugia. Las variables secundarias fueron: tiempo de educcion de la anestesia, intensidad del dolor, consumo de opioides en las 24 horas posteriores a la cirugia y efectos adversos. Resultados: se observo una disminucion del consumo intraoperatorio de opioides en los grupos ketamina (402,3 } 106,3) y lidocaina (397,7 } 107,5) frente al grupo placebo (561,4 } 97,1); p = 0,001. Se encontro una correlacion positiva entre el consumo intraoperatorio de opioides y el tiempo de despertar (r = 0,864, p.

  9. The ear region of earliest known elephant relatives: new light on the ancestral morphotype of proboscideans and afrotherians.

    PubMed

    Schmitt, Arnaud; Gheerbrant, Emmanuel

    2016-01-01

    One of the last major clades of placental mammals recognized was the Afrotheria, which comprises all main endemic African mammals. This group includes the ungulate-like paenungulates, and among them the elephant order Proboscidea. Among afrotherians, the petrosal anatomy remains especially poorly known in Proboscidea. We provide here the first comparative CT scan study of the ear region of the two earliest known proboscideans (and paenungulates), Eritherium and Phosphatherium, from the mid Palaeocene and early Eocene of Morocco. It is helpful to characterize the ancestral morphotype of Proboscidea to understand petrosal evolution within proboscideans and afrotherians. The petrosal structure of these two taxa shows several differences. Eritherium is more primitive than Phosphatherium and closer to the basal paenungulate Ocepeia in several traits (inflated tegmen tympani, very deep fossa subarcuata and ossified canal for ramus superior of stapedial artery). Phosphatherium, however, retains plesiomorphies such as a true crus commune secundaria. A cladistic analysis of petrosal traits of Eritherium and Phosphatherium among Proboscidea results in a single tree with a low level of homoplasy in which Eritherium, Phosphatherium and Numidotherium are basal. This contrasts with previous phylogenetic studies showing homoplasy in petrosal evolution among Tethytheria. It suggests that evolutionary modalities of petrosal characters differ with the taxonomic level among Afrotheria: noticeable convergences occurred among the paenungulate orders, whereas little homoplasy seems to have occurred at intra-ordinal level in orders such as Proboscidea. Most petrosal features of both Eritherium and Phosphatherium are primitive. The ancestral petrosal morphotype of Proboscidea was not specialized but was close to the generalized condition of paenungulates, afrotherians, and even eutherians. This is consistent with cranial and dental characters of Eritherium, suggesting that the ancestral

  10. A PHYSICAL EDUCATION-BASED STRETCHING PROGRAM PERFORMED ONCE A WEEK ALSO IMPROVES HAMSTRING EXTENSIBILITY IN SCHOOLCHILDREN: A CLUSTER-RANDOMIZED CONTROLLED TRIAL.

    PubMed

    Mayorga-Vega, Daniel; Merino-Marban, Rafael; Real, Javier; Viciana, Jesús

    2015-10-01

    Introducción: los profesores de educación física deben llevar a cabo programas de intervención para que los estudiantes alcancen niveles de flexibilidad saludables. Lamentablemente, no se conocen estudios que examinen el efecto de un programa de estiramiento llevado a cabo solo una vez por semana en escolares. Objetivos: el objetivo del presente estudio fue comparar los efectos de un programa de intervención de estiramiento a corto plazo realizado una y dos veces por semana sobre la extensibilidad isquiosural en escolares en el contexto de la educación física. Métodos: una muestra de 180 estudiantes de educación secundaria de 12-14 años fue asignado aleatoriamente (por grupos naturales) a los grupos control, experimental 1 y experimental 2. Durante las clases de educación física, los estudiantes experimentales realizaron un programa de estiramiento durante ocho semanas. El grupo experimental 1 y 2 realizaron el programa de estiramiento una y dos veces por semana, respectivamente. Resultados: los resultados del análisis de varianza mostraron que los estudiantes de ambos grupos experimentales obtuvieron una mejora estadísticamente significativa de la extensibilidad isquiosural, comparado con los estudiantes del grupo de control (p < 0,01). Sin embargo, no se encontraron diferencias estadísticamente significativas entre los dos grupos experimentales (p > 0,05). Conclusiones: un programa de estiramiento a corto plazo realizado una vez por semana mejora la extensibilidad isquiosural en escolares. Cuando el programa de estiramiento se lleva a cabo dos veces por semana, la mejora en la extensibilidad isquiosural de los estudiantes no es estadísticamente mayor.

  11. [Persistence in drug therapy of hypertension among different treatment groups and comparison between fixed-dose combinations of ara II + calcium channel blockers vs ace inhibitors + calcium channel blockers].

    PubMed

    Waisman, Gabriel Dario; Garfi, Leonardo Guillermo; Izbizky, Gustavo Hernan; Tortella, Juan Jose

    2012-01-01

    La hipertensión arterial (HTA) es una enfermedad crónica, y prevalente, que requiere un tratamiento sostenido en el tiempo donde existen medidas farmacológicas y no farmacológicas para su control. La “persistencia” es la continuidad de los tratamientos farmacológicos. Conocer cual es la persistencia de los diferentes grupos terapéuticos antihipertensivos podría ayudar a priorizar aquellos con mejores resultados. El objetivo es describir la persistencia al tratamiento antihipertensivo en una cohorte de pacientes utilizando diferentes métodos y comparar la persistencia en los diferentes grupos farmacológicos utilizados para el tratamiento de la HTA. Materiales y Métodos: Estudio observacional, de cohorte retrospectiva utilizando bases de datos secundarias obtenidas durante la dispensación de medicamentos y de los registros hospitalarios electrónicos del Hospital Italiano de Buenos Aires. Población adulta con diagnóstico de HTA y seguimiento por 2 años. Resultados: Los diuréticos, betabloqueantes de primera generación e inhibidores de la enzima convertidora de angiotensina son los grupos con la caída más importante en la persistencia. Los antagonistas de la angiotensina en monoterapia o junto con diurético y los betabloqueantes de segunda generación demostraron los mejores resultados de persistencia. La persistencia nunca llegó al 60% de los pacientes tratados a los 2 años. Conclusión: Pese a haber realizado la medición de la persistencia a través de distintos métodos los resultados fueron similares y demostraron una baja persistencia al tratamiento antihipertensivo. No encontramos variables extra farmacológicas que pudieran explicar la diferente persistencia en los diferentes grupos terapéuticos.

  12. [Control of epilepsy in adult patients with tuberous sclerosis].

    PubMed

    Gallardo-Tur, Alejandro; García-Martín, Guillermina; Chamorro-Muñoz, María Isabel; Romero-Godoy, Jorge; Romero-Acebal, Manuel

    2013-06-01

    Introduccion. La esclerosis tuberosa es una enfermedad genetica cuyas manifestaciones principales son la formacion de tumores neuroectodermicos, que asocia epilepsia secundaria muy frecuentemente. Objetivo. Describir el perfil epileptico, el control, la frecuencia de crisis y la efectividad del tratamiento en pacientes adultos con esclerosis tuberosa. Pacientes y metodos. Estudio descriptivo en el que se han incluido pacientes adultos (mayores de 14 anos) con diagnostico confirmado de esclerosis tuberosa. Se ha analizado la frecuencia y tipos de crisis. Se ha realizado un estudio y contabilizacion de los diferentes farmacos antiepilepticos en cada paciente, la frecuencia de uso de cada principio activo y un estudio comparativo entre control de crisis y tipo de terapia. Resultados. De 19 adultos estudiados, tuvieron crisis epilepticas 16 (84%). Presentaron control de crisis completo, crisis esporadicas y crisis frecuentes el 44%, 25% y 31%, respectivamente. Hubo frecuencia de crisis focales, generalizadas y ambas en el 38%, 6% y 25%, respectivamente. Estaban en tratamiento con farmacos antiepilepticos en monoterapia, biterapia y triterapia el 38%, 44% y 19%, respectivamente. El mas consumido globalmente fue el levetiracetam, seguido de la carbamacepina y el acido valproico. En monoterapia, el mas frecuente fue la carbamacepina, con mayor proporcion de control completo. Conclusiones. La epilepsia en la esclerosis tuberosa es relativamente benigna, y se consigue un aceptable control en la mayoria de casos con un numero de antiepilepticos acorde con lo aconsejado en las guias de tratamiento. Se observa estabilidad de lesiones, y no hay malignizacion en nuestra serie. El bajo numero de la muestra limita el estudio, pero se observan proporciones similares de efectividad del tratamiento respecto a otra serie publicada.

  13. [Registry of myocardial infarction in a tertiary hospital of the Instituto Mexicano del Seguro Social].

    PubMed

    González-Pliego, José Angel; Gudiño-Amezcua, Diego Armando; Celis, Alfredo; Gutiérrez-Díaz, Gonzalo Israel

    2014-01-01

    Introducción: dado que el pronóstico de infarto del miocardio con elevación del segmento ST (IMCEST) depende de su manejo inmediato y de las medidas de prevención secundaria, el no seguir las recomendaciones actuales impide mejorar las expectativas de la población afectada por este padecimiento. El objetivo es describir el perfil clínico-epidemiológico y el proceso de atención del IMCEST en un hospital de tercer nivel. Métodos: se analiza la información clínica, la estratificación de riesgo, la terapia de revascularización y los hábitos de prescripción al egreso de los casos con IMCEST atendidos en un año. Resultados: se incluyeron 246 pacientes con edad promedio de 61 años; el 76 % fueron varones. La mayoría (37.3 %) de IMCEST ocurrió entre los 60 y los 69 años. El sedentarismo fue el factor de riesgo predominante. El 81.7 % de los casos tuvo score TIMI de riesgo bajo. El 35 % tuvo isquemia/viabilidad y en todos los cateterizados se demostraron obstrucciones coronarias. El 76 % se revascularizó con stent, principalmente farmacológico (77.5 %). Al egreso más del 90 % de los casos recibió estatina y antiplaquetarios, mientras otras drogas se prescribieron al 64-82 % de los casos. Conclusiones: el IMCEST predomina en hombres sedentarios de la séptima década. Estratificar el riesgo, buscar isquemia/viabilidad residual y revascularizar con stent farmacológico son prácticas comunes; el cumplimiento de recomendaciones basadas en la evidencia es mejor que en el pasado, pero todavía no es óptimo.

  14. [Acute pancreatitis and afferent loop syndrome. Case report].

    PubMed

    Barajas-Fregoso, Elpidio Manuel; Romero-Hernández, Teodoro; Macías-Amezcua, Michel Dassaejv

    2013-01-01

    Antecedentes: el síndrome de asa aferente se caracteriza por la obstrucción mecánica del asa aferente luego de la reconstrucción tipo Billroth II o en Y de Roux, en la mayoría de los casos secundaria a gastrectomía distal o subtotal. Caso clínico: paciente masculino de 76 años de edad, con antecedentes de: colecistectomía, adenocarcinoma gástrico seis años previos, gastrectomía subtotal y reconstrucción en Y de Roux. Inició con dolor abdominal, náusea y vómito; abdomen distendido, sin datos de irritación peritoneal. Amilasa 1246 U/L, lipasa 3381 U/L. La tomografía computada abdominal mostró dilatación y engrosamiento de la pared del asa aferente y el páncreas con incremento de tamaño. Se le diagnosticó pancreatitis aguda, originada por síndrome de asa aferente. Conclusiones: el síndrome de asa aferente aparece en 0.3 a 1% de los casos de pacientes con reconstrucción Billroth II, a consecuencia de la obstrucción mecánica del asa aferente, con mortalidad incluso de 57%. La obstrucción del intestino aferente por acumulación de secreción biliar, pancreática e intestinal incrementa la presión, que resulta en dilatación del asa aferente de la vía biliar y del conducto de Wirsung, lo que desencadena una respuesta inflamatoria que finaliza en un cuadro de pancreatitis. Su manifestación severa se relaciona con el grado y duración de la obstrucción.

  15. The Índice Flesch-Szigriszt and Spanish Lexile Analyzer to evaluate Spanish patient education materials in otolaryngology.

    PubMed

    Nassif, Samih J; Wong, Kevin; Levi, Jessica R

    2017-10-09

    Evaluate the reading difficulty of Spanish patient education materials using the validated Índice Flesch-Szigriszt (INFLESZ) and Spanish Lexile Analyzer, and to identify relationships between English and Spanish readability formulas. Cross-sectional analysis. All otolaryngology-related patient education articles written in Spanish from the health libraries of the top 10 US News & World Report-ranked hospitals, top 10 Doximity-ranked otolaryngology residencies, the American Academy of Otolaryngology-Head and Neck Surgery website, and the US National Library of Medicine online section on ears, nose and throat were collected. Reading difficulty was assessed using the INFLESZ and Spanish Lexile Analyzer. Additional readability assessments included the traditional English tools: Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and the Simple Measure of Gobbledygook score. A total of 497 articles were reviewed. The average INFLESZ score for all articles was 57.75, which is considered normal and requires the reading ability of a student who finished Escuela Secundaria Obligatoria or 10th grade equivalent in the United States. The average Spanish Lexile measure for all articles was 1062L, equivalent to a reading level between the 6th and 12th grade. English readability tools calculated a more difficult reading level compared to Spanish tools when performed on the same text. Current Spanish patient education materials in otolaryngology may be too difficult for the average Spanish-speaking reader to understand. Future improvements may be warranted to improve the readability of educational materials and increase health literacy. NA Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. [Perception of health and safety risks among workers pathology laboratories].

    PubMed

    Alvarado-Cabrero, Isabel; Valencia-Cedillo, Raquel

    2015-01-01

    Introducción: Los trabajadores de la salud pueden padecer de numerosas enfermedades relacionadas con su ocupación. Las prácticas de seguridad (PS) en los laboratorios de anatomía patológica (LAP) son indispensables para prevenir las exposiciones innecesarias a los agentes químicos o biológicos en dicha área de trabajo. El objetivo fue evaluar el nivel de conocimientos de los patólogos con respecto a las PS. Se revisaron las regulaciones y recomendaciones actuales para las PS en los LAP y con esa información se elaboró un cuestionario que se envió por Internet a los participantes. Métodos: La evaluación fue realizada por 121 patólogos, de los cuales 87 (71 %) reportaron un entrenamiento inadecuado en PS. La mayoría de los encuestados (82 %) no tenían una idea clara del significado de las medidas o prácticas de seguridad en el LAP. Resultados: Un total de 63 (52 %) de los participantes consideraron que el riesgo de enfermedades secundarias a la exposición a sustancias químicas peligrosas y agentes biológicos era bajo. De los participantes (71 %) reportaron algún accidente con un agente punzocortante o cortante. De 86 encuestados (71 %) reportaron problemas musculoesqueléticos. Conclusión: En este estudio se manifestó que existe una necesidad de implementar programas de capacitación en prácticas de seguridad en los laboratorios de anatomía patológica del Instituto Mexicano del Seguro Social.

  17. [Migraine and evolutionary theory: paths for a clinical approach].

    PubMed

    Alvaro-Gonzalez, L C

    2016-10-01

    Introduccion. La migraña es un trastorno muy comun, con incidencia en aumento. La teoria evolutiva permite explicar su aparicion, dadas las ventajas que aportaba a grupos originarios de Homo sapiens una mayor reactividad a estimulos, y la presencia creciente de interaccion con factores ambientales. Analizamos estos aspectos a traves de los mecanismos potenciales que los explican. Desarrollo. El diseño de los organismos y sus respuestas ambientales surgen para mejorar la supervivencia. Asi, el dolor y la cefalea pueden entenderse como respuestas homeostaticas y adaptativas. Menos del 10% de la poblacion no tiene experiencia de cefalea, y el fenotipo migrañoso es una repuesta dolorosa comun en formas secundarias y sindromicas de cefalea. Estas caracteristicas se entienden segun rasgos neurofisiologicos especificos (falta de habituacion, sensibilizacion y baja preactivacion), caracteristicas geneticas (trastorno poligenico con multiples genes de baja penetrancia, que interaccionan con el ambiente y que son comunes a los de los trastornos comorbidos, como depresion-ansiedad) e interaccion ambiental en las sociedades modernas (aumento del numero de ciclos estrogenicos, y especialmente sobreexposicion al estres). Conclusiones. Lo que fue una ventaja evolutiva se ha transformado en la sociedad moderna en un trastorno muy prevalente y frecuentemente incapacitante. Es el resultado de una interaccion con sobrecarga de estimulos externos (estres) e internos (hormonales), lo que, de acuerdo con la teoria evolutiva, convertiria a la migraña en una enfermedad por desajuste. Los efectos ocurririan precozmente, en la infancia, a traves de mecanismos de epigenetica. Se obtendria un gran beneficio terapeutico mediante intervenciones poblacionales y educativas que incorporen estos aspectos.

  18. [Stroke in children. Experience in an emergency service].

    PubMed

    Huici-Sánchez, Malka; Escuredo-Argullós, Laura; Trenchs-Sáinz de la Maza, Victoria; Luaces-Cubells, Carles

    2014-08-01

    Objetivos. Describir las caracteristicas de la enfermedad cerebrovascular (ECV) en pacientes atendidos en un servicio de urgencias pediatrico y detectar diferencias clinicas segun sea isquemica o hemorragica. Pacientes y metodos. Estudio retrospectivo, analitico observacional, realizado en el servicio de urgencias pediatrico de un hospital de tercer nivel. Se incluyen pacientes entre 1 mes y 18 años de edad atendidos en el servicio durante 10 años (enero de 2001 a diciembre de 2011) con diagnostico final de ECV. Se excluyen las hemorragias por traumatismos o secundarias a tumores, las trombosis de senos venosos y los pacientes no atendidos en el servicio. Resultados. Se incluyen 61 pacientes, 39 (63,9%) de sexo masculino, con una mediana de edad de 4,6 años (rango: 1,3 meses-17,5 años). De ellos, 26 (42,6%) presentan ECV isquemica y 35 (57,4%) ECV hemorragica. La cefalea (n = 20; 57,1%; p = 0,008) y los vomitos (n = 25; 71,4%; p = 0,001) son mas frecuentes en la ECV hemorragica, y la hemiparesia (n = 17; 65,4%; p < 0,001) y la paralisis facial (n = 7; 26,9%; p = 0,001), en la ECV isquemica. Las principales causas de la ECV hemorragica son las malformaciones arteriovenosas (n = 17; 38,6%), y las de la ECV isquemica, las arteriopatias (n = 6; 42,3%). Al alta, 27 (44,3%) presentaban diferentes grados de discapacidad y 6 (9,8%) fallecieron. Conclusiones. La ECV es una entidad poco frecuente, aunque presenta una elevada morbimortalidad. Se observa un ligero predominio de la ECV hemorragica y se comprueba que la ECV hemorragica se presenta mas con signos de hipertension intracraneal, y la isquemica, con focalidad neurologica.

  19. [Neurological disorders and immunosuppression in kidney transplant patients. Preliminary study].

    PubMed

    Romero-Vázquez, Chasity; Rodríguez-Orozco, Alain R; Leal-Cantú, Raúl; Cortés-Rojo, Christian

    2016-01-01

    Antecedentes: Las alteraciones neurológicas en pacientes trasplantados de riñón pueden relacionarse con diversos factores, entre ellos la toxicidad secundaria al uso de medicamentos inmunosupresores. Objetivo: Conocer si existió asociación entre complicaciones neurológicas e inmunosupresión en una muestra de pacientes que recibieron trasplante renal. Métodos: Estudio transversal en el que participaron 121 pacientes con trasplante renal, de los cuales 22 (18 %) presentaron alteraciones neurológicas, Se usó χ2 para analizar la relación entre alteraciones neurológicas y comorbilidad como diabetes mellitus e hipertensión arterial y tiempo del uso de inmunosupresor. Se aceptó un nivel de significación p<0.05 para todas las determinaciones Resultados: De los sujetos estudiados, 13 eran hombres (59%) y nueve mujeres (41%). La edad media de los pacientes incluidos en el estudio fue 33 ± 12 años. El 59 % de las alteraciones neurológicas ocurrieron entre seis meses y cinco años de que los pacientes habían recibido el trasplante. Las alteraciones neurológicas encontradas fueron: temblor (7.4%), vértigo (4.1%), neuropatía periférica (3.3%), cefalea (2.4%) y disminución de la fuerza (0.8 %). Conclusión: No se encontró relación estadísticamente significativa entre las alteraciones neurológicas y el inmunosupresor usado ni entre éstas y el tiempo que duró la inmunosupresión.

  20. Comparative study of preparation of hazardous drugs with different closed-system drug transfer devices by means of simulation with fluorescein.

    PubMed

    González-Haba Peña, Eva; Manrique Rodríguez, Silvia; Herranz Alonso, Ana Mª; Pérez Castán, Patricia; Moreno Gálvez, Mónica; Iglesias Peinado, Irene; Sanjurjo Saez, María

    2016-11-01

    Objetivo: Comparar la contaminación generada durante la elaboración y administración de fármacos peligrosos con diferentes componentes de sistemas cerrados y de manera secundaria, seleccionar el sistema más eficiente. Material y métodos: Estudio comparativo de elaboración de mezclas de fluoresceína con diferentes combinaciones de sistemas cerrados de tipo valvular. Se consideró contaminación ambiental la detectada en los puntos críticos de conexión y las salpicaduras generadas en cualquier otro punto distinto. La variable principal fue la detección cualitativa mediante luz ultravioleta de contaminación por salpicaduras al comparar las modalidades con y sin conector. Se calculó un tamaño muestral de 160 preparaciones por modalidad, para detectar diferencias de al menos un 5%. Resultados: Se produjeron salpicaduras en 7 preparaciones, todas sin conector (p = 0,015). No se encontraron diferencias entre utilizar punzón de apoyo o de anclaje (p = 0,445), ni entre el sistema ChemoCLAVE® vs sistema valvular con sueros Fleboflex®. En todas las preparaciones se produjo contaminación en algún punto crítico. La utilización de punzones de apoyo, conectores y sueros luer se ha identificado como la modalidad más eficiente. Conclusiones: Es importante utilizar el conector de jeringa para que el sistema sea completamente cerrado. El uso de punzones de anclaje no parece presentar ventajas frente a los de apoyo y la combinación con los sueros Fleboflex® presenta una seguridad similar al sistema ChemoCLAVE®. Sin embargo, las conexiones de estos sistemas no son secas y, por tanto, es importante continuar con estudios de contaminación que comparen diferentes sistemas.

  1. Teorí­as de primer y segundo orden sobre el potencial de ciertas figuras de equilibrio de cuerpos celestes

    NASA Astrophysics Data System (ADS)

    Gumbau, Manuel Forner

    2010-11-01

    Uno de los problemas que aborda la Mecánica Celeste es la determinación de las figuras de equilibrio de los cuerpos celestes. Para investigar su solución mediante métodos directos, se precisa evaluar el potencial generado por su autogravitación, el generado por su fuerza centrí­fuga y el generado por la fuerza de atracción entre los cuerpos. Los métodos clásicos de Finlay y Kopal que afrontan estos problemas, para determinar el potencial autogravitatorio en las configuraciones de equilibrio, emplean desarrollos en serie de los potenciales interior y exterior del potencial autogravitatorio. Estos métodos incurren en el error de suponer la convergencia en capas donde resulta cuestionable dicha convergencia para estos desarrollos en serie. En este trabajo se han elaborado unos algoritmos que contemplan toda la casuí&stica y que permiten una manipulación efic iente del producto de polinomios de Legendre, del producto de funciones asociada s de Legendre y del producto de armónicos esféricos como combinacióon lineal de ellos mismos, respectivamente. Se han obtenido, para primer y segundo orden en las amplitudes, los desarrollos correctos para los potencial es interior y exterior del potencial autogravitatorio para configuraciones de equilibrio aisladas, y , en primer orden de amplitudes, los mismos potenciales para los sistemas binarios próximos. Se ha elaborado un método analítico, en primer orden respecto de las amplitudes, para la determinación del potencial de marea en sistemas binarios próximos en el cual se manifiesta la forma de la componente secundaria del sistema

  2. They teach it more successfully

    NASA Astrophysics Data System (ADS)

    Reyes Ruiz-Gallardo, Jose; Valdés, Arturo; Castaño, Santiago

    2010-05-01

    peers (Johnson et al, 1981, Cuseo, 1996, Shachar and Fischer, 2004). It is also related with the increasing of self-esteem (Lawrence, 1996), achieved in environments rich in challenges and low in threat (Abbot and Moylett, 1999). References: Abbot, L. and Moylet, H, 1999. Early education transformed. London: Falmer press. Pp: 214. Bernal, J. M., García-Estañ, R. y Guzman, D. (2005). Las actividades de enseñanza en la Educación Primaria. En: Didáctica de las Ciencias Experimentales I. Sánchez, G. (Coord.). Pp.: 211-322. CUSE (Committee on Undergraduate Science Education), (1997). Science Teaching Reconsidered. A handbook. Washington D. C.: National Academy Press. Cuseo, JB, 1996. Cooperative Learning: A Pedagogy for Addressing Contemporary Challanges & Critical Issues in Higher Education. Marymount college, New Forums Press. Johnson, D., Maruyama, G., Johnson, R., Nelson, C., & Skon, L. (1981) The effects of cooperative, competitive and individualistic goal structures on achievement. A meta-analysis. Psychological Bulletin, 89(1), 47-62. Lawrence, D, 1996. Enhacing Self Esteem in classroom. Paul Chapman Publishing Ltd, London. Pp 224. Lederman, N and Abd-El-Khalick, F (1998): Avoiding De-Natured Science: Activities that Promote Understandings of the Nature of Science In: W. F. McComas (Ed.). The Nature of Science in Science Education. Rationales and Strategies. (83-126). The Netherlands: Kluwer Academic. Pp. 388. McDermott, L. C. (1990). A perspective on teacher preparation in physics and other sciences: the need for special science courses for teachers. American Journal of Physics, 58(8):734-742. Pujol, R.M. (2003). Didáctica de las ciencias en la educación primaria. Madrid: Síntesis. Shachar, H and Fischer, S., 2004. Cooperative learning and the achievement of motivatioin and perceptions of students in 11th grade chemistry classes. Learning and Instruction, 14: 69-87.

  3. PubMed

    Plaza Moral, V; Carrillo, T; Delgado, J; Entrenas, L M; Martinez Moragón, E; Olaguibel, J M; Pérez de Llano, L; Perpiñá, M; Sastre, J; Valero, A; Quirce, S

    2016-11-21

      Fundamento. Numerosos estudios constatan que aproximadamente la mitad de la población asmática no está bien controlada. El objetivo de este trabajo fue analizar entre expertos las causas, consecuencias y las posibles soluciones del asma no controlada (ANC).  Material y métodos. Debate entre expertos en asma de las especialidades de Neumología, Alergología y Atención Primaria, estructurado en tres fases 1) Cuestionario para pulsar la opinión de los participantes en los diferentes elementos implicados del ANC; 2) Reunión presencial de los expertos, en la que se discutieron los resultados de la encuesta y se presentaron y debatieron ponencias sobre el diagnóstico, tratamiento y seguimiento del ANC; 3) Formulación de 83 ítems que fueron sometidos a consenso entre todos los participantes mediante el método Delphi.  Resultados. El 86,7% de los ítems del cuestionario Delphi fue consensuado, mayoritariamente en términos de acuerdo.  Conclusiones. El análisis de los resultados sobre el ANC señala la necesidad de mejora futura en: incorporar en las Guías de Práctica Clínica de asma un protocolo de actuación clínico para identificar agravantes y comorbilidades; desarrollar una herramienta barata y de fácil utilización que permita identificar la adherencia al tratamiento; establecer el fenotipo del paciente; analizar los efectos secundarios del tratamiento y ofrecer un tratamiento personalizado, valorando especialmente la eficacia y seguridad (control de síntomas y riesgo futuro). Se precisa generar nuevas evidencias (estudios) que determinen exploraciones complementarias a emplear en el seguimiento de estos pacientes.

  4. Influence of fear of movement on total knee arthroplasty outcome.

    PubMed

    Kocic, Mirjana; Stankovic, Anita; Lazovic, Milica; Dimitrijevic, Lidija; Stankovic, Ivona; Spalevic, Marija; Stojiljkovic, Predrag; Milenkovic, Marina; Stojanovic, Zorica; Nikolic, Dejan

    2015-01-01

    RiassuntoLo scopo dello studio è quello di verificare l’incidenza del timore postoperatorio ai movimenti nei pazienti sottoposti ad artroplastica totale del ginocchio (TKA) e di determinare l’associazione di questo timore con i provvedimenti da adottare. Lo studio prospettico riguarda 78 pazienti sottoposti ad TKA primaria per osteoartrite. L’incidenza di timore al movimento è stata detenninata con l’uso della Tampa Scale of Kinesiophobia (TSK). I pazienti sono stati valutati in tre fasi temporali: 2 settimane. 4 settimane e 6 mesi dopo l’intervento chirurgico. In tutte e tre le fasi sono stati valutati il dolore e l’entità della flessione, mentre l’aspetto funzionale è stato preso in considerazione soltanto sei mesi dopo l’intervento, secondo la Oxford knee score 1. Il timore al movimento è stato registrato in 17 pazienti (21,8%). Quelli con maggiore entità di timore hanno dimostrato di conseguire risultati significativamente meno buoni in termini di dolore, grado di flessione e funzionalità rispetto a quelli con limitata paura. Miglioramento del dolore e della flessione sono stati progressivamente conseguiti nel tempo in entrambi i gruppi, ma i risultati migliori vengono raggiunti nel gruppo con minore paura al movimento. Lo studio ha dimostrato che la paura postoperatoria alla motilità si associa significativamente con il dolore, l’entità della flessione e la funzionalità del ginocchio. Altri Autori haImo rilevato che il timore preoperatorio alla motilità del ginocchio fa prevedere limitazioni funzionali postoperatorie. In conclusione il timore della motilità si rileva in una significativa proporzione dei pazienti dopo TKA e si associa con gonalgia, e minore flessione e funzionalità, e dunaue questa paura rappresenta un richio di scarsi risultati dopo artroplastica totale del ginocchio.

  5. [Physical fitness level and its relationship with body weight status in school children].

    PubMed

    Gálvez Casas, Aranzazu; Rodríguez García, Pedro Luís; Rosa Guillamón, Andrés; García-Cantó, Eliseo; Pérez Soto, Juan José; Tárraga Marcos, M Loreto; Tárraga López, Pedro J

    2014-09-13

    Objetivo: Analizar y establecer posibles relaciones entre el estatus de peso corporal y el nivel de condición física relacionado con la salud en una muestra de escolares de Primaria. Material y Método: Estudio descriptivo-transversal. Un total de 216 escolares (125 mujeres de 8-11 años) participaron en la evaluación del peso, talla y condición física (Batería ALPHA-Fitness). El estatus de peso corporal (normo-peso, sobrepeso y obesidad) fue categorizado usando estándares internacionales. Resultados: Los varones presentan en promedio valores superiores en el test de carrera 4x10 metros, dinamometría manual, salto longitudinal y Course-Navette. Las mujeres presentan una mayor tendencia a exceder el peso saludable. El análisis de varianza mostró que un nivel alto de condición física se asocia de manera directa con un estatus de normopeso (p< ,01). Conclusiones: Los resultados del presente estudio sugieren que los escolares que poseen niveles superiores de condición física presentan una mayor tendencia a un estatus de peso corporal dentro de parámetros normales. Se precisan programas de fomento de la actividad física con el fin de mejorar la condición física y con ello el estatus corporal de los jóvenes. Incrementar las horas de Educación física escolar o llevar cabo programas educativos centrados en la nutrición pueden ser medidas eficientes para mejorar el estado de salud general.

  6. [Recommendations for management of acute pharyngitis in adults].

    PubMed

    Cots, Josep M; Alós, Juan-Ignacio; Bárcena, Mario; Boleda, Xavier; Cañada, José L; Gómez, Niceto; Mendoza, Ana; Vilaseca, Isabel; Llor, Carles

    2015-10-01

    Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. [Abdominal aneurism screening in Primary Care].

    PubMed

    Alvarez, J; Prada, A; Bermúdez, C; García, R; Ruiz, E; Urbano, J

    To obtain the percentage of abdominal aortic aneurism (AAA) determined in men between 65-74 years old in a health centre using ultrasound, and to describe the distribution of risk factors in the whole sample and in patients with aneurism, as well as determining how many AAA are confirmed at the hospital and those cases of uncertain diagnosis. A cross-sectional study conducted on patients included from September 2014 to February 2015. From a total of 212 randomised patients, a clinical interview and abdominal ultrasound were performed on 115 men, aged 65 to 74, telephone-recruited from a total of 171 that fulfilled inclusion criteria. An infra-renal AAA was found in 2.6% of the sample (95% CI 0.54-7.4). Just over half (51.3%) of the sample had arterial hypertension, and 76.1% were smokers or former smokers. The 3 AAA found, one of which had an initial doubtful diagnosis, were confirmed by the Hospital Universitario Fundación Jiménez Díaz. There were no losses. All of the patients with AAA were active smokers and had at least one other risk factor. The percentage of infra-renal AAA in the sample was lower than expected, but higher than the percentage found in other studies that did not consider smoking in the inclusion criteria. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Resistant arterial hypertension in Primary Care patients in Spain. PRESCAP Study 2010].

    PubMed

    Cinza-Sanjurjo, S; Alonso-Moreno, F J; Prieto-Díaz, M Á; Divisón-Garrote, J A; Rodríguez-Roca, G C; Llisterri-Caro, J L

    2015-04-01

    To determine the prevalence and clinical and epidemiological characteristics of Primary Care patients with resistant hypertension (RHT) in Spain. A cross-sectional multicenter study was conducted on hypertensive patients aged 18 or over and seen in a Primary Care clinic. RHT was considered as the presence of uncontrolled blood pressure in patients treated with at least 3 drugs, one of which is a diuretic. Of the 12,961 hypertensive patients in the PRESCAP 2010 study, 962 (7.4%) fulfilled criteria for RHT, of whom 51% were women, and with a mean age (SD) 68.8 [11.4] years. Patients with RHT were older (68.80 [10.69] years vs. 66.06 [11.44] years, P<.001), had a higher prevalence of obesity (55.2 vs. 38.6%, P<.001), a higher waist circumference (103.90 [13.89] vs. 99.32 [13.69] cm, P<.001), and a higher prevalence of DM (48.3 vs. 29.5%, P<.001). The prevalence of target organ damage (73.0 vs. 61.4%, P<.001) and cardiovascular disease (46.7 vs. 26.8%, P<.001) were higher in patients with resistant hypertension. The multivariate analysis showed that the variables associated with resistant hypertension were the presence of cardiovascular disease, diabetes mellitus, sedentary life style, microalbuminuria, body mass index, duration of AHT, and triglycerides. The prevalence of RHT in Primary Care patients is related to inappropriate lifestyles, the presence of target organ damage, and cardiovascular disease. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  9. [End stage renal disease lymphopenia; characterization and clinical correlation].

    PubMed

    Lepe-Zúñiga, José Luis; Morales-Molina, Pedro; García-Nandayapa, Gabriela Alejandra

    2016-01-01

    Introducción: los pacientes con insuficiencia renal crónica en etapa terminal (ERET), presentan alteraciones inmunológicas diversas que los hacen más susceptibles a infecciones. Entre las alteraciones reportadas se encuentra la linfopenia. Se han realizado pocos estudios en nuestro medio que muestren la frecuencia y características de esta alteración así como su trascendencia clínica, relacionada con las infecciones que afectan a estos pacientes. Métodos: se analizó una serie de variables, incluyendo los valores de linfocitos y la presencia de infecciones, en un grupo de 190 pacientes con ERET de febrero 2008 a noviembre 2012. Se correlacionan y comparan los valores obtenidos entre ellos en dos momentos de su evolución: antes y durante su tratamiento dialítico. Resultados: en los pacientes con ERET, se obtuvo un perfil hematológico característico, caracterizado por anemia crónica severa, leucocitos totales normales o por arriba de lo normal y linfocitos normales o por debajo de lo normal (linfopenia). El grado de alteración hematológica correlacionó con el grado de afección renal y se corrigió en la medida que se corrigieron las alteraciones bioquímicas relacionadas con la ERET mediante diálisis peritoneal. Conclusiones: la linfopenia se encontró en cerca de la mitad de los pacientes con ERET y se asoció con el incremento de infecciones; el tipo de infecciones fue similar a lo observado en pacientes sin linfopenia y diferente al observado en pacientes con inmunodeficiencias primarias o adquiridas que afectan a los linfocitos.

  10. [Early detection and stability of diagnosis in autism spectrum disorders].

    PubMed

    Canal-Bedia, R; Magan-Maganto, M; Bejarano-Martin, A; De Pablos-De la Morena, A; Bueno-Carrera, G; Manso-De Dios, S; Martin-Cilleros, M V

    2016-01-01

    Introduccion. La intervencion temprana en los niños con un trastorno del espectro autista (TEA) depende de una deteccion precoz y fiable. Aunque de manera general se habla de un diagnostico estable, se ha evidenciado la necesidad de profundizar mas en los factores que influyen en dicha estabilidad. Pacientes y metodos. Los participantes de la muestra fueron 142 menores con TEA (118 varones y 24 mujeres), con una mediana de 33 meses y un recorrido intercuartilico de 12 en la primera evaluacion, y con una mediana de 47 meses y un recorrido intercuartilico de 29 en el seguimiento. Los diagnosticos se realizaron con las siguientes pruebas: escala Merrill-Palmer revisada, escala de Leiter revisada, escala de inteligencia de Wechsler para preescolar y primaria III y escala de inteligencia de Wechsler para niños revisada y IV; ademas de la escala Vineland y la escala de observacion diagnostica del autismo generica (ADOS-G), basandose el diagnostico clinico en los criterios diagnosticos del Manual diagnostico y estadistico de los trastornos mentales, cuarta edicion, texto revisado (DSM-IV-TR), y quinta edicion (DSM-5). Para la evaluacion de la estabilidad diagnostica, se realizaron tablas de contingencia para las valoraciones del diagnostico en funcion del juicio clinico y los resultados de la ADOS-G. Resultados. El diagnostico clinico basado en los criterios del DSM-IV-TR, el DSM-5 y el juicio clinico se mantiene estable a traves del tiempo en un 96% de los casos. Si se valora la estabilidad diagnostica teniendo en cuenta los resultados del ADOS-G (n = 30), el 87% de los casos mantiene el diagnostico. El ANOVA muestra diferencias estadisticamente significativas para las medidas del factor intrasujeto del cociente intelectual y la edad social global, pero no para el diagnostico. Conclusiones. La estabilidad diagnostica se beneficia de un uso informado del criterio clinico y de la participacion de un equipo multidisciplinar.

  11. [Increasing incidence of community-acquired pneumonia caused by atypical microorganisms].

    PubMed

    Tazón-Varela, M A; Alonso-Valle, H; Muñoz-Cacho, P; Gallo-Terán, J; Piris-García, X; Pérez-Mier, L A

    2017-09-01

    Knowing the most common microorganisms in our environment can help us to make proper empirical treatment decisions. The aim is to identify those microorganisms causing community-acquired pneumonia. An observational, descriptive and prospective study was conducted, including patients over 14 years with a clinical and radiographic diagnosis of community-acquired pneumonia during a 383 consecutive day period. A record was made of sociodemographic variables, personal history, prognostic severity scales, progress, and pathogenic agents. The aetiological diagnosis was made using blood cultures, detection of Streptococcus pneumoniae and Legionella pneumophila urinary antigens, sputum culture, influenza virus and Streptococcus pyogenes detection. Categorical variables are presented as absolute values and percentages, and continuous variables as their means and standard deviations. Of the 287 patients included in the study (42% women, mean age 66±22 years), 10.45% died and 70% required hospital admission. An aetiological diagnosis was achieved in 43 patients (14.98%), with 16 microorganisms found in 59 positive samples. The most frequently isolated pathogen was Streptococcus pneumonia (24/59, 41%), followed by gram-negative enteric bacilli, Klebsiella pneumonia, Escherichia coli, Serratia marcescens and Enterobacter cloacae isolated in 20% of the samples (12/59), influenza virus (5/59, 9%), methicillin-resistant Staphylococcus aureus (3/59, 5%), Pseudomonas aeruginosa (2/59, 3%), Moraxella catarrhalis (2/59, 3%), Legionella pneumophila (2/59, 3%), and Haemophilus influenza (2/59, 3%). Polymicrobial infections accounted for 14% (8/59). A high percentage of atypical microorganisms causing community-acquired pneumonia were found. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. [Prescription appropriateness: Indication of citicoline in Primary Care].

    PubMed

    Padilla Luz, A; Reyes Rodríguez, J F; Gómez Rodríguez de Acuña, A; González Gómez, C M; Álvarez Dorta, I; Pérez Cánovas, M E

    2015-01-01

    The economic situation has made it necessary to optimize resources by adjusting the pharmaceutical expenditure. Citicoline was (2011) the 10th drug by rank of billed amount. Its approved indications are stroke (acute and sub-acute) and head injury, but not cognitive decline associated with age, the presumed indication for most of its use. To assess the conditions of use of citicoline in the Health Area of Tenerife, in order to detect deviations from the indications of use as stipulated in the prescribing information sheet and the pattern of prescription, with emphasis on the analysis of its use in dementia where currently it has no indication or evidence to support it. Cross-sectional study of prescription-indication. A 680 patient sample, segmented by reference hospital (error±5%; CI: 0.95%; P=0.5) was taken from the 4036 patients with a prescription of citicoline billed during august-october 2011 (obtained from the prescription database program, Farmacanarias). We found that 123 patients (18.1%) had an appropriate indication. By including the prescription regimen, 28 patients (4.1%) had adequate indication and dose levels, and in only 2 patients (0.2%) an appropriate indication, dosage and duration were found. "The correct prescription-indication" of citicoline is inappropiate in almost all patients studied. Impact actions are needed in order to optimize prescription, improve patient safety by reducing potential interactions, and the occurrence of adverse effects, and improve efficiency by promoting savings. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  13. [Primary care in Ireland].

    PubMed

    Sánchez-Sagrado, T

    2017-03-27

    Spanish doctors are still leaving the country to look for quality work. Ireland is not a country with many Spanish professionals but it is interesting to know its particular Health care system. Ireland is one of the countries with a national health care system, although it has a mixture of private health care insurance schemes. People have a right to health care if they have been living in Ireland at least for a year. Access to the primary care health system depends on age and income: free of charge for Category 1 and co-payments for the rest. This division generates great inequalities among the population. Primary Care doctors are self-employed, and they work independently. However, since 2001 they have tended to work in multidisciplinary teams in order to strengthen the Primary Care practice. Salary is gained from a combination of public and private incomes which are not differentiated. The role of the General Practitioner consists in the treatment of acute and chronic diseases, minor surgery, child care, etc. There is no coordination between Primary and Secondary care. Access to specialised medicine is regulated by the price of consultation. Primary Care doctors are not gatekeepers. To be able to work here, doctors must have three years of training after medical school. After that, Continuing Medical Education is compulsory, and the college of general practitioners monitors it annually. The Irish health care system does not fit into the European model. Lack of a clear separation between public and private health care generates great inequalities. The non-existence of coordination between primary and specialised care leads to inefficiencies, which Ireland cannot allow itself after a decade of economic crisis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Prevalence of non-traumatic musculoskeletal pathology as main complaint and its impact in a emergency department].

    PubMed

    Guillén Astete, C; Kaumi, L; Tejada Sorados, R M; Medina Quiñones, C; Borja Serrati, J F

    2016-04-01

    Non-traumatic musculoskeletal pathology (NTMP) generates a high healthcare demand in primary care, however, European studies designed to assess its real impact in Emergency Departments are scarce. The present study aims to determine the prevalence of NTMP and its impact in Emergency Department of a university hospital in Madrid. Two thousand randomized medical registries were reviewed from 2008 to 2011. The epidemiological data collected were, main complaints, time consumed, image test requests, and need of further assessment within a month. Prevalence of NTMP was 13.8% (95% CI; 12.1%-15.4%) of all patients. The most frequent musculoskeletal complaint was lumbar pain. An imaging test was requested in 79.1% of all the NTMP cases assessed. Patients with NTMP consumed an average of 79 minutes, with 17% of them requesting a new urgent assessment within the first month. The results of this study show that NTMP is the leading cause for emergency department visits in our area, producing the highest consumption of time and the highest frequency of new queries for the same reason within a month. The overuse of the emergency services and the lack of medical training in the management of this type of pathology can cause this phenomenon. During the design of strategies to optimize patients care in emergency departments, the importance of this type of pathology should be taken into account. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Centralization of health services in primary care in summer: Patients and professionals view during two consecutive years].

    PubMed

    Giménez, N; Martínez, J M; Clanchet, T

    2015-01-01

    The Spanish primary health care, gateway and pillar of the Health Care System has his resources increasingly constrained by current crisis. To know the opinion of users and professionals on two primary care centers which centralized in August 2011 and 2012 the attendance of seven primary care centers. Two questionnaires were designed: a telephone survey of a random sample of users and a self-completed questionnaire for health care professionals. The variables were scored on a scale of 1-10 (low to high). Cronbach's coefficient α>0,84. 1293 people responded (836 users and 357 professionals). Users rated, in 2011, the satisfaction with 6.7 points in August and 7.3 points the rest of the year (P<.001). And, in 2012, with 7.7 points in August and 8.1 points the rest of the year (P<.001). Health care professionals, rated their satisfaction with 6.8 points in 2011 and 7.3 points in 2012. The waiting time was the only variable best scores in August that the rest of the year. The perception of the solution given in consultation did not change. Satisfaction, marking, care and treatment were highest rated in the regular center than in the reference center (P<.001). The centralization of primary health care during periods of reduced demand could reduce costs while maintaining quality. The experience of centralizing primary care services during August was perceived as acceptable and improved over time. Users showed a slight, but significant, preference for their usual primary care center. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Characteristics of smoking, nicotine dependence and motivation for change in specialists training in health sciences (residents) in Andalusia (Spain)].

    PubMed

    Juárez-Jiménez, M V; Valverde-Bolívar, F J; Pérez-Milena, A; Moreno-Corredor, A

    2015-09-01

    As there are few studies on the smoking habits of specialists training in health sciences (residents), it is of interest to determine the prevalence of smoking, nicotine dependence and motivation for change, and their relationship with other variables (personal, work and consumption of other drugs). A multicentre, cross-sectional study using a questionnaire was conducted in 2012. All the residents who were studying in Teaching Health Centres in Andalusia (Spain) completed a questionnaire, which was sent by e-mail, collecting: age, sex, specialty, country of origin, qualitative-quantitative consumption of tobacco, age of onset/cessation, Fagerström test and stage of change (Proschaka). A total of 2667 residents (63% of total) completed the questionnaire. The mean age was 29.1 years (± 5.2), 69% female, 89% Spanish, and 86% physicians. Of the 17% who smoked (daily pattern-47%, intermittently-41%, related to leisure-3%), starting at 17.4 years (±3.5) and mean of 7.5 cigarettes per day (±7.1), higher medical specialties (P=.067 ANOVA), and in men (P=.074, Student-t). More than three-quarters (82%) had a low nicotine dependence, being higher in hospital medical specialties (P=.078 χ(2)). Of the total, 7% were former smokers, and 48% wanted to quit smoking (contemplation 38%, preparation 10%). In the multivariate analysis there was a link between smoking and alcohol consumption (OR 2.84) and illegal drugs (OR 3.57). There were no differences by age or country. The consumption of tobacco in residents is less than the general population, with a low dependence and better willingness to change. The period of specialised training is a good time to offer tobacco interventions. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Oral magnesium supplementation: an adjuvant alternative to facing the worldwide challenge of type 2 diabetes?].

    PubMed

    Guerrero-Romero, Fernando; Rodríguez-Morán, Martha

    2014-01-01

    Antecedentes: ante la repercusión de la diabetes tipo 2 en la calidad de vida y los altos costos de su tratamiento, es urgente la búsqueda de alternativas para el control metabólico y la prevención primaria de esta enfermedad. Objetivo: revisar la evidencia derivada de estudios de cohortes acerca de la relación entre las concentraciones séricas y la ingesta de magnesio con el riesgo de diabetes tipo 2, y de ensayos clínicos de la eficacia de las sales orales de magnesio en la reducción de la glucemia. Material y métodos: estudio retrospectivo, efectuado con base en la búsqueda de estudios de cohorte mayores de 10 años en MEDLINE, EMBASE, y Cochrane Controlled Trials Register, actualizada al 30 de septiembre del 2013. Resultados: se encontraron siete estudios de cohorte (24,388 personas/ año) que muestran que la ingesta de magnesio disminuye el riesgo de diabetes tipo 2; dos estudios (13,076 personas/año) indican que la baja ingesta de magnesio en la dieta no parece asociarse con el riesgo de diabetes; 1 estudio (8,735 personas/año) demuestra que la hipomagnesemia se asocia con alteraciones del metabolismo de la glucosa. De 11 ensayos clínicos con asignación al azar, 5 estudios en sujetos de riesgo muestran que las sales orales de magnesio reducen la glucemia, y 6 estudios en pacientes con diabetes tipo 2 muestran resultados inconsistentes. Conclusiones: la ingesta de magnesio en la dieta habitual o de sales orales de magnesio es recomendable en la prevención de diabetes. La eficacia de las sales de magnesio en la reducción de la glucemia de pacientes con diabetes tipo 2, es inconsistente.

  18. [Social-health characteristics of subjects who make a living will].

    PubMed

    del Pozo, Katia; López-Torres, Jesús; Simarro, M José; Navarro, Beatriz; Rabanales, Joseba; Gil, Vicente

    2014-04-01

    The Living Will (LW) is well publicised, and still largely unknown to the general public and health professionals. To describe the characteristics of the subjects that formalize a LW related to socio-demographic situation, health status, degree of dependence, healthcare characteristics and psychosocial aspects. Descriptive observational study conducted in the Health Area of Albacete including 123 people who formalized the LW in a Will Register in 2011. Study variables included: self-perceived health, functional status, morbidity, socio-demographic characteristics, use of health services, attitudes towards the LW, and psychosocial aspects. Those that made an LW, were mainly women (64.2%), had a mean age of 53.3 years (SD: 14.5), higher levels of education (61% with at least secondary education), and a lifestyle other than living with a partner, and with children (67.5%). The majority were self-sufficient for their daily living activities (98.4% to 94.3% for basic and instrumental), and suffered from chronic disease (73.2%). Despite lasting relationships with their physicians (9.4 years; SD: 7.9), there was very little talk about the end of life (18.3%). More than a half had a family member who had previously signed a document (54.5%). More than two-thirds (68.5%) considered this document useful in the death of a relative, and also a 56.7% had also served as a caregiver of a terminal patient. Middle-aged people, predominantly women, formalized an LW most often. They are usually chronic, but self-sufficient for their daily living activities, and are convinced that they can influence their health situation. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  19. Teamwork: relevance and interdependence of interprofessional education.

    PubMed

    Tamayo, M; Besoaín-Saldaña, A; Aguirre, M; Leiva, J

    2017-04-27

    Determine the perception of university students regarding interprofessional and interdependent work between team members in their inclusion in primary care. Analytical cross-sectional study. The sampling had a probabilistic, stratified random type with 95% confidence and 5% margin of error. Seven-hundred and four students of Public Universities in Santiago (Chile) answered self-administered questionnaire. Ninety-seven point eight of students say that interprofessional work is important; 27.1% of them declare that their university did not seem to show that their study plans were important. The professionals listed as most important in teams are physicians and nurses. Spaces for development and institutional support are key elements to promote interprofessional work. If this competence can involve each academic unit in their different formative spaces there will be a significant contribution to said promotion. Teamwork is a pending task. Determinar la percepción de estudiantes universitarios respecto al trabajo interprofesional e interdependencia entre los miembros del equipo en su inserción en la atención primaria. Estudio de tipo analítico y transversal. El muestreo fue de tipo aleatorio, probabilístico estratificado con un 95% de confianza y un 5% de margen de error. Se utilizó un cuestionario auto-administrado en 704 estudiantes de Universidades del Estado en Santiago de Chile. Un 97,8% de los estudiantes opinan que el trabajo interprofesional es importante; un 27,1% de ellos declara que su universidad no le ha entregado importancia en sus planes de estudios. Los profesionales mencionados como más importantes en el equipo son los médicos y enfermeras. Espacios de desarrollo y respaldo institucional son elementos claves para promover el trabajo interprofesional. Que esta competencia logre involucrar a cada unidad académica en sus diferentes espacios formativos será un aporte significativo en aquello. Trabajo en equipo es una tarea pendiente.

  20. [Health status, quality of life, and use of healthcare resources by patients with diabetes mellitus in Spain].

    PubMed

    García-Soidán, F J; Villoro, R; Merino, M; Hidalgo-Vega, Á; Hernando-Martín, T; González-Martín-Moro, B

    2017-09-01

    This study analyses the health status of patients diagnosed with diabetes mellitus (DM), their health related quality of life (HRQoL) and their use of healthcare resources in Spain. A descriptive analysis was conducted using the Spanish Health National Survey (ENSE, 2012), gathering data on those patients aged 15 and over diagnosed with DM. Their health status, their HRQoL, and their use of healthcare resources were systematically compared with those of patients diagnosed with other chronic conditions (OCC), as well as a population without DM (non-DM). Out of 21,007 subjects that took part, 7.4% were diagnosed with DM and 59% with OCC conditions (mean age 65.6±14.2 years with DM, 51.3±18.1 years with OCC, and 45.7±18.2 years with non-DM). When compared to non-DM and OCC, DM was statistically significantly associated with higher frequencies of hypertension, hypercholesterolaemia, obesity, myocardial infraction, hospital admissions in the last year, and drug consumption, but with a lower number of visits to secondary healthcare. The mean quality adjusted life years (QALY) of patients with DM was 0.75 per year, significantly lower (P<.05) to that of individuals with OCC (0.89), and those without DM (0.92). The difference vs. non-DM remained statistically significant after adjusting for age, gender, and number of comorbidities (P<.001). In Spain, DM is associated with a high comorbidity, involves a greater loss in HRQoL than those diagnosed with other chronic conditions as a whole, and generates a significant burden on the healthcare system. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Quality of life of patients with asthma on beclomethasone/formoterol. Cost-utility analysis].

    PubMed

    García-Ruiz, A J; Quintano Jiménez, J A; García-Agua Soler, N; Ginel Mendoza, L; Hidalgo Requena, A; Del Moral, F

    2016-01-01

    To perform a cost-utility analysis on asthmatic patients on beclomethasone/formoterol fixed combination in Primary Health Care. Material and methods Non-probability sampling was used to select a group of asthmatic patients with moderate/severe persistent severity (GEMA 2009), treated with beclomethasone/formoterol fixed combination, over 18 years, had given their informed consent. The study observation period was 6 months. The variables studied were: age, sex, duration of disease, health resources used, analysis of health related quality of life by EQ-5D and SF-36, and the specific Asthma Quality of Life Questionnaire. For the qualitative variables, the frequency and percentages were calculated, and for the quantitative variables, the mean, SD and 95% CI. Chi-square, Student t-test and ANOVA were used for statistical inference. Comparisons were made with a statistical significance of 0.05. Of the 64 patients that completed the study, 59.4% were female. The mean age was 49 years, and mean disease duration was 93 months. For asthma control, 53% of patients had a prescription pattern of one/12h. All health related quality of life scales were modified with respect to the baseline and the differences were statistically significant. Our patients had a better health related quality of life than Spanish asthma cohort. The incremental cost utility beclomethasone/formoterol versus usual treatment option was € 6,256/QALY. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  2. [Satisfaction of principal caregivers of patients followed-up by palliative care teams].

    PubMed

    Fernández-Isla, L E; Conde-Valvis-Fraga, S; Fernández-Ruíz, J S

    2016-10-01

    To determine the satisfaction of main caregivers of deceased patients followed-up by palliative care teams. Web research on electronic data bases: PubMed and MEDES, using "Palliative Care" and "Patient Satisfaction" as main descriptors, and "Family", "Professional-Family Relations", "Quality of Health Care" and "Quality Assurance, Health Care" as secondary descriptors. Studies written in Spanish and English were included. Profile of principal caregiver: a woman between her mid-forties and her mid-fifties, usually related with the patient as a daughter, and of primary educational level. The items that the main caregivers valued the most were: a kind manner, feeling free to ask questions about problems during the process, tactful explanations, receiving information, pain management, time for answering questions, interest for emotional problems, and information about treatment. The worse valued items were: symptoms control, lack of psychological support after death, preparation for a death of a relative, keeping in touch after death, help to resolve outstanding issues, and help during grief. In general, a great majority of palliative care teams achieved excellent results. In spite of the good results obtained in satisfaction surveys from caregivers with regard to palliative care teams, it is essential to improve the quality of scientific-technical training (both from the medical and the psychological point of view), as well as to improve communicational skills among palliative care staff. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. [Perceived quality of life in the "healthy people" municipal community health promotion program in Ciudad Lineal-Madrid].

    PubMed

    Esteban-Peña, M; Gerechter-Fernández, S; Martínez-Simancas, A M; Zancada-González, J; Hernandez-Barrera, V; Jiménez-García, R

    The measurement of the health-related quality of life (HRQoL) is a comprehensive way to estimate the health of both the individual and the community. The aim of this study was to assess changes in health and HRQoL using the intervention strategies «healthy people» and «health promotion programs» of the City Council of Madrid-Madrid Health. The study was conducted in the Municipal Health Centre of Ciudad Lineal, in 2014, and included promotion of exercise, healthy eating, smoking cessation, psycho-hygiene, memory training, and health education for the elderly, with group interventions. A before and after community trial, with the administration of questionnaire with COOP/WONCA HRQoL charts to 200 participants. The study population (n=87), included those who completed the first and second questionnaire. Positive changes were seen in the overall before and after COOP/WONCA scores, with a mean change from 23.16 to 21.94, with statistical significance, p≤0.002. In the psychology groups, it changed from 28.14 to 23.57 with a p≤0.05, and healthy eating from 22.81 to 20.85, with p≤0.03. In the health education groups it changed from 21 to 20.81 points, and in memory training from 23.31 to 22.45 points (both without significance). The significant improvement in scores reflects a positive change in self-perceived health of this community after the intervention and proper operation of programs. The areas directly related to health and interventions in psychology and nutrition-exercise, are those with the most significant changes. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Randomised clinical trial to evaluate the efficacy and safety of a new pediculicide made with saponified olive oil in the eradication of Pediculus humanus capitis].

    PubMed

    Soler, B; Castellares, C; Viver, S; Díaz, L; Gómez, R; Ruíz, E

    2017-03-01

    The aim of the study was to evaluate the efficacy and safety of a new pediculicide in the eradication of Pediculus humanus capitis infestation. A randomised clinical trial was designed, in which children aged between 5 and 15 years diagnosed with pediculosis were selected. Treatment was administered on days 1 and 7 after selection, and they were evaluated in 4 visits (day 2, 7, 9, and 14). The product under evaluation with saponified olive oil was Inex Pediculicide Soap(®), which was compared with Paranix(®), with a similar mechanism of action. The primary efficacy endpoint was the eradication of the parasite by day 14 (louse-free rate), using an intention to treat analysis. Six paediatricians from 5 Primary Health Care centres in the Community of Madrid (Spain) and one private clinic participated in the study. A total of 45 children were included, of which 75.6% were girls (n=34). The mean age was 7.1 years (95% CI 6.3-7.9). The large majority (80%) were middle class, and 82.2% had a history of previous pediculosis. The efficacy at 14 days was 76.2% (95% CI 52.8-91.8) in the group treated with Inex Pediculicide Soap(®) group, and 79.2% (95% CI 57.9-92.9) in Paranix(®) group (NNT=33.3). No adverse effects were observed with treatment. The 2 products were effective and safe in the eradication therapy Pediculus humanus capitis, with no statistical differences. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. [Management of a first depressive episode in the primary care setting. Use of antidepressants and referrals].

    PubMed

    López-Lanza, J R; Villa Puente, M; Lopez Videras, R; Arribas, I; Pandiella, M J; Sineiro, E

    2016-03-01

    The majority of patients who have a first depressive episode are treated by Primary Care physicians. The aim of this study was to evaluate the use of antidepressants and referrals to mental health and the treatment modifications made by psychiatrists. A descriptive, retrospective study was conducted on patients from 64 Primary Care clinics, distributed in five Spanish provinces. The clinical history data, regarding use of antidepressants, criteria for referral, and response of psychiatric services were evaluated from June 2008 to June 2011. The study included 324 patients. The most commonly prescribed medication was escitalopram, with selective serotonin reuptake inhibitors (SSRI) making up 73.5% of the total. More than two-thirds (69.7%) of the patients were on treatment for at least 6 months, with no reason recorded for the 40.4% drop-outs. A large majority of professionals (76.9%) wait at least 3 weeks before modifying the medication, especially changing antidepressant. The Primary Care physicians referred 39.2% of patients to psychiatry, although much of these referrals (43.9%) had no justification. There was a lower referral rate to psychology (23.1%). An antidepressant was given to a large number of patients on multiple medications, without taking into account the risk of interactions in a high percentage. The Primary Care physician appropriately uses the antidepressants of the first choice, but does not pay attention to the risks in complex patients. There must be an appropriate duration of treatment and an improvement of the criteria for referral to mental health services. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Depression in the elderly: prevalence and associated factors].

    PubMed

    Sarró-Maluquer, M; Ferrer-Feliu, A; Rando-Matos, Y; Formiga, F; Rojas-Farreras, S

    2013-10-01

    To determine the prevalence of depression, and to study the factors associated with it among community-dwelling 85-year-olds. A cross-sectional study was conducted within the framework of a randomized clinical trial in elderly people, all born in 1924, from seven urban and rural primary health care centers. Sociodemographic data and geriatric assessment were performed. Functional status was measured with Barthel index and Lawton index, cognitive impairment with Mini-mental Status Examination, social risk with Gijon test, and comorbidity by Charlson index. The presence of exhaustion and physical activity were recorded along with the chronic prescription of psycothropic drugs, and the presence of depression in clinical registers. Depression was evaluated using the Yesavage Geriatric Depression Scale (GDS) of 5 items (depression ≥ 2). The statistical program used was the R project: (version 2.12.2) Foundation for Statistical Computing, Vienna. The sample was consisted of 220 subjects, 129 women (58.6%), 76 (34.5% were depressed using the GDS, 46 (20.9%) subjects had depression in the clinical records, and 60 (35.5%) patients were taking antidepressant drugs, 66 (36,8%) benzodiazepine, and 10 (4%) antipsychotic drugs. Depression was associated with poorer functional status according to basic and instrumental activities of daily living, cognitive impairment, exhaustion, low physical activity, and psychotropic drugs. Finally, the factors significantly associated with depression were low physical activity and increased exhaustion. The present study found a high prevalence of depression in subjects older than 85 years. Physical activity and having a good self-perception of energy are associated to a lower prevalence of depression. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  7. [Are domiciliary care patients receiving adequate thromboprophylaxis?].

    PubMed

    Cátedra, B; Muñoz, F; Cabello, L

    2014-01-01

    The study aims to determine the percentage of patients treated at home with an indication of prophylaxis of thromboembolic disease (TED) according to the PRETEMED guidelines and whether they receive such prophylaxis. A cross-sectional descriptive study was conducted in Segovia Palace Health Centre (Madrid). to be included in the domiciliary care protocol. terminal patient, hospitalised or surgery in the last 3 months. The variables used include, age, sex, duration of domiciliary care, mobility, anticoagulant or antiplatelet treatment and reason, and associated and precipitating factors to calculate the risk of TED according to the PRETEMED guidelines, and if they receive such prophylaxis, by reviewing computerised medical records and meeting with the staff responsible. The study included a total of 187 patients, of whom 81% were women There was a significant differences in mean age by sex (men, 76.91 years, 95% CI; 72.59-81.24, and women, 86.72 years, 95% CI; 72.59-81.24, P<.05). Almost two-thirds (65%) walked in the home. There were 3.7% patients who had an indication for receiving prophylaxis, but did not receive it, although 85.8% of them were on anticoagulants or antiplatelet therapy for other reasons. Most patients in domiciliary care have a low baseline risk of developing a TED episode in our study. There should be more emphasis placed on the prophylaxis of TED in acute medical episodes in which patients with slightly elevated risk may increase the likelihood of TED. Observational studies should be conducted to study the baseline risk and the subsequent development of TED in the population receiving home care. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. [Prevalence and features of coeliac disease in the Mediterranean area of Spain].

    PubMed

    Navalón-Ramon, E; Juan-García, Y; Pinzón-Rivadeneira, A

    The aim of this study is to determine the prevalence of coeliac disease in patients of a basic health area in Valencia, on the Mediterranean coast, and describe their sociodemographic and clinical features. A descriptive, cross-sectional, observational study was conducted on a target population of the inhabitants of the Basic Health Area 14(th), Health Department Xàtiva-Ontinyent, in Valencia, comprising the municipalities of Ontinyent, Aielo de Malferit, and Fontanars dels Alforins. the patient belongs to a quota of Primary Care in the basic health area and the diagnosis of coeliac disease was active in the computerised medical records. the patient did not have any serology or intestinal biopsy compatible with coeliac disease. The study included 115 patients, selected to complete an interviewer-administered questionnaire. As 9 patients did not respond, the study was performed with 106 people. The prevalence of coeliac disease is 0.26%, and higher among women than among men (2.31: 1), with a statistically significant difference. The mean age of the patients was 29.71 years. The mean diagnostic delay was 5.15 years, and among the paediatric population it was 0.68 years. There were no statistically significant differences between patients (60) born in spring and summer, and the 46 born in autumn and winter. The prevalence of coeliac disease among first-degree relatives was 7.06%. Coeliac disease is an underdiagnosed condition in our environment, especially among adults, so knowledge and awareness about this disease by general practitioners is necessary. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Effect of nitrogen-rich cell culture surfaces on type X collagen expression by bovine growth plate chondrocytes

    PubMed Central

    2011-01-01

    Background Recent evidence indicates that osteoarthritis (OA) may be a systemic disease since mesenchymal stem cells (MSCs) from OA patients express type X collagen, a marker of late stage chondrocyte hypertrophy (associated with endochondral ossification). We recently showed that the expression of type X collagen was suppressed when MSCs from OA patients were cultured on nitrogen (N)-rich plasma polymer layers, which we call "PPE:N" (N-doped plasma-polymerized ethylene, containing up to 36 atomic percentage (at.% ) of N. Methods In the present study, we examined the expression of type X collagen in fetal bovine growth plate chondrocytes (containing hypertrophic chondrocytes) cultured on PPE:N. We also studied the effect of PPE:N on the expression of matrix molecules such as type II collagen and aggrecan, as well as on proteases (matrix metalloproteinase-13 (MMP-13) and molecules implicated in cell division (cyclin B2). Two other culture surfaces, "hydrophilic" polystyrene (PS, regular culture dishes) and nitrogen-containing cation polystyrene (Primaria®), were also investigated for comparison. Results Results showed that type X collagen mRNA levels were suppressed when cultured for 4 days on PPE:N, suggesting that type X collagen is regulated similarly in hypertrophic chondrocytes and in human MSCs from OA patients. However, the levels of type X collagen mRNA almost returned to control value after 20 days in culture on these surfaces. Culture on the various surfaces had no significant effects on type II collagen, aggrecan, MMP-13, and cyclin B2 mRNA levels. Conclusion Hypertrophy is diminished by culturing growth plate chondrocytes on nitrogen-rich surfaces, a mechanism that is beneficial for MSC chondrogenesis. Furthermore, one major advantage of such "intelligent surfaces" over recombinant growth factors for tissue engineering and cartilage repair is potentially large cost-saving. PMID:21244651

  10. [Determining factors in the sedation of geriatric and oncology patients treated at home].

    PubMed

    Zamora-Mur, A; García-Foncillas, R; Zamora-Catevilla, A; Nabal-Vicuña, M; Calderero-Aragón, V; Lostalé-Latorre, F

    2017-04-01

    Sedation, used as a therapeutic measure in the field of Palliative Care, continues to present difficulties for many professionals in its management and indications. Is varied existing literature in this regard, often exclusive cancer patients. Our objective is to analyse the characteristics of patients attended by a Home Care Support Team who required sedation compared to non-sedated patients, for possible determining factors for its use that could help in decision-making. A prospective analytical study conducted in Barbastro (Huesca) from September 2007 to February 2011. The study population are patients referred to the Home Care Support Team of Barbastro. Age, sex, medical history, symptoms, previous and current Barthel, Karnofsky, primary caregiver, previous drugs, drugs after intervention, sedation yes/no. Required sedation 16.6% (n=106) of the cases (N=638). Sedated patients were younger, with no differences in sex, and the large majority (83%) were oncology patients. The presence of metastases showed no differences in need for sedation. Sedated patients have an increased functional impairment, determined by Barthel index decreased and a worse Karnofsky. Sedated patients showed increased frequency of uncontrolled symptoms, except psychomotor agitation, a fact determined by the medications used pre- and post-intervention. The presence of neoplastic disease, marked with existence of functional decline, and uncontrolled clinical need for certain medications to control symptoms may determine the need for sedation at the end of the process, above other factors such as patient comorbidity. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. [Epidemiology of parkinsonism in the Guadalajara Health Area].

    PubMed

    Martínez-Pérez, J A; Ortiz-García, R; González-Zerega, A; López-Gosling, I; Guzmán, A; Dragomir, E

    2014-09-01

    1) To determine the prevalence of Parkinson syndromes in the Guadalajara Health Area and its Basic Health Zones, as well as the typology of the Parkinson's disease; 2) to determine the distribution of antiparkinsonian medication use in the whole Area, and 3) to evaluate the cost per person and per year of this use according to the criteria of sex and age. A descriptive cross-sectional study including 1,352 subjects affected by parkinsonism in the Guadalajara Area of both sexes and all ages. The variables measured were age, sex, environment, diagnosis, typology of the Parkinson's disease using the Hoehn and Yahr index, treatment, total cost and mean cost of the treatment per person per year. Prevalences were calculated, and the appropriate descriptive statistics were used. The prevalence of parkinsonism was 585/10(5) inhabitants, being higher in a rural environment (P<.05), in females (P<.01) and in subjects over 90 years (P<.01). The majority suffered from Parkinson's disease (P<.001), of whom 43.4% had symptoms equivalent to Yahr grade II (P<.001). The active ingredient most used was levodopa/carbidopa (51.3%) (P<.001) and the mean drug cost per person was 514.37€. The prevalence of parkinsonism is similar to that in the rest of the country, although in our study there is a predominance of females and it is in a rural environment. Levodopa is the drug most used, and the mean therapeutic cost per person is similar to the rest of Spain. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  12. [Use of intravenous immunoglobulin in pregnancy. Report of a patient with common variable immunodeficiency].

    PubMed

    Cambray-Gutiérrez, Julio César; García-Ramírez, Ulises Noel; Del Rivero-Hernández, Leonel Gerardo; López-Pérez, Patricia; Chávez-García, Aurora

    2016-01-01

    Antecedentes: La inmunodeficiencia común variable es la inmunodeficiencia primaria más diagnosticada en los adultos; se caracteriza por infecciones sinopulmonares y gastrointestinales de repetición y mayor incidencia de procesos autoinmunes y malignidad. Numerosos pacientes inician con las manifestaciones clínicas durante la edad reproductiva. Caso clínico: Mujer de 34 años de edad con 12 semanas de gestación, en quien se diagnosticó inmunodeficiencia común variable después de cuadros recurrentes de rinosinusitis, faringoadmidalitis y neumonías. Durante el segundo trimestre se prescribió 0.6 g/kg de inmunoglobulina intravenosa cada 21 días; la paciente solo presentó un episodio de faringoamigdalitis, con adecuada respuesta al tratamiento con antibióticos. Durante el tercer trimestre se ajustó la dosis a cada 14 días. La paciente concluyó el embarazo a término sin complicaciones, con producto sin malformaciones y con peso y talla adecuados. Conclusiones: La administración de inmunoglobulina es el principal tratamiento para controlar la inmunodeficiencia común variable. Si bien la dosis inicial recomendada es de 400-800 mg/kg en forma intravenosa cada 3 a 4 semanas, no existe un consenso sobre la dosis que debe emplearse en la mujer que cursa con embarazo. La recomendación es realizar controles de niveles séricos antes de la infusión para determinarla y ajustarla.

  13. [Control of cardiovascular risk factors among patients with diabetes with and without cardiovascular disease].

    PubMed

    Herrero, A; Garzón, G; Gil, A; García, I; Vargas, E; Torres, N

    2015-10-01

    There is evidence that cardiovascular goals are beneficial in diabetes. To determine the distribution of cardiovascular risk levels in patients with diabetes and the clinical interventions they have received. Descriptive cross-sectional study. SERMAS (Madrid) 2010. All patients with diabetes. (n=41,096). Patients in primary or secondary prevention, metabolic and cardiovascular risk factors control, pharmacological and non-pharmacological interventions. Patient and professional variables. Around one-fifth (21.5%) (95%CI: 21.1% -21.9%) in secondary prevention (very high cardiovascular risk). HbA1c was under control in 31% (95%CI: 30.1%-32%), with 49.9% (95%CI: 48.8%-50.9%) with BP under control, and 39.4% (95% CI: 38.4%-40.4%) with LDL controlled. Only 8.9% (95%CI: 8.3%-9.5%) had a well-controlled HdA1c, BP and LDL, and in 19.8% (95%CI: 19%-20.6%) none of these were under control. Of those with an uncontrolled BP, 23.6% (95% CI: 23.2%-24%) had antihypertensive drugs. There was better control in patients older than 70 years, and those who lived in an urban center, or a lower number of patients per day. In diabetic patients with very high cardiovascular risk (secondary prevention), just half of them had good control of cardiovascular risk factors (BP and LDL). An association was found between better control and older than 70, urban center or lower number of patients per day. This suggests developing strategies to promote a comprehensive control of cardiovascular risk factors in diabetic patients in secondary prevention. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Prevalence of physical activity in primary health care workers of Catalonia].

    PubMed

    Molina Aragonés, J M; Sánchez San Cirilo, S; Herreros López, M; Vizcarro Sanagustín, D; López Pérez, C

    Physical inactivity is the fourth leading risk factor for global mortality, and a significant percentage of the world population does not perform the necessary physical activity for health benefits. Certain professional groups are seen as an example for the general population with whom they interact. Prevalence of physical activity in health workers, one of these reference groups, is mainly unknown. The aim of this study has been to assess the prevalence of physical activity levels in Primary Health Care professionals. A study was conducted on the physical activity levels in Primary Health Care workers who came voluntarily for a medical examination in 2014, and completed the short version of the International Physical Activity Questionnaire activity. A low level of physical activity was reported by 26.5% of those taking part, with 31.5% of the medical group indicating a low level of activity, followed by support staff (28.1%), nurses (24.7%), and finally the administrative staff (19.0%). The physical activity levels of Primary Health Care staff are significantly different from those of the general reference population. The latter has a higher percentage of physical activity of mild to moderate intensity, and below the level of physical activity of high intensity. Although there seems to be a tendency to significantly lower physical activity in other health groups, we do not have sufficiently reliable data to compare them. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Control of blood pressure by using an intelligent telephone application with feedback and competitiveness strategy. HTApp Control project].

    PubMed

    Sánchez-Prieto, J; Sabatel, F; Villarrubia Mendez, G; Divisón, J A; Garcia-Donaire, J A; Rodríguez-Padial, L

    2017-09-04

    Arterial hypertension is a highly important cardiovascular risk factor, with low control percentages. New technologies can help to obtain a better control of this disease. The intention is to know if a mobile application can help achieve this goal. A mobile phone application is used to give feedback to physicians with the aim of generate competitiveness in achieving objectives. The application could, at any time, determine the rate of controlled patients (<140/90mmHg) by each physician, and compare them with the mean number of the patients controlled by the group. The possible changes in the therapeutic attitude of physicians are also analysed and the differences in achieving objectives are compared based on specific characteristics of patients. The study included 220 patients aged 18-80 years, with mean blood pressure>140/90mmHg, despite medical treatment, tracked for 4 visits. At the end of the follow-up, 69.03% achieved good control, compared to 12.8% in the baseline study (P<.001), with no differences between gender (control of 68.6 and 69.29% of women and men, respectively), nor among the different levels of cardiovascular risk. The use of interactive tools that allow the dynamic process of feedback on the results fosters the motivation and improves the therapeutic inertia in the control of blood pressure. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Neurological examination in patients undergoing sedation with propofol: a descriptive study].

    PubMed

    Ordas-Bandera, Carlos M; Sanchez-Marcos, Carolina; Janeiro-Lumbreras, David; Jimenez-Martin, M José; Muniz-Castrillo, Sergio; Cuadrado-Perez, M Luz; Porta-Etessam, Jesús

    2014-06-16

    Introduccion. La exploracion neurologica es un recurso en la evaluacion de los pacientes en coma. La anestesia puede ser un factor influyente en los hallazgos. Evaluamos la exploracion del paciente en coma en pacientes anestesiados con propofol para definir su valor clinico. Pacientes y metodos. Estudio prospectivo en sometidos a cirugia cardiaca en los cuidados intensivos de un hospital terciario durante los meses de abril y mayo de 2011. Se analiza la exploracion del coma anestesico, factores farmacologicos o medicos que pueden influir y exploracion neurologica completa tras la recuperacion. Se excluyeron pacientes con sintomas neurologicos previos. Resultados. Se seleccionan 30 pacientes (16 hombres y 14 mujeres); edad media: 72 ± 10 años. Todos los pacientes estaban sedados con propofol. Durante la sedacion, 17 (46,7%) presentaban pupilas arreactivas. En el 100% no se observaron movimientos espontaneos de los ojos. El 23,3% presentaba alteracion ocular en posicion primaria. Los reflejos oculocefalicos estaban ausentes en el 93,3%, y los oculovestibulares, en el 100%; el reflejo corneal, en el 70% (con asimetria); el espinociliar, en el 83,3%. La respuesta motora algesica estaba ausente en el 93,3%; en un 20%, los reflejos cutaneoplantares extensores; e indiferentes, en el 66,7%. Tras la anestesia, la exploracion neurologica fue normal en el 80%, hubo leves alteraciones de orientacion en un 16,7% y se encontro un sindrome hemisferico en un paciente. Conclusiones. La anestesia con propofol altera los reflejos pupilares, del tronco, respuestas motoras y reflejo cutaneoplantar reversibles al retirar la sedacion. Las alteraciones pueden ser asimetricas. No se deberia utilizar la exploracion neurologica en el paciente sedado con propofol para la toma de decisiones clinicas.

  17. PubMed

    Ávila García, Manuel; Huertas Delgado, Francisco Javier Huertas Delgado; Tercedor Sánchez, Pablo

    2016-11-29

    Introducción: España es el tercer país europeo con mayor prevalencia de obesidad infantil, dando lugar a la aparición de programas de intervención destinados a fomentar hábitos alimentarios saludables y/o de actividad física (AF).Objetivo: el propósito de esta revisión sistemática fue conocer aquellos programas de intervención para la promoción de hábitos alimentarios y de AF desarrollados en escolares españoles de Educación Primaria (EP) y analizar la influencia que han tenido las intervenciones sobre la composición corporal, los hábitos alimentarios y la AF.Método: se revisaron los artículos publicados entre los años 2000 y 2015 en las siguientes bases de datos: Web of Science, Scopus, Dialnet, PubMed, Eric, Sportdiscus y Psycinfo por dos revisores independientes.Resultados: se contabilizaron un total de 813 artículos, de los cuales tras la eliminación de duplicados (192), lectura de títulos y resumen (587) y lectura del texto completo (17), tan solo 7 cumplieron con los criterios de inclusión.Conclusiones: los programas de intervención analizados mostraron cambios positivos en la mejora de la composición corporal en algo menos de la mitad de los estudios analizados; por otro lado, casi todos los programas de intervención analizados tuvieron un efecto positivo sobre conductas respecto a ciertos hábitos alimentarios, como la ingesta de frutas, y sobre el incremento del nivel de AF.

  18. [Control of anticoagulation in patients with non-valvular atrial fibrillation in a primary care clinical practice setting in the different autonomous communities. PAULA study].

    PubMed

    Polo García, J; Barrios Alonso, V; Escobar Cervantes, C; Prieto Valiente, L; Lobos Bejarano, J M; Vargas Ortega, D; Prieto Díaz, M Á; Alonso Moreno, F J; Barquilla García, A

    2017-04-01

    To determine the differences between regions in the level of control of patients with non-valvular atrial fibrillation treated with vitamin K antagonists, included in the PAULA study. Observational, and coss-sectional/retrospective study, including 139 Primary Care physicians from 99 Health Care centres in all autonomous communities (except La Rioja). Anticoagulation control was defined as the time in therapeutic range assessed by either the direct method (poor control <60%), or the Rosendaal method (poor control <65%). A total of 1,524 patients were included. Small differences in baseline characteristics of the patients were observed. Differences in the percentage of time in therapeutic range were observed, according to the Rosendaal method (mean 69.0±17.7%), from 78.1%±16.6 (Basque Country) to 61.5±14% (Balearic Islands), by the direct method (mean 63.2±17.9%) from 73.6%±16.6 (Basque Country) to 57.5±15.7% (Extremadura). When comparing regions, in those where the Primary Care physicians assumed full control without restrictions on prescription, the percentage of time in therapeutic range by the direct method was 63.89 vs. 60.95% in those with restrictions (p=.006), by Rosendaal method, 69.39% compared with 67.68% (p=.1036). There are significant differences in the level of control between some regions are still inadequate. Regions in which the Primary Care physicians assumed the management of anticoagulation and without restrictions, time in therapeutic range was somewhat higher, and showed a favourable trend for better control. These findings may have clinical implications, and deserve consideration and specific analysis. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Update on the control of patients on treatment with vitaminK antagonist oral anticoagulants in Primary Care].

    PubMed

    Fernández López, P; López Ramiro, M I; Merino de Haro, I; Cedeño Manzano, G; Díaz Siles, F J; Hermoso Sabio, A

    In Spain, more than 80% of patients with atrial fibrillation (AF) receive oral anticoagulant therapy (OAT), and 72% of these patients are followed up in the Primary Care (PC) setting. Recent studies have shown that there is insufficient control of patients on OAT. The objective of the present study was to obtain more detailed information on the state of control of patients on treatment with vitaminK antagonist (VKA) oral anticoagulants (OAC), on the diseases for which the therapy was indicated and on concomitant diseases. This was a retrospective, cross-sectional, observational study with the participation of patients from a single health area included in an OAT programme throughout 2014. In patients on treatment with OAC, International Normalised Ratio (INR) control was considered insufficient when the percentage time in therapeutic range (TTR) was below 65% during an evaluation period of at least 6months. A total of 368 patients were included in the study, where the most frequent indication for oral anticoagulation was non-valvular AF. A total of 5,128 INR controls were performed, of which 2,359 (46%) were outside the therapeutic range, and 2,769 (54%) were within range. The risk of thromboembolism was very high in 91% of patients on treatment with VKA OAC. The indication for anticoagulation is correct in our population, assuming a low-intermediate risk of haemorrhage in the majority of patients. Measurement of the TTR using the Rosendaal method shows that the control of patients on treatment with VKA OAC is insufficient. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Prevalence and factors associated with frequent attendence in family medicine clinic].

    PubMed

    Parejo Maestre, N; Lendínez-de la Cruz, J M; Bermúdez-Torres, F M; Gónzalez-Contero, L; Gutierrez-Espinosa de Los Monteros, M P; Espejo-Almazán María, T

    2016-01-01

    The use of health services has seen a steep rise. The frequent users are responsible for significant economic, human and social impact. The objective is to analyze the characteristics of frequent attenders in our Health Center, in order to evaluate the possibility of taking corrective measures to improve the quality of care and efficiency in the use of resources. Descriptive observational study of a sample of 379 patients over 18 years old. The dependent variables were attendance (number of visits to their family doctor during the previous year), frequent attendance (10 or more visits to the family doctor in the last year), and persistent frequent attenders (10 or more visits to the family doctor in each of the last two years). Data were collected from medical records and by telephone interview. The mean attendance was 6.83 (95%CI: 6.13-7.53), frequent attendance reached 25.4% (95%CI: 21.4-29.6), and persistent frequent attenders, 1.6% (95%CI: 0.5-2.9). Frequent attendance was associated with sex, age, marital status, educational level, family structure, existence of chronic disease, use of anxiolytic and antidepressants, request for additional tests, and referrals to other specialists, proximity to the health center, and level of satisfaction with their family doctor. The low persistent frequent attenders found suggests that frequent attendance could be largely due to factors related to professional and organization. Studies are required to address the high level of consumption of psychotropic drugs, and improving professional skills in dealing with mental problems. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. [Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit].

    PubMed

    Márquez-Godínez, S A; Zonana-Nacach, A; Anzaldo-Campos, M C; Muñoz-Martínez, J A

    2014-01-01

    To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95%CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95%CI: 2.8-9.4), female gender (OR 2.0; 95%CI: 1.1-3.6), monthly familiar income <236 euros (OR 2.0; 95%CI: 1.1-3.8), and a glycosylated hemoglobin ≥ 7.0% (OR 2.8; 95%CI: 1.5-5.0). It is necessary that all DM patients seen in a family medicine clinic have a yearly screening for the early detection of diabetic neuropathy, since they have a high risk of diabetic foot. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. [Current state of the attention deficit hyperactivity disorder approach in neuropediatrics].

    PubMed

    Cardo, E; Ros-Cervera, G; Eiris-Punal, J; Escofet-Soteras, C; Fernandez-Jaen, A; Mulas, F; Sanchez-Carpintero, R; Sans, A; Grupo de Trabajo de Tdah de la Sociedad Espanola de Neurologia Pediatrica, Grupo de Trabajo de Tdah de la Sociedad Espanola de Neurologia Pediatrica

    2017-02-24

    Objetivo. Conocer el estado actual del enfoque del trastorno por deficit de atencion/hiperactividad (TDAH) entre los neuropediatras. Sujetos y metodos. Se realizo una encuesta telematica que recogia informacion preliminar sobre el interes, las dificultades en el manejo y el tratamiento del TDAH a los 437 socios de la Sociedad Española de Neurologia Pediatrica. Resultados. Respondio un 32,49% de los cuestionarios enviados, con una importante variabilidad geografica. El 97,89% afirmo que el 50% de sus consultas eran niños con trastornos de aprendizaje y TDAH. Respecto a quien iniciaba el tratamiento para el TDAH en su area, la mayoria contesto que el neuropediatra (57,97%), seguido del psiquiatra infantil (34,78%) y del pediatra de atencion primaria (5,31%). Respecto a las mayores dificultades para la valoracion inicial de los niños con sospecha de TDAH, se citaron la falta de un estudio psicopedagogico por parte de la escuela (49,79%), seguido de la falta de tiempo en la consulta (29,11%). Sobre las dificultades en el seguimiento, la mayor queja se produjo por la falta de coordinacion entre los profesionales, la escuela y los padres. Respecto a la medicacion, la mayoria de los pacientes se encontraba en tratamiento con algun tipo de metilfenidato de liberacion prolongada, un porcentaje estable utilizaba metilfenidato de liberacion inmediata como tratamiento unico o combinado, y se observo en un rango inferior el uso de clonidina y atomoxetina, y un incipiente uso de lisdexanfetamina. La adhesion al tratamiento farmacologico al año fue alrededor del 80%. Conclusiones. Es necesario avanzar en la capacitacion y educacion continua de nuestros especialistas neuropediatricos en el manejo del TDAH, y en homogeneizar la practica clinica y la coordinacion con educacion en el territorio español.

  3. [Comparison of the cardiovascular predictive value of MDRD and CKD-EPI in estimating chronic kidney disease].

    PubMed

    Cinza-Sanjurjo, S; Calvo-Gómez, C; Hermida-Ameijeiras, A; López-Paz, J E; González-Juanatey, J R

    2016-01-01

    To assess predictive value of the cardiovascular prognosis by comparing the two most used formulas for the estimation of glomerular filtration rate in hypertensive patients. A retrospective cohort study was designed that included 405 patients diagnosed with essential hypertension. The patients were referred from Primary Care to the Hypertension and Vascular Risk Unit between January 1, 1998 and August 31, 1999. Blood pressure measurements, blood and urine analysis, and echocardiography were simultaneously performed. They were followed up for 12.5 years (mean [± IQR]: 10.61 [± 3.11] years) and 174 events were recorded. The study included 405 patients (53.8% women), with a mean age of 55.5 years. The estimated glomerular filtration rate according to the MDRD and CKD-EPI equations was 73.9±2.6 mL/min/1.73m(2) and 76.9±2.2 mL/min/1.73m(2), respectively. The prevalence of chronic kidney disease was 31.6% and 23.9%, respectively. Using the CKD-EPI equation led to the re-classification of 22.9% of patients. The incidence rate ratio (IRR [95%CI] for chronic kidney disease identified by the MDRD equation was 2.4 [1.8-3.3], and for the CKD-EPI calculation it was 2.5 [1.8 to 3.3]). Both equations estimate similar magnitudes of renal function, although the CKD-EPI equation has less false positives, and both have similar prognostic values in patients at high cardiovascular risk as well those at low risk. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Cardioprotective aspirin users and their excess risk of upper gastrointestinal complications

    PubMed Central

    Hernández-Díaz, Sonia; García Rodríguez, Luis A

    2006-01-01

    Background To balance the cardiovascular benefits from low-dose aspirin against the gastrointestinal harm caused, studies have considered the coronary heart disease risk for each individual but not their gastrointestinal risk profile. We characterized the gastrointestinal risk profile of low-dose aspirin users in real clinical practice, and estimated the excess risk of upper gastrointestinal complications attributable to aspirin among patients with different gastrointestinal risk profiles. Methods To characterize aspirin users in terms of major gastrointestinal risk factors (i.e., advanced age, male sex, prior ulcer history and use of non-steroidal anti-inflammatory drugs), we used The General Practice Research Database in the United Kingdom and the Base de Datos para la Investigación Farmacoepidemiológica en Atención Primaria in Spain. To estimate the baseline risk of upper gastrointestinal complications according to major gastrointestinal risk factors and the excess risk attributable to aspirin within levels of these factors, we used previously published meta-analyses on both absolute and relative risks of upper gastrointestinal complications. Results Over 60% of aspirin users are above 60 years of age, 4 to 6% have a recent history of peptic ulcers and over 13% use other non-steroidal anti-inflammatory drugs. The estimated average excess risk of upper gastrointestinal complications attributable to aspirin is around 5 extra cases per 1,000 aspirin users per year. However, the excess risk varies in parallel to the underlying gastrointestinal risk and might be above 10 extra cases per 1,000 person-years in over 10% of aspirin users. Conclusion In addition to the cardiovascular risk, the underlying gastrointestinal risk factors have to be considered when balancing harms and benefits of aspirin use for an individual patient. The gastrointestinal harms may offset the cardiovascular benefits in certain groups of patients where the gastrointestinal risk is high and

  5. [Bibliometric map of research done in primary care in Spain during the period 2008-2012].

    PubMed

    López-Torres Hidalgo, Jesús; Basora Gallisà, Josep; Orozco Beltrán, Domingo; Bellón Saameño, Juan Ángel

    2014-12-01

    To describe the Spanish scientific production of primary care during 2008-2012. Observational study bibliometric. Spanish scientific production in primary care. The study focused on publications indexed in Medline. In each record was obtained journal, year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content or areas of research. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. Using search criteria, were selected 1,048 documents. The transiency rate was 62.6%. Production increased from 170 papers in 2008 to 291 in 2012. Most (65.7%) came from health centers, but we observed a significant increase (P=.01) of the articles from units or research institutes (5.9% in 2008, 12.0% in 2012). Of the total, 61.6% were classified as «clinical aspects», 22.5% were published in the journal Atención Primaria, 80.5% in journals with impact factor and 33.49% in foreign journals, being higher this proportion (P<.001) in units or research institutes (70.5% vs. 29.8%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.1), Castilla-La Mancha (3.6), Aragón (3.4) and Navarra (3.4). In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  6. [Management of hypertension and diabetes in Primary Care clinical practice: ATENCION study].

    PubMed

    Millán Núñez-Cortés, J; de la Figuera von Wichmann, M; Rodríguez de Miguel, M; Orera Peña, M L; Labrador Barba, E; Lería Gelabert, M

    2017-04-01

    Cardiovascular diseases are the main cause of death in the Spanish population. The detection and control of cardiovascular risk factors are fundamental in the prevention of cardiovascular disease. The main objectives of this study are to analyse the attitudes and therapeutic decisions of Primary Care (PC) physicians when treating hypertension (HT) and diabetes mellitus type 2 (DM2), with the aim of establishing the situation and eventually proposing improvement strategies. A national ecological, multicentre, cross-sectional, and descriptive study was conducted in 2013. A questionnaire was used and 1,028 PC physicians took part in the study. A total of 92.9% of the investigators consulted have indicated that they follow the guidelines for evaluation, treatment, and diagnosis of HT, and 91.4% in the case of diabetes. The latter is diagnosed as a casual finding, while HT is diagnosed through active investigation in patients with other risk factors. Combined therapy takes more than 6 months to take effect in patients with HT, and between 8 and 9 months in diabetic patients. The percentage of non-compliance is similar (10-40%) in both pathologies. Around half the physicians questioned considered interaction with the specialist to be good or excellent (46% HT and 57.3% DM2). Clinical practices in PC for HT and DM2 have some basic criteria in common. The interaction with the specialist is good, but there is a considerable margin for improvement. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. [Evaluation of the capacity of elderly patients to make decisions about their health].

    PubMed

    Atienza-Martín, F J; Garrido-Lozano, M; Losada-Ruiz, C; Rodríguez-Fernández, L M; Revuelta-Pérez, F; Marín-Andrés, G

    2013-09-01

    To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P <.0001) and function intellectual intact (OR: 282.750, 95% CI 34.0 to 2351.2, P <.0001). Numeric variables associated with the capacity for decision-making that had a more important effect size were the Barthel index (d: -1.398) and Pfeiffer index (d: 3.084). The prevalence of incapacity to make decisions about their health in elderly patients who are cared for in their homes is high. The level of dependence in activities of daily living and the deterioration of intellectual function are factors associated with the presence of this capacity. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. [Use of ineffective practices in Primary Health Care: professional opinions].

    PubMed

    Domínguez Bustillo, L; Barrasa Villar, J I; Castán Ruíz, S; Moliner Lahoz, F J; Aibar Remón, C

    2014-01-01

    To estimate the frequency of ineffective practices in Primary Health Care (PHC) based on the opinions of clinical professionals from the sector, and to assess the significance, implications and factors that may be contributing to their continuance. An on line survey of opinion from a convenience sample of 575 professionals who had published articles over the last years in Atención Primaria and Semergen medical journals. A total of 212 professionals replied (37%). For 70.6% (95% confidence interval [CI] 64.5 to 73.3) the problem of ineffective practices is frequent or very frequent in PHC, and rate their importance with an average score of 7.3 (standard deviation [SD]=1.8) out of 10. The main consequences would be endangering the sustainability of the system (48.1%; 95% CI, 41.2 to 54.9) and harming patients (32.1%; 95% CI, 25.7 to 38.5). These ineffective practices are the result of the behaviour of the patients themselves (28%; 95% CI, 22.6 to 35.0) workload (26.4%; 95% CI, 20.3 to 32.5), and the lack of the continuous education (19.3%; 95% CI, 13.9 to 24.7). Clinical procedures of greatest misuse are the prescribing of antibiotics for certain infections, the frequency of cervical cancer screening, rigorous pharmacological monitoring of type 2 diabetes in patients over 65 years, the use of psychotropic drugs in the elderly, or the use of analgesics in patients with hypertension or renal failure. The use of ineffective procedures in PHC is considered a very important issue that negatively affects many patients and their treatment, and possibly endangering the sustainability of the system and causing harm to patients. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  9. [Use of multiple regression models in observational studies (1970-2013) and requirements of the STROBE guidelines in Spanish scientific journals].

    PubMed

    Real, J; Cleries, R; Forné, C; Roso-Llorach, A; Martínez-Sánchez, J M

    In medicine and biomedical research, statistical techniques like logistic, linear, Cox and Poisson regression are widely known. The main objective is to describe the evolution of multivariate techniques used in observational studies indexed in PubMed (1970-2013), and to check the requirements of the STROBE guidelines in the author guidelines in Spanish journals indexed in PubMed. A targeted PubMed search was performed to identify papers that used logistic linear Cox and Poisson models. Furthermore, a review was also made of the author guidelines of journals published in Spain and indexed in PubMed and Web of Science. Only 6.1% of the indexed manuscripts included a term related to multivariate analysis, increasing from 0.14% in 1980 to 12.3% in 2013. In 2013, 6.7, 2.5, 3.5, and 0.31% of the manuscripts contained terms related to logistic, linear, Cox and Poisson regression, respectively. On the other hand, 12.8% of journals author guidelines explicitly recommend to follow the STROBE guidelines, and 35.9% recommend the CONSORT guideline. A low percentage of Spanish scientific journals indexed in PubMed include the STROBE statement requirement in the author guidelines. Multivariate regression models in published observational studies such as logistic regression, linear, Cox and Poisson are increasingly used both at international level, as well as in journals published in Spanish. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. [A 6-year evaluation of dyslipidemia in a health center: Importance of improvement actions].

    PubMed

    Antón-García, F; Correcher-Salvador, E; Rodríguez-Lagos, F A; González-Caminero, S

    2014-01-01

    Dyslipidemia, especially an increased LDL-cholesterol, has been shown to be one of the most important risk factors in the genesis of coronary involvement. The prevalence of dyslipidemias in Spain is high. The objective of this study is to assess the progress of dyslipidemic patients in our health center over a 6-year period, and see if there has been any improvement in its control after the presentation of the evaluation of the first 3 years, as well as an updated dyslipidemia protocol. Assessment Period 1 (2006-2008): 267 patients with dyslipidemia. Assessment Period 2 (2009-2011): 222 patients, excluding exitus and address changes. age, sex, personal history of CVD, vascular risk factors, lipids, drug treatment, risk levels, and percentages of CV control objectives. Mean age was 66.2 years (SD 13.4), 66.3% women. Period 1-Period 2: Total cholesterol: 221.9-196.6 mg/dl (P=.000); LDL-cholesterol: 147.9-115.8 mg/dl (P=.000). In high risk patients, therapeutic targets: 14-50.5% (P=.024); medium risk: 35-68.1% (P=.038); low risk: 44-68.2% (P=NS). Pharmacotherapy 68-77% (P=.000). Changing treatment: 30-43% (P=.001). Adherence: 75-86% (P=.003). Untreated high risk: 15.4-16.3% (P=NS). There was a significant improvement in Period 2, especially in high-risk patients, after presenting the results of the evaluation for Period 1 and with the updated dyslipidemia protocol. There are high risk patients without lipid-lowering treatment to be detected and reviewed. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. [A retrospective, observational and multicentre study on patients with hyperactive bladder on treatment with mirabegron and oxybutinine under usual clinical practice conditions].

    PubMed

    Sicras-Mainar, A; Navarro-Artieda, R; Ruiz-Torrejón, A; Saez, M; Coll-de Tuero, G; Sánchez, L

    To evaluate therapeutic persistence, healthcare resources, medical costs and adverse events of oxybutynin and mirabegron treatments in patients with overactive bladder in routine medical practice. An observational, retrospective, multicentre study was carried out using the records of patients attended to in 3 different geographic locations (Barcelona, Girona, Asturias). An analysis was made on the 2 study groups (oxybutynin and mirabegron). Follow-up time was one year. Persistence was defined as the time (months), without discontinuation of the initial treatment, or without change of treatment at least 60 days after the initial prescription. Primary endpoints: comorbidity, healthcare resources used, and adverse events. The data was analysed using the SPSSWIN Program, with a significance of P<.05. Of the total of1,277 patients included in the study, 42.9% were on oxybutynin and 57.1% mirabegron. The mean age was 69.3 years and 53.2% were female. Demographic characteristics and morbidity were similar between the drugs and had a similar persistence (35.0% oxybutynin vs. 32.2% mirabegron, P=.294), although their costs were lower (1,151.2 vs. €1,809.6, P<.001). The biggest differences were observed in the price of medication (279.2 vs. €692.3, P<.001; a variation of: -€413.1); and adverse events (9.7 vs. 4.9%, P<.001). Patients treated with oxybutynin vs. mirabegron for overactive bladder had similar persistence with the treatment, lower healthcare costs, but with higher oxybutynin vs. mirabegron adverse reaction rates. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  12. [Impact of colorectal cancer screening using an immunological assay in a basic urban health area].

    PubMed

    García-Rodríguez, M A; Cubillo-Durán, E; Moreno-Camelo, S; Mata-Román, L; Muñoz-Moreno, M F; Cáceres-Pereira, A

    2013-01-01

    To describe the results of implementing a pilot screening program, in the Castilla y León, for colorectal cancer (CRC) with the faecal occult blood test (iFOBT) using a quantitative immunological latex agglutination assay. The study population included 4930 persons between 50-69 years from the Basic Health Area of Medina del Campo. Colonoscopy was performed on those who had a positive iFOBT. The rates of participation were calculated, positivity, acceptance of colonoscopy, detection of lesions, percentages and predictive positive value (PPV) of the test. A total of 2241 (46.33%) people took part. There were 138 (6.15%) positive iFOBT. The rate acceptance of the colonoscopy was 99.27%. CRC was detected in 12 patients (91.66% in early stages), a high risk adenoma (HRA) in 42, and a low risk adenoma (LRA) in 34. The rates of detection were for CRCwas 5.35‰, 18.74‰ for HRA, 15.17‰ for LRA, and 39.26‰ for all kinds of adenoma. The PPV was 8.69% for CCR, 30.43% for HRA and 24.63% for LRA. The CRC screening program is feasible in our context. The iFOBT indicators are superior to those of other studies performed using the classic test. The high rates of detection of CRC, and all kinds of adenoma would be enough to justify the study. These together with the diagnosis of CRC in the early stages could lead to a reduction of the mortality. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. [Nutritional status of the population over 65 years of age in the city of Badajoz].

    PubMed

    Suárez-Gómez, A; Sánchez-Vega, J; Suárez-González, F; Peral-Pacheco, D; Dorado-Martin, J J; Suárez-Gómez, M

    2017-03-01

    Nutritional status is strongly associated with the level of health and quality of life of the population, and is especially relevant in the case of the elderly. The aim was to study the nutritional status in a population of non-institutionalised over 65 year-olds in the city of Badajoz, describing the sociodemographic variables, biochemical parameters, and functional assessment. A descriptive study was performed using a design population, which was randomised and stratified in health centres of the city, with a sample size of 298 patients being obtained. The sociodemographic variables included gender, age, educational level, anthropometric analysis with estimated body mass index, and percentage fat weight. Statistical tests were performed using SPSS v.15 statistical package. The prevalence of overweight and obesity as measured by fat weight was 61.9% (56.1-67.8), with a body mass index of 65.8% (60.2-71.4). It was higher in women, with a fat weight of 67.3% (2.56 to 2.73) and a body mass index of 71.8% (2.64 to 2.78). The nutritional status of the population according to the questionnaire "Know your nutritional health" was rated "good". The most common nutritional problem in the non-institutionalised population over 65 years in the city of Badajoz is obesity, especially in women, and in people with low educational level. This high prevalence suggests that health education on a better lifestyle in this population should be a priority. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. [Cardiovascular risk and cardiovascular events in the general population of the sanitary area of Toledo. RICARTO Study].

    PubMed

    Rodríguez-Roca, G C; Rodríguez-Padial, L; Alonso-Moreno, F J; Segura-Fragoso, A; Villarín-Castro, A; Rodríguez-García, M L; Menchén-Herreros, A; Rojas-Martelo, G A; Fernández-Conde, J A; Artigao-Rodenas, L M; Carbayo-Herencia, J A; Escobar-Cervantes, C; Hernández-Moreno, J; Fernández-Martín, J

    2017-05-26

    The main aim of this study is to ascertain the prevalence of cardiovascular risk factors (CVRF), target organ damage (TOD), cardiovascular disease (CVD), as well as life habits (physical exercise, alcohol consumption, and Mediterranean diet) in the population of a Health Area in Toledo, Spain, to assess cardiovascular risk (CVR). Epidemiological and observational study that will analyse a sample from the general population aged 18 years or older, randomly selected from a database of health cards, and stratified by age and gender. Clinical history, physical examination, and complementary tests will be performed. Aliquots of whole blood and serum samples will be stored at a temperature of-85°C to evaluate future genetic studies. CVR will be estimated by using SCORE project scales calibrated for Spanish population and the Framingham Heart Study scale. When the estimated sample size has been achieved and after a minimum follow-up of 5 years, a final visit will performed in which CVRF, TOD, CVD, CVRF control, and fatal and non-fatal outcomes will be evaluated. The RICARTO study is aimed to assess the prevalence of the main CVRF, TOD and CVD in order to determine the CVR in the general population of a health area of Toledo. An analysis will be repeated on the final sample after at least 5 years of follow-up to ascertain the incidence of CV outcomes and the temporal trends of life style, as well as the prevalence of CVRF, TOD, and CVD. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. [Opinion from physicians on the need for dyslipidemia screening in cardiovascular risk. Similarities and differences between primary care and other specialties. The DIANA study].

    PubMed

    Serrano, Adalberto; Pascual, Vicente

    2016-08-16

    The clinical inertia in the screening and treatment of patients at high or very high cardiovascular risk leads to the failure to achieve LDLc targets in this population. The aim of the DIANA study was to determine the opinion of doctors about the screening for dyslipidaemia, the usual practice, and the differences between Primary Care physicians and other specialties. A questionnaire, using the modified Delphi method, included four blocks on dyslipidemic patients with impaired glucose metabolism. Of the 497 participating experts, 58% were Primary Care physicians. There was agreement on the need for dyslipidemia screening in patients with diabetes, ischaemic heart disease or hypertension, although to a lesser extent among Primary Care physicians. Greater significant differences were found in situations such as pre-diabetes or family history of premature cardiovascular disease (86.2% and 88.6% in Primary Care physicians versus 96.1% and 97.6% in other specialties, respectively). There was no agreement on the need for screening in the presence of xanthomas, xanthelasmas or corneal arcus in people under the age of 45 years, with statistically significant differences in the latter. Dyslipidaemia screening is mainly performed on patients with cardiovascular disease or any major cardiovascular risk factor, and cutaneous lesions of familial hypercholesterolaemia are underestimated. The need for accurate screening and treatment of dyslipidemia in subjects at high cardiovascular risk must be stressed. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. [Association between limited joint mobility syndrome and risk of accidental falls in diabetic patients].

    PubMed

    López-Martín, I; Benito Ortiz, L; Rodríguez-Borlado, B; Cano Langreo, M; García-Martínez, F J; Martín Rodríguez, M F

    2015-03-01

    Limited joint mobility syndrome (LJMS) appears exclusively in both type 1 and type 2 diabetic patients. It is characterized by a limited range of digital motion, with involvement of small joints of the hands. It initially affects the proximal interphalangeal joints, followed by wrists, elbows, shoulders, knees, and axial skeleton. The diagnosis can be made by the simple "prayer sign" test. The objective was to study the prevalence of diabetic patients with LJMS, and to evaluate the association between LJMS and metabolic control, and the risk of accidental falls. A cross-sectional study was conducted in the San Fernando II Health Centre, Madrid (suburbs). The sample consisted of 184 patients with a diagnosis of diabetes of over 5 years from November to March, 2013. The prayer sign was used to define which patients had LJMS. Fall risk was determined using the Timed Up & Go test. A total of 99 patients (53.8%) (95% CI 46.6 to 61) had a positive prayer sign. No statistically significant relationship was found with HbA1c, but there was an association with the Timed Up & Go test (P<.001) (95% CI 1.173 to 1.611). The patients with LJMS had a moderate risk of falls compared with those without LJMS, which was of low risk. The prevalence of LJMS is high. This is the first study that shows a relationship between LJMS and the risk of falls in diabetic patients. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  17. [Bibliometric analysis of IBERPOC and EPI-SCAN studies. Contribution of the smoking variable on the iberpoc study].

    PubMed

    de Granda-Orive, J I; Alonso-Arroyo, A; López-Padilla, D; Segrelles-Calvo, G; Jiménez-Ruiz, C A; Solano-Reina, S

    2017-02-09

    The aim of this study was to perform a bibliometric analysis of EPI-SCAN and IBERPOC studies using the Science Citation Index and Scopus databases, and to determine the overall impact with the impact of smoking on IBERPOC as a secondary objective. A general searching was conducted in Science Citation Index-Expanded through the Web of Science (WoS) (Thomson Reuters) platform and Scopus on 23 March 2015. The search strategy included the terms "iberpoc" OR "episcan" was performed on 15 October 2015. A total of 24 publications were obtained; 13 from IBERPOC study (9 on "COPD" and 4 for "tobacco"), with 11 from the EPI-SCAN (All COPD) study. A total of 841 WoS citations were obtained (445 IBERPOC [99 of tobacco]), and 1,442 from Scopus (963 IBERPOC [144 tobacco]). The theme "tobacco" contributed with 22.24% and 14.95% of total citations in WoS and Scopus, respectively to the IBERPOC study. It was found that Scopus citations were newer, and a similar impact from both WoS studies was detected, although the IBERPOC impact was greater in Scopus. Collaborative networks of institutions and authors of both studies were identified. There is an important productivity and impact of both studies. Scopus citations are newer than those in WoS. The "tobacco" variable added IBERPOC impact and visibility. There was high density, accessibility, and cohesion in collaborative networks of both studies. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. [Primary care in Italy].

    PubMed

    Sánchez-Sagrado, T

    2017-05-25

    Italy is not a country where Spanish doctors emigrate, as there is an over-supply of health care professionals. The Italian Servizio Sanitario Nazionale has some differences compared to the Spanish National Health System. The Servizio Sanitario Nazionale is financed by national and regional taxes and co-payments. There are taxes earmarked for health, and Primary Care receives 50% of the total funds. Italian citizens and residents in Italy have the right to free health cover. However, there are co-payments for laboratory and imaging tests, pharmaceuticals, specialist ambulatory services, and emergencies. Co-payments vary in the different regions. The provision of services is regional, and thus fragmentation and major inequities are the norm. Doctors in Primary Care are self-employed and from 2000 onwards, there are incentives to work in multidisciplinary teams. Salary is regulated by a national contract and it is the sum of per-capita payments and extra resources for specific activities. Responsibilities are similar to those of Spanish professionals. However, medical care is more personal. Relationships between Primary Care and specialised care depend on the doctors' relationships. Primary Care doctors are gatekeepers for specialised care, except for gynaecology, obstetrics and paediatrics. Specialised training is compulsory in order to work as general practitioner. The Italian Health Care System is a national health system like the Spanish one. However, health care professionals are self-employed, and there are co-payments. In spite of co-payments, Italians have one of the highest average life expectancy, and they support a universal and publicly funded health-care system. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Diabetic retinopathy screening programme in primary health care. Diagnostic concordance between family and eye care practitioners].

    PubMed

    Alonso Porcel, C; Martínez Ibán, M; Arboleya Álvarez, L; Suárez Gil, P; Sánchez Rodríguez, L M

    2016-09-01

    To evaluate the diagnostic concordance in retinography interpretation between primary care and eye care practitioners and assess the soundness index of a diabetic retinography screening programme during its implementation stage. Descriptive, observational study was conducted on a sample of 243 patients with diabetes mellitus (type 1 and 2) over age 14, in 2 urban health care centers, gathered in an opportunistic manner between the dates of 21/07/2011 and 26/01/2012. A 45° digital bilateral retinography, intraocular pressure and visual acuity were obtained from each patient. The primary care practitioners prepared a report for each patient, which was telematically sent to the eye care doctor within the corresponding retinographies. A new diagnostic report was prepared then by the eye care doctor after revising the images. The lack of retinographies and/or reports were considered both as losses. The diagnostic concordance between the observers and the validity and reliability from the screening programme were estimated. The kappa value obtained was 0.62 (95% CI 0.42-0.82) and 0.89 PABAK. The following validity indexes were obtained: Sensitivity 68.8%, specificity 96.5%, positive and negative predictive values: 61.1 and 97.5%, respectively. A percentage of 57.2 of the patients were not observed any pathology requiring referral to a eye care doctor. The concordance value obtained varied between considerable and almost perfect, depending on the index used for the analysis (kappa/PABAK, respectively). It's worth highlighting that carrying out retinographies in the primary care centers enhances patient-treatment capacity of the primary care doctors and the patients accessibility to screening. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. PubMed

    Martínez Alfonso, Julia; Pozuelo-Carrascosa, Diana P; Solera-Martínez, Montserrat; González-García, Alberto; Martínez-Vizcaíno, Vicente; Sánchez-López, Mairena; Martínez-Hernández, David

    2016-11-29

    Introducción y objetivos: los objetivos del presente estudio fueron: a) estimar la prevalencia de sobrepeso/obesidad y delgadez en escolares nacidos en 2007 y 2008 de Castilla-La Mancha, España, en los años 2013 y 2015; y b) analizar la persistencia en las mismas categorías de estatus ponderal entre 2013 y 2015 en esta cohorte de escolares.Material y métodos: estudio de seguimiento en el que se analizaron los datos antropométricos de los escolares nacidos en 2007 y 2008 en los años 2013 (4-6 años) y 2015 (6-8 años). Se invitó a participar a todos los escolares de 21 colegios de las provincias de Cuenca y Ciudad Real que cursaban tercero de Educación Infantil o primero de Educación Primaria en 2013. En todos ellos se determinaron, además de variables sociodemográficas, peso, talla y porcentaje de grasa corporal por bioimpedancia eléctrica.Resultados: la prevalencia de delgadez, sobrepeso y obesidad en la medición basal fue de 20,7%, 12% y 8,2% respectivamente. Dos años después, la prevalencia de delgadez disminuyó hasta 14,7% y la de sobrepeso y obesidad aumentó hasta 15,4% y 8,4% respectivamente. Por otro lado, el 78,8% de los escolares permanecía en 2015 en la misma categoría ponderal que en 2013.Conclusiones: el aumento en la prevalencia de sobrepeso/obesidad de los escolares parece estar remitiendo, al mismo tiempo que el incremento en la prevalencia de bajo peso ha aumentado sustancialmente. Por último, los escolares tienden a mantener el estatus ponderal previo al rebote adiposo durante la edad escolar.

  1. [Publications on primary care evaluation in Spain after twenty years of reform (1984-2004). Thematic and bibliometric analysis].

    PubMed

    de Lorenzo-Cáceres Ascanio, Antonio; Oter Puime, Angel o

    2007-01-01

    In view of the widespread opinion as to the lack of data for evaluating the results of the Primary Care reform which began in Spain in 1984, the conducting of a thematic and bibliometric analysis for the published evaluation studies is posed. The documents published within the 1984-2004 time period, located by means of systematic bibliographic search both in biomedical journals and in theses, reports or books on any of the components of Primary Care included within the proposed thematic classification and referred to scopes broader than one single healthcare center. Three complimentary search strategies were used: electronic databases, manual review of indexes and reference work quote-based searches. A total of 684 documents met the criteria for inclusion: 85% having been taken from biomedical journals, 12.3% having been doctoral theses, and 2.6% reports or books. Documents were located in 49 different journals (29 foreign), Atención Primaria (52.7%) being the journal having provided the largest number of articles. A total 12.7% of the articles were published in journals indexed in the SCI, and 8.6% in foreign journals. In 32% of the studies, the first author was working at a reformed healthcare center. Two-thirds of the evaluations revolved around the analysis of the process; the topics most often evaluated having been related to healthcare spending (pharmacy), the system organization (emergencies) and professional satisfaction. Broad-based documentation is provided with evaluations of primary care in Spain. Studies have been focused more on the evaluation of the process than on that of the results. Research in this field requires including studies not published in journals (theses and reports).

  2. [Use of glucose-lowering drugs in a primary care setting in Malaga during the years 2008-2012].

    PubMed

    Mancera-Romero, J; Hormigo-Pozo, A; Fernández-Arquero, J; Baca-Osorio, A; Aparicio-Cervantes, M J; Muñoz-González, L

    2014-01-01

    The aim of the study is to describe the pattern of use of hypoglycemic agents in a primary health care district of Málaga between the years 2008-2012. Cross-sectional descriptive study. Málaga health district. Population of 609,781 inhabitants; 42,060 people in the diabetes process. Therapeutic sub-group A10 (drugs used in diabetes). Data is presented as defined daily dose (DDD). Years 2008-2012. Measures of frequency. The population grew by 0.4% and the people included in the diabetes process, by 19%. The hypoglycemic agents have increased from 12,453,443 to 14,144,817 DDD (13.5%). Oral antidiabetics increased by 13.8% and insulin by 9.7%. Metformin is the most used oral antidiabetic (6,655,923 DDD) and the iDDP4 was the one that had increased more (from 63,882 DDD to 1,482,574). The growth in insulin use was mainly due to the long-acting (38%) and the shorter-acting one (40%). The most used insulin doses are the long-acting ones, followed by the pre-mixed. The proportion of insulin use as regards the use of ADOs has remained stable (31%)., Long-acting (36%) insulin has become the most used, followed by pre-mixed (34%), shorter-acting (16%), and the intermediate-acting (12%). There is an increase in the use of hypoglycemic agents., Metformin and iDPP4 are the antidiabetics oral with the greatest growth., There is an increase in shorter-acting and long-acting insulins with a decrease in intermediate-acting and pre-mixed., The proportion of oral antidiabetics/insulins has remained stable. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  3. [Baseline clinical characteristics and management of patients included in IBERICAN study].

    PubMed

    Barrios, V; Escobar, C; Llisterri, J L; Rodríguez Roca, G; Badimón, J J; Vergara, J; Prieto, M Á; Serrano, A; Cinza, S; Murillo, C

    2015-01-01

    To determine the prevalence and incidence of cardiovascular risk factors and cardiovascular events in Spain, as well as the quality of the follow-up in clinical practice. In this study the baseline data of the first interim analysis of IBERICAN are shown (n=830). IBERICAN is a multicenter, longitudinal and observational population-based study of patients daily attended in primary care setting according to clinical practice in Spain. Subjects between 18 and 85 years daily attended in primary care setting are being included consecutively. Treatment of patients will be performed according only to clinical criteria of investigators. Blood pressure control was defined according to 2013 European guidelines of hypertension; LDL-cholesterol control was defined according to 2012 European guidelines of cardiovascular prevention; diabetes control was defined as HbA1c<7%. Mean age was 57.9±14.1 years. 54.1% of patients had dyslipidemia, 47.5% hypertension, 17.7% diabetes, and 10.8% history of ischemic heart disease. Regarding drugs, despite 55% of hypertensive patients were taking≥2 antihypertensive agents, only 59.9% achieved blood pressure targets; 65.7% of patients with dyslipidemia were taking statins, but only 35.6% attained LDL-cholesterol goals. Only 51.4% of diabetics achieved HbA1c goals. Subjects attended in primary care showed a high prevalence of cardiovascular risk factors with a poor control. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  4. [Prevalence of abdominal aortic aneurysm in a rural population of 65-80 year-old males].

    PubMed

    Salcedo Jódar, L; Alcázar Carmona, P; Tenías Burillo, J M; García Tejada, R

    2014-01-01

    The prevalence of aortic aneurysm (AAA) is reported to be 3.55%-4% in men over 65. But it is not known if this prevalence, resulting from ultrasound measurements made by Family Physicians, can be extrapolated to a rural population. To estimate the prevalence of AAA in a rural population of males aged 65-80 years, using abdominal ultrasound by family physicians, and to identify its association with different cardiovascular risk factors. A cross sectional study was conducted that included males of 65-80 years (n=320) in a rural population of the province of Ciudad Real, Spain. The dependent variable was the presence or not of AAA using ultrasound measurements of the aorta. Those with a diameter greater than or equal to 3cm were considered positive. Explanatory variables were measured; ankle/brachial index (ABI), body mass index (BMI), medical history of high blood pressure (hypertension), diabetes mellitus (DM), dyslipidaemia (DLP), ischemic heart disease, cerebrovascular accidents (CVA), and smoking habits. A bivariate and multivariate analysis of the prevalences was performed, as well as a study of the agreement between observers. The prevalence of AAA in the population was 3.3% (95% CI: 1.1-5.5%. DM and DLP were significantly associated with AAA. The agreement between observers was 0.96 (95% CI; 0.91-0.98). The high prevalence of different cardiovascular risk factors (CVRF) was particularly noteworthy. The prevalence of AAA in 65-80 year-old males in a rural population is similar to that found in the literature. Due to the cross-sectional nature of the study, CVRFs such as hypertension or CVA were not associated with the AAA. A screening program for the early detection of AAA could be introduced into Primary Health Care by family physicians. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  5. [Prevalence and factors associated with peripheral artery disease in patients with type 2 diabetes mellitus in Primary Care].

    PubMed

    Montero-Monterroso, J L; Gascón-Jiménez, J A; Vargas-Rubio, M D; Quero-Salado, C; Villalba-Marín, P; Pérula-de Torres, L A

    2015-01-01

    Peripheral artery disease in the lower limbs (PAD) is a prevalent condition that entails high morbidity in diabetic patients; this study assesses PAD in these patients and its socio-demographic and clinic associated variables. Descriptive study in a systematic sample of diabetic patients (DM2) aged 50-80 years, in Primary Care settings. The dependent variable was the presence of PAD diagnosed by ankle-brachial index (ABI) ≤ 0.9; independent variables: socio-demographic, clinical and laboratory. bivariate and multiple logistic regression analyses were performed to determine the variables associated with low ABI. A sample of 251 patients, 52.6% women; mean age: 68.5 ±8.5. A low ABI was detected in 18.3% (95% Confidence Interval (95% CI):13.3-23.3%), with 6 subjets (2.4%) previously diagnosed as suffering PAD. Age (OR=1.07; 95% CI: 1.02-1.12) and retinopathy (OR=2.69; 95% CI: 1.06-6.81) were associated (multiple logistic regression analysis) with ABI. The percentage of patients diagnosed with PAD is very low, although PAD prevalence is high among DM2 patients attending Primary Care clinics, especially in older patients and those with retinopathy. We emphasize the recommendation of performing the ABI test in this population at risk. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Baseline characteristics and clinical management of the first 3,000 patients enrolled in the IBERICAN study (Identification of the Spanish population at cardiovascular and renal risk)].

    PubMed

    Cinza Sanjurjo, Sergio; Prieto Díaz, Miguel Ángel; Llisterri Caro, José Luis; Pallarés Carratalá, Vicente; Barquilla García, Alfonso; Rodríguez Padial, Luis; Díaz Rodríguez, Ángel; Polo García, José; Vergara Martín, Jesús; Vidal Pérez, Rafael; Rodríguez Roca, Gustavo Cristóbal

    2016-08-23

    To determine the prevalence and incidence of cardiovascular risk factors in Spain, as well as cardiovascular events, in Spanish adult population attended in primary care. IBERICAN is a longitudinal, observational, multicenter study in which patients aged 18 to 85years attended in primary care health center in Spain are being included. The obtained cohort will be followed annually for at least 5years. The estimated final sample is 7,000 patients. The baseline characteristics of the second cut (n=3,042) are presented. The mean age of the subjects included is 57.9±14.6 years, and 55.5% are women. 54.9% live in urban habitat, and 57.3% have primary education. 50.3% had dyslipidemia, 47.4% hypertension, 29.7% physical inactivity, 28.2% abdominal obesity and 19% diabetes mellitus. The degree of control of hypertension, dyslipidemia and type2 diabetes was 58.5%, 25.8% and 75.9%. 28.2% have criteria for metabolic syndrome. 15.6% of patients had previous cardiovascular disease. 7.8% have a history of coronary heart disease, a glomerular filtration rate <60ml/min (CKD-EPI) 8.4%, microalbuminuria 9.6%, atrial fibrillation 5.5%, stroke 4.6%, and heart failure 2.9%. Although the population treated in primary care is relatively young, the high prevalence of risk factors, their poor control and the existence of previous cardiovascular disease will determine the impact on the prognosis of the cohort. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Cardiovascular risk factors in chronic treatment with antipsychotic agents used in primary care.

    PubMed

    Mundet-Tudurí, Xavier; Iglesias-Rodal, Manuel; Olmos-Domínguez, Carmen; Bernard-Antoranz, M Lluïsa; Fernández-San Martín, M Isabel; Amado-Guirado, Ester

    2013-12-01

    Objetivo. Comparar la prevalencia de factores de riesgo cardiovascular (FRCV) y eventos vasculares en pacientes tratados con antipsicoticos, comparandolos con los no tratados. Sujetos y metodos. Estudio descriptivo transversal de pacientes atendidos en atencion primaria de la ciudad de Barcelona y tratados con antipsicoticos entre el 2008 y el 2010, comparandolos con una poblacion no tratada. Se registraron las variables antropometricas y clinicas y los FRCV. Se estudio por separado a pacientes adultos y ancianos, y a los tratados con antipsicoticos tipicos y atipicos. Resultados. Un total de 14.087 pacientes habian sido tratados con antipsicoticos (63,4% atipicos). El mas prescrito fue la risperidona. Se aparejaron 13.724 pacientes de la misma edad y genero, pero no tratados (n total = 27.811). Los tratados con antipsicoticos presentaron una prevalencia superior de obesidad (16,9% frente a 10,6%), tabaquismo (22,2% frente a 11,1%), diabetes mellitus (16% frente a 11,9%) y dislipemia (32,8% frente a 25,8%) (p < 0,001). La prevalencia de accidente vascular cerebral fue significativamente superior entre los tratados, tanto en los adultos (odds ratio = 2,33) como en los ancianos (odds ratio = 1,64). La prevalencia de cardiopatia isquemica fue similar en ambos grupos (odds ratio = 0,97). No se observaron diferencias significativas entre los tratados con un antipsicotico tipico o atipico. Conclusiones. Los pacientes tratados con antipsicoticos presentaron una mayor prevalencia de FRCV (diabetes, obesidad y tabaquismo). La presencia de ictus fue superior entre los tratados con antipsicoticos. No se detectaron diferencias importantes entre los pacientes tratados con antipsicoticos tipicos y atipicos.

  8. Ascertainment of acute liver injury in two European primary care databases.

    PubMed

    Ruigómez, A; Brauer, R; Rodríguez, L A García; Huerta, C; Requena, G; Gil, M; de Abajo, Francisco; Downey, G; Bate, A; Tepie, M Feudjo; de Groot, M; Schlienger, R; Reynolds, R; Klungel, O

    2014-10-01

    The purpose of this study was to ascertain acute liver injury (ALI) in primary care databases using different computer algorithms. The aim of this investigation was to study and compare the incidence of ALI in different primary care databases and using different definitions of ALI. The Clinical Practice Research Datalink (CPRD) in UK and the Spanish "Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria" (BIFAP) were used. Both are primary care databases from which we selected individuals of all ages registered between January 2004 and December 2009. We developed two case definitions of idiopathic ALI using computer algorithms: (i) restrictive definition (definite cases) and (ii) broad definition (definite and probable cases). Patients presenting prior liver conditions were excluded. Manual review of potential cases was performed to confirm diagnosis, in a sample in CPRD (21%) and all potential cases in BIFAP. Incidence rates of ALI by age, sex and calendar year were calculated. In BIFAP, all cases considered definite after manual review had been detected with the computer algorithm as potential cases, and none came from the non-cases group. The restrictive definition of ALI had a low sensitivity but a very high specificity (95% in BIFAP) and showed higher rates of agreement between computer search and manual review compared to the broad definition. Higher incidence rates of definite ALI in 2008 were observed in BIFAP (3.01 (95% confidence interval (CI) 2.13-4.25) per 100,000 person-years than CPRD (1.35 (95% CI 1.03-1.78)). This study shows that it is feasible to identify ALI cases if restrictive selection criteria are used and the possibility to review additional information to rule out differential diagnoses. Our results confirm that idiopathic ALI is a very rare disease in the general population. Finally, the construction of a standard definition with predefined criteria facilitates the timely comparison across databases.

  9. Hip/femur fractures associated with the use of benzodiazepines (anxiolytics, hypnotics and related drugs): a methodological approach to assess consistencies across databases from the PROTECT-EU project.

    PubMed

    Requena, Gema; Huerta, Consuelo; Gardarsdottir, Helga; Logie, John; González-González, Rocío; Abbing-Karahagopian, Victoria; Miret, Montserrat; Schneider, Cornelia; Souverein, Patrick C; Webb, Dave; Afonso, Ana; Boudiaf, Nada; Martin, Elisa; Oliva, Belén; Alvarez, Arturo; De Groot, Mark C H; Bate, Andrew; Johansson, Saga; Schlienger, Raymond; Reynolds, Robert; Klungel, Olaf H; de Abajo, Francisco J

    2016-03-01

    Results from observational studies may be inconsistent because of variations in methodological and clinical factors that may be intrinsically related to the database (DB) where the study is performed. The objectives of this paper were to evaluate the impact of applying a common study protocol to study benzodiazepines (BZDs) (anxiolytics, hypnotics, and related drugs) and the risk of hip/femur fracture (HFF) across three European primary care DBs and to investigate any resulting discrepancies. To measure the risk of HFF among adult users of BZDs during 2001-2009, three cohort and nested case control (NCC) studies were performed in Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria (BIFAP) (Spain), Clinical Practice Research Datalink (CPRD) (UK), and Mondriaan (The Netherlands). Four different models (A-D) with increasing levels of adjustment were analyzed. The risk according to duration and type of BZD was also explored. Adjusted hazard ratios (cohort), odds ratios (NCC), and their 95% confidence intervals were estimated. Adjusted hazard ratios (Model C) were 1.34 (1.23-1.47) in BIFAP, 1.66 (1.54-1.78) in CPRD, and 2.22 (1.55-3.29) in Mondriaan in cohort studies. Adjusted odds ratios (Model C) were 1.28 (1.16-1.42) in BIFAP, 1.60 (1.49-1.72) in CPRD, and 1.48 (0.89-2.48) in Mondriaan in NCC studies. A short-term effect was suggested in Mondriaan, but not in CPRD or BIFAP. All DBs showed an increased risk with the concomitant use of anxiolytic and hypnotic drugs. Applying similar study methods to different populations and DBs showed an increased risk of HFF in BZDs users but differed in the magnitude of the risk, which may be because of inherent differences between DBs. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Cardioprotective aspirin users and their excess risk of upper gastrointestinal complications.

    PubMed

    Hernández-Díaz, Sonia; García Rodríguez, Luis A

    2006-09-20

    To balance the cardiovascular benefits from low-dose aspirin against the gastrointestinal harm caused, studies have considered the coronary heart disease risk for each individual but not their gastrointestinal risk profile. We characterized the gastrointestinal risk profile of low-dose aspirin users in real clinical practice, and estimated the excess risk of upper gastrointestinal complications attributable to aspirin among patients with different gastrointestinal risk profiles. To characterize aspirin users in terms of major gastrointestinal risk factors (i.e., advanced age, male sex, prior ulcer history and use of non-steroidal anti-inflammatory drugs), we used The General Practice Research Database in the United Kingdom and the Base de Datos para la Investigación Farmacoepidemiológica en Atención Primaria in Spain. To estimate the baseline risk of upper gastrointestinal complications according to major gastrointestinal risk factors and the excess risk attributable to aspirin within levels of these factors, we used previously published meta-analyses on both absolute and relative risks of upper gastrointestinal complications. Over 60% of aspirin users are above 60 years of age, 4 to 6% have a recent history of peptic ulcers and over 13% use other non-steroidal anti-inflammatory drugs. The estimated average excess risk of upper gastrointestinal complications attributable to aspirin is around 5 extra cases per 1,000 aspirin users per year. However, the excess risk varies in parallel to the underlying gastrointestinal risk and might be above 10 extra cases per 1,000 person-years in over 10% of aspirin users. In addition to the cardiovascular risk, the underlying gastrointestinal risk factors have to be considered when balancing harms and benefits of aspirin use for an individual patient. The gastrointestinal harms may offset the cardiovascular benefits in certain groups of patients where the gastrointestinal risk is high and the cardiovascular risk is low.

  11. The prevalence of overweight and obesity in adolescents in Bahia, Brazil.

    PubMed

    Ferreira Marques, Cibele Dantas; Ribeiro Silva, Rita de Cássia; Machado, Maria Ester C; Portela de Santana, Mônica Leila; Castro de Andrade Cairo, Romilda; Pinto, Elizabete de Jesus; Oliveira Reis Maciel, Leonardo; Rodrigues Silva, Luciana

    2013-01-01

    Objetivo: Un estudio transversal se llevó a cabo con 1477 estudiantes de primaria matriculados en las escuelas públicas de Salvador, Bahía, Brasil, para evaluar la prevalencia del sobrepeso y la obesidad. Métodos: La muestra se determinó por la técnica de muestreo por conglomerados en dos etapas para la selección de escuelas y clases. Más tarde, posteriori error se calculó. Los estudiantes fueron clasificados como sobrepeso u obesos de acuerdo con la clasificación de la Organización Mundial de la Salud, 2007. Ellos también fueron clasificados de acuerdo a la edad, la etapa de maduración sexual, y la presencia de obesidad abdominal. Resultados: En general, el 9,3% de los estudiantes tenían sobrepeso y el 6,4% eran obesos, por lo tanto, el 15,7% de los alumnos se considera que tienen exceso de peso (sobrepeso + obesidad), con un intervalo de confianza del 95%. De la población total estudiada el 12,9% presentaron obesidad abdominal, esta condición se observa en el 13% de su peso normal. Se encontró asociación entre el sobrepeso y la edad < 14 AÑOs (p = 0,030) y obesidad abdominal (p = 0,001). Conclusiones: Los programas de intervención deben ser implementados para prevenir y tratar la obesidad en la infancia y la adolescencia. Además, los profesionales que trabajan con las personas en este grupo de edad deben ser sensibles a este problema. La necesidad de estandarizar los indicadores antropométricos utilizados en los diferentes estudios se enfatiza también.

  12. [Spanish interdisciplinary committee for cardiovascular disease prevention and the spanish society of cardiology position statement on dyslipidemia management. Differences between the European and american guidelines].

    PubMed

    Lobos Bejarano, José María; Galve, Enrique; Royo-Bordonada, Miguel Ángel; Alegría Ezquerra, Eduardo; Armario, Pedro; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Cordero Fort, Alberto; Maiques Galán, Antonio; Mantilla Morató, Teresa; Pérez Pérez, Antonio; Pedro-Botet, Juan; Villar Álvarez, Fernando; González-Juanatey, José Ramón

    2015-04-01

    The publication of the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of high blood cholesterol has had a strong impact due to the paradigm shift in its recommendations. The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention and the Spanish Society of Cardiology reviewed this guideline and compared it with current European guidelines on cardiovascular prevention and dyslipidemia management. The most striking aspect of the American guideline is the elimination of the low-density lipoprotein cholesterol treat-to-target strategy and the adoption of a risk reduction strategy in 4 major statin benefit groups. In patients with established cardiovascular disease, both guidelines recommend a similar therapeutic strategy (high-dose potent statins). However, in primary prevention, the application of the American guidelines would substantially increase the number of persons, particularly older people, receiving statin therapy. The elimination of the cholesterol treat-to-target strategy, so strongly rooted in the scientific community, could have a negative impact on clinical practice, create a certain amount of confusion and uncertainty among professionals, and decrease follow-up and patient adherence. Thus, this article reaffirms the recommendations of the European guidelines. Although both guidelines have positive aspects, doubt remains regarding the concerns outlined above. In addition to using risk charts based on the native population, the messages of the European guideline are more appropriate to the Spanish setting and avoid the possible risk of overtreatment with statins in primary prevention. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. [Importance of the detection of dysphagia in geriatric patients].

    PubMed

    Zamora Mur, A; Palacín Ariño, C; Guardia Contreras, A I; Zamora Catevilla, A; Clemente Roldán, E; Santaliestra Grau, J

    2017-04-27

    Oropharyngeal dysphagia is one of the lesser known geriatric syndromes, despite its enormous impact on functional capacity, quality of life, and health of those affected. A descriptive and prospective study was conducted by the Geriatric Department of Barbastro Hospital (Huesca), from March 2012 to October 2014, as biannual and annual reviews in October 2015. This study included all patients on whom a volume-viscosity clinical examination (MECV-V test) was performed to suspecting dysphagia. The study included 266 patients with a mean age of 82.35±12.3 years, and with a mean Barthel index score of 20.5±25.4, and mean Charlson index of 1.77±1.6. The test was performed in 105 cases after stroke (40%), 53 in dementia (20%), 24 in Parkinsonism (9%), and for other different reasons in 80 (31%). Dysphagia was diagnosed in 228 (86%) cases. Enteral nutrition was given in 25 (10.9%) cases. The test results were shown in the discharge report in 45% of the tests with positive result. The mean survival obtained after test in the patients who died was 230.8±256.5 days. Differences in survival at 12 months were found in patients with positive test, without finding a clear relationship with functional status and comorbidity. Dysphagia has a significant mortality, and the use of thickeners after its detection should be properly reported. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. OVERWEIGHT OBESITY AND CARDIOVASCULAR RISK IN MENOPAUSAL TRANSITION.

    PubMed

    Villaverde Gutiérrez, Carmen; Ramírez Rodrigo, Jesús; Olmedo Alguacil, Maria Milagrosa; Sánchez Caravaca, Maria Angeles; Argente del Castillo Lechuga, Maria Josefa; Ruiz Villaverde, Alberto

    2015-10-01

    Introducción: el declive hormonal característico de la menopausia, junto al aumento ponderal añadido, está considerado como un factor determinante de riesgo cardiovascular. Propósito: examinar la situación ponderal en relación con la sintomatología clínica, durante la transición menopáusica, en mujeres derivadas desde atención primaria a la especialidad de endocrinología, para describir los posibles perfiles de riesgo cardiovascular. Método: se realizó un diseño observacional, analítico, de corte transversal, con los datos registrados en las historias clínicas en el momento de la derivación. 805 mujeres con 40 y más años de edad disponían de los registros necesarios para la estimación del riesgo cardiovascular. Resultados: la agrupación jerárquica distingue cuatro grupos. La frecuencia de obesidad en todos ellos superó el 60%, observándose los mayores promedios de riesgo cardiovascular en las mujeres de mayor edad y elevada frecuencia de obesidad e hipertensión arterial. En los grupos de menor edad, la estimación del riesgo fue baja, incrementándose hasta niveles similares a los de mayor edad, al proyectarlo a 65 años. Conclusión: estos resultados sugieren la necesidad de un seguimiento preventivo y terapéutico de la obesidad y los factores de riesgo modificables durante la transición menopáusica, para reducir el riesgo atribuible a dichos factores con el paso de los años.

  15. [Knowledge and prevention management of vitamin D deficiency in primary care].

    PubMed

    Senan Sanz, M R; Gilaberte Calzada, Y; Olona Tabueña, N; Magallón Botaya, R

    2014-01-01

    To determine the knowledge and management of vitamin D (Vit D) in primary care (PC). Observational study. A total of 69 primary care centres, with 57 in Barcelona and 12 in Huesca. All medical and nursing graduates of these centres. A specifically designed questionnaire was used to collect knowledge on the actions of Vit D (on bone metabolism, cardiovascular and immune systems), its deficiency and prevention measures. Of the total of 2100 professionals, 785 completed the survey (37.78%), of whom 79.9% were women. Their mean age was 47 years (SD: 9.7). Only 4.8% knew the overall actions of Vitamin D, although the majority (66%) knew only its effects on bone metabolism. Almost two-thirds (62.4%) were unaware that its deficiency was a common problem, and 54.9% believed that photoprotection was contraindicated. Almost three-quarters of those surveyed (73.6%) never or almost never determined Vit D levels in their patients. A minority (23%) offered advice to maintain an adequate level of Vit D, with the most frequent being sun exposure (16.8%). Pediatricians were more knowledgeable (p<.001) and offered more advice for maintaining adequate levels of Vit D in blood (p<.001). Most of the professionals were unaware of the overall actions of Vit D, or that its deficiency was common, or the factors contributing to this. The advice that was more often offered to avoid its deficiency was not the safest. Paediatricians are more aware of how to prevent Vit D deficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. [Reliability of a chronic obstructive pulmonary disease diagnosis register in Primary Care].

    PubMed

    Garrastazu, R; García-Rivero, J L; Ruiz-Nuñez, M; Helguera, J M; Arenal, S; Bonnardeux, C; León, C; Miravitlles, M; Santibañez, M

    One of main limitations in studies of COPD in health databases could be the low quality of the information. Our first aim was evaluate reliability of the registry of COPD diagnosis register in Primary Care. A description and comparison is also presented of the characteristics of the patients according to the diagnostic confirmation. A cross-sectional study using healthcare databases of Cantabria. A pre-selected sample of 1,457 patients was obtained in which COPD diagnosis was specifically registered. COPD confirmation was classified into confirmed COPD, not confirmed-not rejected COPD, and diagnostic error (over-diagnosis). Descriptive and clinical characteristics, comorbidities, and treatments were collected in each group. COPD was confirmed in 766 patients: 52.6% (95%CI: 49.9-55.2). Prevalence of over-diagnosis was 7.2% (95%CI: 5.9-8.6). There were statistically significant gender differences. In the COPD confirmed group age, tobacco consumption and severity according to FEV1 was higher. An average of 1.95 bronchial exacerbations during the last 4years was observed among diagnostic errors. Inhaled corticosteroids were prescribed in 74.9% of COPD confirmed patients, and in 41.9% of over-diagnosed patients. The reliability of the COPD register was deficient, with only 52.6% with a confirmed diagnosis. Stable treatment for COPD was prescribed in all groups, highlighting the use of inhaled corticosteroids. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Level at which control objectives are reached in patients in different population groups with type 2 diabetes].

    PubMed

    Herrero, A; Pinillos, J; Sabio, P; Martín, J L; Garzón, G; Gil, Á

    2016-11-23

    There is evidence of increased macro- and micro-vascular risk in diabetic patients. The objective of this study was to determine the level of control in patients in different population groups with type 2 diabetes. Descriptive cross-sectional study. Primary care. Madrid Health Service. Year: 2014. Patients over 14 years with type 2 diabetes. Number of patientes: n=6674. Variables on the degree of control (HbA1c, systolic blood pressure [SBP], diastolic blood pressure [DBP], LDL-c) and variables on patient characteristics (demographic, other cardiovascular risk factors, complications). The mean age of patients with controlled HbA1c was 67.8 years vs. 62.9 years in the uncontrolled (P<.001). Patients diagnosed with hypertension have a higher percentage of control with respect to the undiagnosed in HbA1c, SBP, DBP and LDL-c: 51 vs. 37%, 62 vs. 43%, 75 vs. 47% and 57 vs. 44% respectively; diagnosed with dyslipidaemia: 51 vs. 39%, 60 vs. 49%, 70 vs. 56% and 56 vs. 46%. With a diagnosis of macroangiopathy: 46 vs. 45%, 58 vs. 54%, 71 vs. 62% and 15 vs. 60%. All differences were statistically significant (P<.001). Over 50% of patients without a diagnosis of hypertension had an SBP> 140mmHg or DBP> 90mmHg. Over 25% of patients with hypertension or DL and uncontrolled levels were not receiving drug treatment. Control was improved in all groups, especially in younger patients, with particularly high cardiovascular risk by the presence of other cardiovascular risk factors or macroangiopathy. A significant percentage of patients with uncontrolled BP and cLDL were not diagnosed or receiving drug treatment. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. [Palliative care needs in the inmobilized population of a Primary Care area in Vigo Spain].

    PubMed

    Ferraz-Falcao, J R; Cadaval-Rodríguez, T; Rodríguez-Iglesia, R M; del Campo-Pérez, V M

    2015-09-01

    To determine palliative care needs in a sample of people with mobility problems in the area of the C.S. Matama by using the NECPAL instrument (identification and integral-integrated care of people with advanced chronic diseases in social and healthcare provision services). Descriptive and cross-sectional study of patients immobilized in a health centre in Vigo (87 subjects overall). The average age of our patients is 84.34 years and 82% are women. The most frequent immobilization type was the patient's inability to leave their home (64%). The result of this test was positive in 38% of cases (33 patients), most of whom have chronic diseases and only 1 patient has been diagnosed with cancer. There is a significant negative association between the score obtained on the Barthel scale and the ratio of positives to the test. Concerning the use of resources there are important differences regarding hospital admissions and PHC depending on the outcome of the test. These differences were statistically significant with regard to PHC and emergency consultations. An immobilized patient is not synonymous with a patient in need of palliative care; the tool used has been proved to be useful to detect this need, which concerns a third of our patients. The results of the questionnaire of need for care palliative (NECPAL) relate well to the basic activities of daily living (Barthel scale score) and to indicators of use of health services. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Pain and workplace. Sociodemographic variables influence in therapeutic response and labor productivity].

    PubMed

    Vicente-Herrero, M T; López-González, Á A; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; Terradillos García, M J; Aguilar Jiménez, E

    2016-09-01

    Pain is a major cause of medical consultation. The complexity of managing it is due to its long duration and intensity, and it sometimes requires a combination of multiple drugs. The objective of this study is to assess the use of drugs for pain in workers, the clinical response obtained, its influence on estimating work productivity, its relationship to sociodemographic variables, and the type of drug used. A cross-sectional study on 1,080 workers, aged 18-65 years, during periodic surveys to monitor their health in companies in the service sector in Spain. Treatments used, clinical efficacy, influence on work productivity and sociodemographic variables (age, gender) are evaluated. The Brief Pain Inventory questionnaire, validated for Spain, was used to assess pain, and the SPSS(®) 20.0 package for the statistical analysis. NSAIDs and simple analgesics have higher percentages of improvement in pain (P=.032 and P<.0001, respectively). Men respond better to NSAIDs, and women to simple analgesics. Improved productivity is higher in men than in women (P=.042). No significant differences were observed for age, pain improvement or productivity, except in those over 55 years. The analgesic prescription pain conditions must consider the age and gender of the patient, as well as the type of drug. The choice of drug should be based on the aetiology and aspects unrelated to the clinical variables, such as sociodemographic, work or psychosocial. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Consensus on hereditary cancer between the Spanish Oncology Society and the primary care societies].

    PubMed

    Robles, L; Balmaña, J; Barrel, I; Grandes, S; Graña, B; Guillén, C; Marcos, H; Ramírez, D; Redondo, E; Sánchez, J

    2013-01-01

    It is believed that 5% of all cancers are hereditary, on being caused by mutations in the germinal line in cancer susceptibility genes. The hereditary pattern in the majority of cases is autosomal dominant. Genetic tests are only recommended to individuals whose personal or family history is highly suggestive of a hereditary cancer. The appropriate assessment of these individuals and their families must be performed in Cancer Genetic Counselling Units (UCGC). Representatives of the Spanish Medical Oncology Society (Sociedad Española de Oncología Médica [SEOM]) and the three primary care scientific societies: Spanish Society of Family and Community Medicine (Sociedad Española de Medicina de Familia y Comunitaria [SEMFyC]), Spanish Society of Primary Care Physicians (Sociedad Española de Médicos de Atención Primaria [SEMERGEN]) and the Spanish Society of General and Family Doctors (Sociedad Española de Médicos Generales y de Familia [SEMG]), met to prepare this consensus document on hereditary cancer. The consensus identified the three main aspects: how to identify subjects at risk of hereditary cancer; how to refer to a UCGC; and the usefulness of the assessment and genetic studies. A document, with the text fully agreed by all the participants, has been prepared. It contains a summary of the principal characteristics of the care for individuals with hereditary cancer. It shows how to; identify them, assess them, refer them to a UCGC. How to assess their genetic risk, perform genetic studies, as well as prevention measures and reduction of the risk is also presented. This consensus document is a landmark in the relationships with several Scientific Societies that represent the professionals who provide care to individuals with cancer and their families, and will help to improve care in hereditary cancer in Spain. Copyright © 2013. Publicado por Elsevier España.