[Characteristics and evolution of COVID-19 in an urban Health Center at the pandemic beginning']. / Características y evolución de los pacientes COVID-19 en un centro de salud urbano al inicio de la pandemia.

OBJETIVE: To evaluate SAR-COV-2 pacients' features. To analyse de diferences between those who required hospital care and those who didn't. DESIGN: Observational, descriptive and retrospective study. SETTING: Twomedical practices of an urban health center in Salamanca (Spain). PARTICIPANTS: ≥18 years diagnosed with SAR-CoV-2 between March 11th and April 20th. MAIN MEASUREMENTS: clinical-epidemiological chatacteristics, diagnosis, treatment and outcome at the end of study RESULTS: 122 patients (63.9% female), 19.7% social and health care workers y 4.9% from nursing homes. Predominant age group: 46-60 years. 67.2% without comorbility. Predomint symptoms: low-grade fever (73.5%), cough (65.2%) y fever (43%). Average age of the patients requiring hospital care was higher: 59.85 (DE16.22) versus 50.78 (DE17.88) P=.013. 63.6% of all the patients monitored by Primary Health Care and 14.1% of patients that required assistance did not present dyspnea P=.001. Only 2.5% of the hospital-assisted patients, compared to 61.5% of Primary Health Care, were not tested P=.0001. 26 patients were attendedn at an emergency room: 11(9%) stayed and 2 (1.6%) passed away. No antibiotic or inhaler treatment for 52.5% and 70.5% respectively. The most used antipyretic treatment was paracetamol (78.7%). CONCLUSIONS: Prevalence in females, comorbility-free patients and in age range: 46-60 years. Complementary and confirmatory test were performed mainly in hospital care. Predominance of mild symptoms and favourable evolution. Highliting the role played by Primary Health Care in detection, early intervention and monitoring of severe cases.

Effectiveness of a primary care clinical ultrasound classroom for family physicians as a formative intervention system, a quasi-experimental trial: Study protocol.

INTRODUCTION: Clinical ultrasound is a technique that increases diagnostic capacity and facilitates clinical decision making. The objective is to develop and validate an ultrasound training methodology oriented to the clinical practice of the family physician. METHODS: Quasi-experimental study, with a before/after design, a control group, and 1 year of follow-up. Twenty family physicians working in primary care health centers with a list of over 800 patients will be included, as well as a control group of family physicians with similar characteristics in terms of age, sex, and patient list. A structured training process oriented to the clinical practice of the family physician, primary care clinical ultrasound classroom (AECAP), will be carried out, and the improvement of knowledge and skills of the participants will be evaluated, as well as the improvement of the quality of care based on clinical indicators. DISCUSSION: The family physician is in a privileged situation allows increasing the performance of ultrasound in frequent clinical situations and reducing care hours. We hope that the results obtained in this study demonstrate the effectiveness of the structured training method (AECAP) and support the generalization of ultrasound in primary health care. ETHICS AND DISSEMINATION: The study was approved by the Medical Research Ethics Committee of Salamanca on December 17, 2018 (cod 2018 11 134). The trial was registered in ClinicalTrials.gov provided by the US National Library of Medicine-number: NCT04283383.

Características y evolución de los pacientes COVID-19 en un centro de salud urbano al inicio de la pandemia / Characteristics and evolution of COVID-19 in an urban Health Center at the pandemic beginning

OBJETIVO: Evaluar las características de los pacientes con SARS-CoV-2 y analizar diferencias entre los que requirieron asistencia hospitalaria y los seguidos ambulatoriamente. DISEÑO: Estudio observacional, descriptivo, retrospectivo. EMPLAZAMIENTO: 2 unidades básicas asistenciales de un centro de salud urbano en Salamanca (España). PARTICIPANTES: Pacientes ≥ 18 años diagnosticados de SARS-CoV-2 entre el 11 de marzo y el 20 de abril. MEDICIONES PRINCIPALES: Características clínico-epidemiológicas, diagnóstico, tratamiento y desenlace a fecha fin de estudio. RESULTADOS: Ciento veintidós pacientes (63,9% mujeres), 19,7% trabajadores sociosanitarios y 4,9% institucionalizados. Franja etaria predominante: 46-60 años, edad media: 52,1(DE 17,85). El 67,2% sin comorbilidad. Síntomas más prevalentes: febrícula (73,5%), tos (65,2%) y fiebre (43%). La edad media de los que requieren atención hospitalaria es mayor a los seguidos ambulatoriamente: 59,85 años (DE 16,22) vs. 50,78 (DE 17,88); p = 0,013. El 63,6% del total seguidos por Atención Primaria no presentó disnea, frente a 17 (14,1%) de los que acudieron a Urgencias; p = 0,001. No se realizaron pruebas confirmatorias al 2,5% de los que visitaron el hospital, frente al 61,5% de los seguidos ambulatoriamente; p = 0,0001; 26 acuden a Urgencias: 11 (9%) ingresaron y 2 (1,6%) fallecieron. El 52,5% no necesitó antibioterapia y el 70.5% no requirió inhaladores. El antipirético más empleado fue paracetamol (78.7%). CONCLUSIONES: Prevalencia en mujeres, personas sin comorbilidad y en la franja de edad de 46-60 años. Las pruebas complementarias y confirmatorias se realizaron mayoritariamente en asistencia hospitalaria. Predominancia de sintomatología leve y evolución favorable. Destacamos el papel de Atención Primaria en la detección, la intervención temprana y el seguimiento en casos graves

OBJETIVE: To evaluate SAR-COV-2 pacients' features. To analyse de diferences between those who required hospital care and those who didn't. DESIGN: Observational, descriptive and retrospective study. SETTING: Two medical practices of an urban health center in Salamanca (Spain). PARTICIPANTS: ≥ 18 years diagnosed with SAR-CoV-2 between March 11 th and April 20 th. MAIN MEASUREMENTS: clinical-epidemiological chatacteristics, diagnosis, treatment and outcome at the end of study RESULTS: 122 patients (63.9% female), 19.7% social and health care workers y 4.9% from nursing homes. Predominant age group: 46-60 years. 67.2% without comorbility. Predomint symptoms: low-grade fever (73.5%), cough (65.2%) y fever (43%). Average age of the patients requiring hospital care was higher: 59.85 (DE16.22) versus 50.78 (DE17.88) P = .013. 63.6% of all the patients monitored by Primary Health Care and 14.1% of patients that required assistance did not present dyspnea P = .001. Only 2.5% of the hospital-assisted patients, compared to 61.5% of Primary Health Care, were not tested P = .0001. 26 patients were attendedn at an emergency room: 11(9%) stayed and 2 (1.6%) passed away. No antibiotic or inhaler treatment for 52.5% and 70.5% respectively. The most used antipyretic treatment was paracetamol (78.7%). CONCLUSIONS: Prevalence in females, comorbility-free patients and in age range: 46-60 years. Complementary and confirmatory test were performed mainly in hospital care. Predominance of mild symptoms and favourable evolution. Highliting the role played by Primary Health Care in detection, early intervention and monitoring of severe cases