[Impact of vortioxetine on sexual function compared to other antidepressants]. / Repercusión de vortioxetina sobre la función sexual frente a otros antidepresivos.

OBJECTIVE: To analyze the impact of the antidepressant vortioxetine on sexual function, compared to selective serotonin reuptake inhibitors (SSRIs) and mixed selective serotonin and norepinephrine reuptake inhibitors (IRSN or Dual) in patients with depression. MATERIAL AND METHODS: Analytical, observational, longitudinal and prospective study, which included men and women over 18years of age, with depressive disorder and sexual activity with a partner, separating them into two groups: (i)study, starting treatment with vortioxetine; (2)control, maintaining treatment with SSRIs or Duals. Three visits were made: inclusion, follow-up at 4weeks and final 3months from inclusion. The total follow-up period was 3months. RESULTS: A total of 87 patients were included (mean age 46.85years). At the end of the study, significant differences (SD) were found in the mean value of the sum of the scores of the evaluative domains of the sexual response of the Women's Sexual Function Questionnaire (FSM-2) between the study group and the control (22.42±4.39 and 16.13±7.76, respectively), with a lower risk of sexual dysfunction in women treated with vortioxetine. Also, lower risk of sexual dysfunction in these same women in the domains of desire, lubrication, orgasm, sexual frequency and sexual satisfaction. These differences were not found when assessing male sexual function. CONCLUSIONS: Women treated with vortioxetine presented better sexual function than those treated with SSRIs or Duals and a lower risk of sexual dysfunction.

[Analysis of neonatal mortality in the University Hospital La Fe Valencia. Years 1971-2009]. / Análisis de la mortalidad neonatal en el Hospital Universitario La Fe de Valencia. Años 1971-2009.

BACKGROUND AND OBJECTIVES: Neonatal mortality (NM) is a reliable marker of quality clinical care. The primary objective of this study was to analyse evolution of NM in the Division of Neonatology (level IIIc according to the Spanish Classification) University Hospital La Fe Valencia (HULF) from the beginning of its activity in 1971 until 2009. Secondary objectives were the evaluation of prematurity rate (PR) and low birth weight rate (LBWR). MATERIAL AND METHODS: There was a total of 308,989 births, with 2.135 neonatal deaths (ND), during the period studied. RESULTS: NM has shown a significant decrease (10.18% in 1971 vs. 6.24% in 2009; P<.01). This decrease was even more significant for neonates with birth weight between 500-999g (923.1% in 1980 vs. 238.1% in 2009; P<.0001) and less for preterm with gestational age less than 28 weeks (403.8% in 1993 vs. 287.9% in 2009; P<.01). The Prematurity rate increased from 8.7% (1993) to 14% (2009) (P<.01), and LBWR increased from 5.3% (1979) to 12.8% (2009) (P<.001). Males represent 58.2% of ND, and these occurred in the first day of life in 48.2% of the cases. Respiratory conditions represent 36.3% of ND, severe congenital malformations 31.5%, neurologic conditions 14.6%, and infections 7.9%. CONCLUSIONS: In spite of the increase in LBWR and PR, a significant descent of NM has been achieved in the HULF in the last decades.

Management of osteoporosis in general practice: a cross-sectional survey of primary care practitioners in Spain.

A cross-sectional survey was conducted to determine the current situation in Spain regarding diagnosis and care of patients with osteoporosis in the primary care setting. A total of 2,500 primary care physicians who were homogeneously grouped in autonomous communities throughout the country received a postal 30-item anonymous self-administered questionnaire. The questionnaire covered demographics and personal characteristics of the physicians, conditions in everyday consultation, and degree of knowledge with regard to risk factors, diagnosis, treatment, and follow-up of the disease. The overall response was 850 (34%). The mean age of physicians surveyed was 43 years (range 23-66 years). The percentage of physicians specialized in community and family medicine was 46.7%. In 55.2% of cases, years of practice ranged between 11 and 20, and 55.7% of physicians visited between 31 and 50 patients per day. Age and years of practice were not associated with daily number of visits. Only 4% of physicians stated that there were specific programs for osteoporosis implemented in their primary care center. Diagnostic complementary investigations that could be ordered included plain radiographs in 96.2% of cases and bone densitometry in 27.8%. Laboratory tests included serum hormones in 61.6% of cases, PTH in 50.2%, and bone alkaline phosphatase in 33.4%. The diagnosis of osteoporosis was made always personally in 25.2% of cases. Personal diagnosis and follow-up, as well as actions directed to detection of osteoporosis were significantly higher among physicians working in centers with specific programs for osteoporosis. With regard to knowledge about osteoporosis, the mean percentage of correct responses was 63%. The percentage of correct responses was inversely associated with age and years of practice, and positively associated with speciality of community and family medicine. Primary care providers are in a good position to assess risk factors and recommend prevention strategies, as well as to play an active role in the diagnosis, care, and follow-up of patients with osteoporosis. Practitioners of younger age and relatively few years of practice were those with more up-to-date information regarding the disease, and the existence of a specific program for osteoporosis seems to improve the management of this condition.