Sociodemographic factors affecting the comprehension of clinical information by inpatients undergoing trauma surgery. / Determinantes sociodemográficos de la comprensión de la información clínica en pacientes hospitalizados intervenidos de cirugía traumatológica.

INTRODUCTION: The clinical information process is the basis of the doctor-patient relationship. It starts with the information provided before signing informed consent and ends on the termination of the doctor-patient relationship. The influence of demographic variables in the information process has not been thoroughly studied for inpatients undergoing surgery. In this study we aim to answer two questions: 1) Does gender have an influence on the information process for these patients? 2) Are there other factors that affect the process? METHOD: A prospective study carried out using an 'ad hoc' designed survey on a 200-inpatient sample after undergoing surgery in the trauma and orthopaedics department of our hospital. Sampling was simple random. RESULTS: We found differences in the consistency of the answers by gender in the question regarding surgical priority, with the women having a better understanding of it (p=.04). The rest of the questions show no differences by gender. However, in the population analyzed, age and educational level are the main modifiers of understanding, and they are both related to gender (p<.0001; p=.003, respectively). CONCLUSIONS: In clinical practice, it is fundamental to keep in mind the factors that affect the information process. According to our results, the factors that define greater vulnerability in relation to the information process are age and low educational level.

[Physical attacks in prison, mental illness as an associated risk factor]. / Agresiones físicas en prisión, la enfermedad mental como factor de riesgo asociado.

OBJECTIVE: To analyze physical victimization in the prison population, taking into account the existence of some kind of mental illness, in the prison of Albolote (Granada). METHODS: 270 inmates conducted an anonymous and voluntary survey about victimization. RESULTS: 36.7% of all inmates suffered some form of physical victimization in prison. 62.2% of participants consider that they have anxiety, depression, bipolar disorder, schizophrenia or other mental illness, half of whom receive treatment for these problems. CONCLUSIONS: Physical attacks on people with mental illness are 2.5 times higher than on those who do not have a mental illness.

[Study of sociodemographic and psychopathological risk factors in suicide attempts. 2008-2010]. / Análisis de los intentos de autolisis en un área de salud. 2008-2010.

OBJECTIVE: The aim of this study is to determine the sociodemographic and psychopathological features and risk factors associated with suicide attempts. DESIGN: A descriptive cross-sectional study based on medical records. Emergency Primary Care Centres (Jumilla, Yecla) and Hospital Emergency Departments (Yecla, Murcia, Spain). RESULTS: The suicide attempt rate increases in younger people (average of 36.4 years old). Suicide attempts are higher among women (67%). In terms of psychopathological data, suicide attempts were characterised by a higher prevalence of depression and anxiety disorder (30%), and substance abuse (13%). The percentage of patients who had made a previous suicide attempt was 37%. Self-poisoning was the most recurrent method of suicide attempt, present in at least 80% of the cases. Gender was a significant factor in the cause of suicide attempt (P=.042) and psychopathology (P=.011). The geographic origin of the patient is significantly associated with the suicide method used (P=.000). CONCLUSIONS: Suicide treatment protocols and suicide prevention programs must be developed, as well as recording the risk factors in the patient history.

[Quality recording of information in the health centre medical records on the use of analgesic and anti-inflammatory drugs]. / Calidad del registro de la información acerca del consumo de antiinflamatorios y analgésicos en la Historia clínica del Centro de Salud.

INTRODUCTION: To examine medical records within a health centre to determine whether there are data in the information process on the secondary effects and interactions of analgesic and anti-inflammatory drugs, and to determine the patient profile as regards whether or not this information is recorded in their medical records. MATERIAL AND METHODS: Descriptive, cross-sectional study based on electronic medical records in the Mariano Yago Primary Care Centre in Yecla (Murcia), Spain. A systematic random sample of 232 electronic medical records was reviewed. All the 232 patients, of legal age, gave their consent to review of their electronic medical records for the purposes of the study. RESULTS: The percentage of doctors who recorded the fact that they had provided information regarding secondary effects and non-compatibilities of the prescription of analgesic and antiinflammatory drugs was 21.6%. The factors involved in the non- recording of this information in the medical record were the type of prescription, the type of analgesic and anti-inflammatory drug prescribed, glomerular filtration, and adequate gastrointestinal protection. CONCLUSIONS: The degree of compliance to patients rights to information about treatment with analgesic and anti-inflammatory drugs is low.

[The patient's right to information: influence of socio-professional factors in primary care]. / Derecho de información de los pacientes: influencia de las características socioprofesionales en atención primaria.

OBJECTIVES: To describe the information provided by primary care doctors to their patients in different phases of the care provision process and to analyse any relationships with socio-professional factors. DESIGN: Descriptive, cross-sectional study based on postal questionnaire. SETTING: Primary care centres in Murcia, Spain. PARTICIPANTS: 227 family physicians. INTERVENTIONS: Distribution of a questionnaire which includes: a) socio-professional variables (age, sex, marital status, years in practice, years in present post, work environment, previous training, number of patients on list, number of patients seen daily); b) an evaluation of job satisfaction (Likert scale) related to salary, career choice, immediate superiors and daily surgery; and c) the frequency with which information is provided to patients concerning diagnosis, prognosis, treatment, complementary examinations and personal, professional and family impact. MAIN MEASUREMENTS AND RESULTS: The reply rate was 59%. The percentages of doctors who always provided information concerning diagnosis, prognosis, treatment, complementary examinations and person, professional and family impact was, 23.3%, 7%, 64.3%, 40.5%, and 9.7%, respectively. There was a direct and statistically significant relationship between job satisfaction and the information provided to patients, the doctors feeling most satisfaction providing the most information on the different phases of the care process. On the other hand, there was an inverse and statistically significant relationship between the number of patients on the doctors' lists and the information provided. CONCLUSIONS: The degree of fulfillment of the patient's right to information is low. Doctors should realise the practical importance of clinical information in their work. There is a general feeling of discontent amongst family doctors, which has a negative impact on their professional activity. A lighter workload would significantly improve the extent to which doctors provide patients with information and mechanisms should be put in place to improve working conditions to avoid the non-fulfillment of the patient's right to information.

Is bioethical training useful in preparing doctors to take decisions in the emergency room?

We study the decisions taken in five real cases by 178 doctors working in hospital emergency services and compare their decisions with those proposed a reference group composed of professionals with a master's degree in bioethics. The findings of our study point to an increased ability to take difficult decisions in critical situations involving the use of life-support measures in the emergency room. The group of professionals chosen as "gold standard", despite lacking the training and clinical preparation of emergency doctors, made decisions that were technically very close to the most suitable. In this respect, an adequate ethical training facilitated the taking of decisions that required the involvement of personally held values, underlining the need for such training in the case of professionals who will work in hospital emergency services.

[Comparative study of determined biochemical parameters in semen of vasectomized and non-vasectomized subjects]. / Estudio comparativo de determinados parámetros bioquímicos en semen de sujetos vasectomizados y no vasectomizados.

OBJECTIVE: Biochemical parameters, fundamentally those of prostatic origin, were analyzed and compared to determine the semen composition of vasectomized and non-vasectomized subjects. METHODS: 100 ml of semen from each group (vasectomized and non-vasectomized) were obtained. After thawing, the pool was homogenized and 5 one-ml sample from each one were analyzed for the following biochemical parameters: gamma glutamyl transferase (GGT), lactic dehydrogenase (LDH), prostate acid phosphatase (PAP), prostate-specific antigen (PSA) and total protein (TP) in the seminal plasma. Determination of the foregoing biochemical parameters was performed automatically with autoanalyzers. RESULTS: The mean values for the vasectomized and non-vasectomized groups were respectively: a) GGT: 8890 +/- 811 and 5714 +/- 403 IU/L; b) LDH: 7045 +/- 879 and 2465 +/- 339 IU/L; c) PAP: 2,099,000 +/- 330,764 and 1,860,000 +/- 302,138 ng/ml; d) PSA: 953,000 +/- 154,715 and 1,018,000 +/- 119,685 ng/ml; total protein: 39,860 +/- 1094 and 37,900 +/- 5606 micrograms/ml. CONCLUSIONS: Analysis of the different biochemical parameters showed no statistically significant differences between the mean values for PAP, PSA and total protein for the vasectomized and non-vasectomized group, but statistically significant differences were found for GGT and LDH (p < 0.001).

[Environmental and biological control in a population exposed to isoflurane in the operating room]. / Control ambiental y biológico de una población expuesta a isoflurano en el quirófano.

OBJECTIVE: To measure the level of occupational exposure to isoflurane in the operating room, and to determine the relation between isoflurane concentration in atmospheric and exhaled air. PATIENTS AND METHODS: One hundred seventy-eight samples were obtained from 60 male and female subjects who work in the operating room of our hospital. To monitor workplace exposure we used passive diffusion samplers. Biological monitoring (isoflurane in exhaled air) was accomplished with standard adsorption tubes to collect exhaled air samples. Gases were thermically separated and analyzed by gas chromatography. RESULTS: Atmospheric isoflurane concentrations ranged between 1.14 and 157.23 mg/m3 (geometric mean 16.23 mg/m3). Exhaled isoflurane concentrations ranged from 0.15 to 26.09 mg/m3 (geometric mean 2.85 mg/m3). Atmospheric and exhaled isoflurane concentrations were strongly related (r = 0.82; p < 0.0001). Linearity was determined by the following equation: log of exhaled isoflurane concentration = -0.69 + 0.95 log of atmospheric isoflurane concentration. CONCLUSIONS: The concentrations of isoflurane in atmospheric and exhaled air found in our study exceed the maximum levels for halogenated gases recommended by the National Institute for Occupational Safety and Health, although they do not exceed the levels stipulated by Swiss authorities. In order to adequately assess operating room antipollution measures, atmospheric and biologic monitoring of isoflurane and other inhaled anesthetic gas concentrations is necessary.