Articles publicats (Medicina i Cirurgia)

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    Open Access
    Factors associated with influenza immunization in primary care health workers
    (Elsevier, 2015) Montserrat i Capdevila, Josep; Godoy i García, Pere; Marsal Mora, Josep Ramon; Barbé Illa, Ferran
    Objetivo: Conocer la cobertura vacunal antigripal en profesionales de atención primaria y determinar los factores asociados a la vacunación (temporada 2013-2014). Métodos: Estudio transversal realizado a 287 profesionales que cumplimentaron un cuestionario que incluía preguntas sobre conocimientos, creencias y actitudes frente la gripe y la vacunación. Se determinó la cobertura y aquellas variables asociadas a recibir la vacunación, utilizando modelos de regresión logística no condicional. Resultados: La participación fue del 47,2%. La cobertura vacunal fue del 60,3%; fue mayor en los profesionales > 55 años de edad, mujeres y pediatras. Factores asociados a recibirla fueron la percepción de que la vacunación protege la propia salud (odds ratio ajustada [ORa]: 11,1; intervalo de confianza del 95% [IC95%]: 3,41-35,9) y de que es efectiva (ORa: 7,5; IC95%: 0,9-59,3). No se halló asociación entre la vacunación y el conocimiento sobre la gripe y la vacunación, pero sí para prescribirla en gestantes, en > 65 años y en inmunodeprimidos. Conclusiones: Se recomienda diseñar estrategias para aumentar la cobertura, basadas en cambiar actitudes negativas frente a la vacunación.
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    Open Access
    Impacto de la COVID-19 en la salud mental de la población: estudio en atención primaria
    (2023-11-30) Montserrat i Capdevila, Josep; Fornells Barberà, Immaculada; Roso-Llorach, Albert; Olivares Sanzo, Pau; Romero Gracia, Albert; Ichart Tomás, José Javier
    Objetivo: Principales: determinar la prevalencia y las características de los pacientes con COVID-19, y la incidencia del trastorno mental asociado a la infección y los factores de riesgo. Secundarios: conocer la prevalencia y las características de los afectados de COVID persistente. Diseño: Estudio de incidencia del trastorno mental en los pacientes diagnosticados de COVID-19, y estudio de casos y controles del síndrome de COVID persistente en la submuestra de pacientes diagnosticados de COVID-19, sin antecedente de trastorno mental. Emplazamiento: Atención Primaria de la Región Sanitaria de Lleida. Participantes: Se incluyeron 46.258 pacientes diagnosticados de COVID-19 sin antecedente de trastorno mental. Mediciones principales: La variable dependiente fue el desarrollo de trastorno mental (ansiedad, trastorno del estado de ánimo, trastorno adaptativo e insomnio) en el periodo de estudio (11/03/2020 a 11/03/2022) y las independientes variables clínicas y sociofamiliares. Se analizó su asociación con el desarrollo del trastorno mental mediante el cálculo de las hazard ratio ajustadas a un modelo de regresión logística. Resultados: La edad media ± desviación estándar de los 46.258 pacientes incluidos fue de 43 ± 17,9 años. El 47% eran mujeres. El 3,46% desarrollaron algún trastorno mental (59,20% ansiedad). El síndrome de «COVID persistente» se manifestó más en las mujeres de edad mayor, sin hábitos tóxicos, con obesidad y comorbilidad asociada. Conclusiones: La COVID-19 ha generado impacto en la salud mental de los pacientes. Conocer los factores de riesgo para los trastornos mentales y para el síndrome de «COVID persistente» permitiría al clínico identificar a los pacientes susceptibles de recibir medidas preventivas y evitar su aparición.
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    Open Access
    Epidemiology of Psoriasis. A Population-Based Study
    (2019) Fernández Armenteros, José Manuel; Gómez Arbonés, Javier; Buti, Miquel; Betriu i Bars, M. Àngels; Sanmartín Novell, Verònica; Ortega Bravo, Marta; Martínez Alonso, Montserrat; Casanova i Seuma, Josep M. (Josep Manel)
    BACKGROUND AND OBJECTIVES: Psoriasis is a chronic immunoinflammatory skin disease very frequent in the western world. Several authors have tried to calculate its prevalence in different regions, although most of them obtained the data from surveys and there are few publications from Mediterranean areas. The objective of our study was to analyze the prevalence and severity of psoriasis in Lleida (a northeastern region in Spain), identify age and sex specific differences and compare our results with other European series. MATERIALS AND METHODS: A joint database of primary care medicine and the dermatology department was obtained from the entire province of Lleida with epidemiological data and psoriasis diagnosis and treatment codification. RESULTS: A corrected database was obtained with 398,701 individuals and 6,868 of them (1.72%) were coded with the diagnosis of psoriasis. The prevalence was significantly higher in men than in women (1.88% vs 1.56%, OR=1.21, 95% CI: 1.15-1.27). The highest prevalence of psoriasis was found in the 61-70 years group (2.90%) and psoriasis in population under 18 years of age was 0.30%. In our sample, 7.27% of the patients were classified as moderate-severe psoriasis (499/6,868). CONCLUSION: This study reports the prevalence and severity of psoriasis in a large Mediterranean region sample, obtaining the information through a electronic database. This study reveals a lower prevalence of psoriasis compared to other European countries, and the proportion of severe psoriasis (based on treatment criteria) is lower than in other studies. We emphasize that these differences could probably due to genetic background, life style and diet. Copyright © 2018 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved. KEYWORDS: Epidemiology; Epidemiología; Poblacional; Population; Prevalence; Prevalencia; Psoriasis
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    Open Access
    Implementing Mobile Health-Enabled Integrated Care for Complex Chronic Patients: Patients and Professionals' Acceptability Study
    (2020) Batlle Garcia, Jordi de; Massip, Mireia; Vargiu, Eloisa; Nadal Braque, Núria; Fuentes Botargues, Araceli; Ortega Bravo, Marta; Colomina, Jordi; Drudis Morell, Reis; Torra, Montserrat; Pallisó i Folch, Francesc; Miralles, Felip; Barbé Illa, Ferran; Torres, Gerard
    Background: Integrated care (IC) can promote health and social care efficiency through prioritization of preventive patient-centered models and defragmentation of care and collaboration across health tiers, and mobile health (mHealth) can be the cornerstone allowing for the adoption of IC. Objective: This study aims to assess the acceptability, usability, and satisfaction of an mHealth-enabled IC model for complex chronic patients in both patients and health professionals. Methods: As part of the CONNECARE Horizon 2020 project, a prospective, pragmatic, 2-arm, parallel, hybrid effectiveness-implementation trial was conducted from July 2018 to August 2019 in a rural region of Catalonia, Spain. Home-dwelling patients 55 years and older with chronic conditions and a history of hospitalizations for chronic obstructive pulmonary disease or heart failure (use case [UC] 1), or a scheduled major elective hip or knee arthroplasty (UC2) were recruited. During the 3 months, patients experienced an mHealth-enabled IC model, including a self-management app for patients, a set of integrated sensors, and a web-based platform connecting professionals from different settings or usual care. The Person-Centered Coordinated Care Experience Questionnaire (P3CEQ) and the Nijmegen Continuity Questionnaire (NCQ) assessed person-centeredness and continuity of care. Acceptability was assessed for IC arm patients and staff with the Net Promoter Score (NPS) and the System Usability Scale (SUS). Results: The analyses included 77 IC patients, 58 controls who completed the follow-up, and 30 health care professionals. The mean age was 78 (SD 9) years in both study arms. Perception of patient-centeredness was similarly high in both arms (usual care: mean P3CEQ score 16.1, SD 3.3; IC: mean P3CEQ score 16.3, SD 2.4). IC patients reported better continuity of care than controls (usual care: mean NCQ score 3.7, SD 0.9; IC: mean NCQ score 4.0, SD 1; P=.04). The scores for patient acceptability (UC1: NPS +67%; UC2: NPS +45%) and usability (UC1: mean SUS score 79, SD 14; UC2: mean SUS score 68, SD 24) were outstanding. Professionals' acceptability was low (UC1: NPS -25%; UC2: NPS -35%), whereas usability was average (UC1: mean SUS score 63, SD 20; UC2: mean SUS score 62, SD 19). The actual use of technology was high; 77% (58/75) of patients reported physical activity for at least 60 days, and the ratio of times reported over times prescribed for other sensors ranged from 37% for oxygen saturation to 67% for weight. Conclusions: The mHealth-enabled IC model showed outstanding results from the patients' perspective in 2 different UCs but lacked maturity and integration with legacy systems to be fully accepted by professionals. This paper provides useful lessons learned through the development and assessment process and may be of use to organizations willing to develop or implement mHealth-enabled IC for older adults.
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    Open Access
    Results of a Community-Based Screening Program for Chlamydia trachomatis Genital Infection in Young People Aged 18-25 Years
    (Springer, 2023) Espies, Noemi; Fernandez , Joan; Justribo, Elena; Aramburu, Jesus; Bernet, Albert; Marquez, Alicia; Godoy i García, Pere; Yuguero Torres, Oriol
    Introduction and aim Chlamydia trachomatis (CT) cases have increased in the last decade. The aim of the study was to assess the prevalence of CT genital infection in asymptomatic, sexually active young people and determine whether a community screening program would be effective in reducing the number of cases. Methods A descriptive cross-sectional studyof consecutive inclusion of asymptomatic people aged 18-25 years between September 2021 and May 2022. Community interventions in high schools, universities, and cultural events were planned to realize the screening. Sociodemographic variables of gender, age, country of origin, and educational level, as well as sexual habits, were recorded for each patient. CT was detected via urine samples. An estimate of the prevalence of CT genital infection and its 95% confidence interval (CI) was made based on the exact binomial distribution, assuming that the sample is representative of the study population. Results A total of 628 subjects participated in the study, of whom 33 had a CT infection, giving a prevalence of 5.2% (95% CI: 3.6%, 7.3%). 93.9% of subjects with CT infection were female (p≤0.019) and 85% of the participants were Spanish nationals. Among vocational training students, the prevalence was 8.1%. Having had four or more sexual partners in the last month and in the previous year was significantly associated with CT infection (p<0.001). Conclusion Screening for CT genital infection in young sexually active women should be implemented in our country, as recommended by the various guidelines.