Adherence to inhaled corticosteroids in patients with asthma prior to and during the COVID-19 pandemic.

The electronic prescription refill rate (EPRR) of 183 consecutive patients was determined over a 19-month retrospective study period, divided into 7 months PRE (Sep-19 to Mar-20) and 12 months POST pandemic (Apr-20 to Mar-21), in order to compare adherence to inhaled corticosteroids (ICS) in patients with asthma prior to and during the COVID-19 pandemic. Before the pandemic (PRE), an average of 0.58 inhalers/month were refill from the pharmacy; [SD 0.33], very similar to the 0.59 inhalers/month; [SD 0.34] retrieved during the 12 subsequent months since the pandemic (POST) (p = 0.768). EPRR showed no differences (p = 0.784). When EPRR was dichotomous or ordinal categorised no differences were found either (p = 0.851 and 0.928), even when McNemar's test was used (p = 0.949), with prevalences of nonadherence (EPRR < 80%) of 57 and 58% respectively. Our results do not support increased adherence to inhaler treatment in terms of EPRR, comparing before and since COVID-19 pandemic. Compliance with prescription remains suboptimal.

Main Challenges of Incorporating Environmental Impacts in the Economic Evaluation of Health Technology Assessment: A Scoping Review.

Health technology assessment (HTA) provides evidence-based information on healthcare technology to support decision making in many countries. Environmental impact is a relevant dimension of a health technology's value, but it has been poorly addressed in HTA processes in spite of the commitment that the health sector must have to contribute to mitigating the effects of climate change. This study aims to identify the state of the art and challenges for quantifying environmental impacts that could be incorporated into the economic evaluation (EE) of HTA. We performed a scoping review that included 22 articles grouped into four types of contribution: (1) concepts to draw up a theoretical framework, (2) HTA reports, (3) parameter designs or suitable indicators, and (4) economic or budgetary impact assessments. This review shows that evaluation of the environmental impact of HTAs is still very incipient. Small steps are being taken in EE, such as carbon footprint estimations from a life-cycle approach of technologies and the entire care pathway.

Cost-effectiveness and epidemiological impact of gender-neutral HPV vaccination in Spain.

All EU countries have introduced Human papilloma virus (HPV) vaccination for adolescent girls and many countries are expanding the strategy to include adolescent boys. There is uncertainty about the cost-effectiveness and epidemiological impact of a gender-neutral HPV vaccination strategy. Here we present the results of an economic model adapted for Spain. Five vaccination strategies were compared from the Spanish healthcare system perspective, combining two vaccines (4-valent and 9-valent) in a gender-neutral or girls-only programme in a dynamic population-based model with a discrete-time Markov approach. Costs and benefits were discounted at 3%. The benefits of immunization were measured with quality-adjusted life years (QALYs), which are achieved by reducing the incidence of diseases attributable to HPV. Incremental cost-effectiveness ratio (ICER) was compared with the willingness-to-pay threshold in Spain. The two most effective strategies were compared: gender-neutral 9-valent vaccination vs. girls-only 9-valent vaccination, resulting in an ICER of € 34,040/QALY, and an important number of prevented cases of invasive cancers and anogenital warts. The sensitivity analysis revealed that gender-neutral 9-valent vaccination would become cost-effective if protection against oropharyngeal and penile cancers was included or if the price per dose decreased from €45 to €28. The gender-neutral 9-valent HPV vaccination in Spain offers more benefits than any other modeled strategy, although in the conservative base case it is not cost-effective. However, certain plausible assumptions would turn it into an efficient strategy, which should be borne in mind by the decision makers together with equity and justice arguments.

What is the context? Human papillomavirus (HPV) is a group of viruses that causes sexually transmitted diseases, including certain cancers. European countries offer HPV vaccination to adolescent girls.Many countries have also introduced the vaccination in adolescent boys.There are doubts about whether it is worth vaccinating adolescents of both genders.What this study adds? We estimated costs and benefits of the vaccination in Spain, comparing two types of vaccine, only in girls and in both genders. This analysis considered indirect protection of vaccinated people to unvaccinated ones.It seems that the benefits of HPV vaccination in all adolescents do not compensate the costs.However, when we included likely protection against additional cancers or we reduced the price per vaccine dose, it would be worth vaccinating all adolescents in Spain.We also stated ethical arguments in favor of HPV vaccination for both genders.What is the impact? HPV vaccination in adolescent boys and girls in Spain will prevent more HPV-related diseases.For certain scenarios, HPV vaccination in both genders would be worth in Spain.Ethically, vaccinating also boys would be fair, equitable and would not discriminate a part of the population.

A programme for early diagnosis of atrial fibrillation: a multi-centre study in primary care.

BACKGROUND: Atrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated. OBJECTIVE: To assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres. METHODS: In an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled. They were allocated to intervention and control groups in a 1:2 ratio. Participants in the intervention group had three clinical and educational visits (0, 6 and 12 months). In intervention subgroup A, an electrocardiogram (ECG) was performed at each visit and in subgroup B, only if arrhythmia was detected on auscultation. After 2 years, the medical records of all participants were reviewed. Participants diagnosed with AF were followed for two additional years. RESULTS: Of the total 2231 participants enrolled, 1503 (67.36%) were allocated to the control group and 728 (32.63%) to the intervention groups (355 in subgroup A, 373 subgroup B). The groups showed similar clinical characteristics. New-onset AF was diagnosed in 38 patients. Early detection in subgroup B was similar to subgroup A and superior to control group (3.2% versus 1.2%, hazard ratio 3.149, 95% confidence interval 1.503-6.597, P = 0.002). AF patients in subgroups A and B had similar long-term complications and a tendency for fewer complications than AF patients in the control group. CONCLUSIONS: An intervention programme consisting of health education, systematic auscultation and opportunistic ECG by a primary care provider is a useful method for the early diagnosis of AF.

Acenocumarol: uso, adherencia y conocimiento del usuario. Oportunidades para la Atención Farmacéutica / Acenocumarol: use, adherence and knowledge. Opportunities for Pharmaceutical Care

Objetivo: El acenocumarol se mantiene como terapia anticoagulante (TAO) de primera elección. El objetivo de este estudio es valorar y mejorar el conocimiento que sobre el medicamento tienen sus usuarios y favorecer la personalización de la Atención Farmacéutica. Método: 60 pacientes usuarios de acenocumarol de 6 farmacias de Tenerife han participado en una encuesta anónima para valorar el uso, la adherencia y el conocimiento del fármaco. Resultados: 16% de los usuarios desconoce la indicación para la que se les prescribe el anticoagulante, un 32% son pacientes sin adherencia terapéutica y existe un alto grado de desconocimiento (47%) sobre cómo actuar en caso de olvido de una toma. La duplicidad de dosis es un PRM (Problema Relacionado con el Medicamento) real para el 12% de los pacientes. El 87% usa otros tratamientos junto con el acenocumarol (antihipertensivos (24%), antihipercolesterolémicos (11%), ansiolíticos/sedantes (13%) y antiulcerosos (13%)) destacando el uso conjunto de acenocumarol y analgésicos/antiinflamatorios en el 11% de nuestros usuarios de acenocumarol lo que se identifica como un riesgo potencial grave de PRM por interacción. El 35% de los pacientes desconoce las interacciones del acenocumarol, un 70% afirma haber recibido información sobre el fármaco y sólo un 42% de los pacientes manifiesta no haber leído el prospecto. Conclusiones: Se pone de manifiesto la necesidad de mejorar el conocimiento sobre este fármaco por parte del paciente. La intervención farmacéutica mediante la dispensación activa e informada y el seguimiento fármaco terapéutico personalizado permitiría la detección y prevención de PRM durante el uso de acenocumarol.(AU)

Aims: Acenocoumarol remains the first-line anticoagulant therapy (OAT). The objective of this study is to assess and improve the knowledge that users have about this drug and advance in the personalization of pharmaceutical care. Method: 60 acenocoumarol patients from 6 Tenerife pharmacies have participated in an anonymous survey to assess the use, adherence and knowledge of the drug. Results: 16% of acenocoumarol users do not know the indication for which the anticoagulant is prescribed, 32% are patients without therapeutic adherence and there is a high degree of ignorance (47%) about how to act in case of forgetting a dose. Duplication of doses is a real DRP (Drug Related Problem) for 12% of patients. 87% of those surveyed use other treatments together with acenocoumarol (antihypertensive (24%), antihypercholesterolemic (11%), anxiolytic / sedative (13%) and antiulcer (13%)), highlighting the joint use of acenocoumarol and analgesic/anti-inflammatory in 11% of our acenocoumarol users this is identified as a potential serious risk of DRP by interaction. 35% of the patients admit that they are unaware of the possible interactions of acenocoumarol, 70% of the patients affirm that they have received information about the drug, and only 42% of the patients state that they have not read the package leaflet. Conclusions: The need to improve knowledge about this drug by the patient is highlighted. Pharmaceutical intervention through active and informed dispensing and personalized therapeutic drug monitoring would allow the detection and prevention of DRP during the use of acenocoumarol.(AU)

Cost-effectiveness of extending the HPV vaccination to boys: a systematic review.

BACKGROUND: Human papillomavirus (HPV) infection can have severe consequences both in women and men. Preadolescent girls are vaccinated against HPV worldwide but a gender-neutral vaccination is being adopted only little by little. This systematic review offers an overview of cost-effectiveness of the gender-neutral HPV vaccination. METHODS: Economic evaluations of gender-neutral HPV vaccination with a two-dose schedule compared with girls-only strategy were systematically searched in Medline, Embase and WOS up to June 2020. Incremental cost-effectiveness ratios and key parameters were analysed. RESULTS: Nine studies met the inclusion criteria. Four studies concluded in favour of the gender-neutral programme, another four found it cost-effective only in alternative scenarios. The most influential parameters are the discount rate of benefits (same as for costs vs reduced), vaccine price (listed vs publicly negotiated) and included health problems (inclusion of oropharyngeal and penile cancers). Sponsorship was not decisive for the final result, but there were differences between industry-funded and independent studies in some cost categories. CONCLUSIONS: The evidence of the cost-effectiveness of extending HPV vaccination to boys is scarce and ambiguous. Before the adoption of such a strategy, countries should carry out context-specific cost-effectiveness analyses, but the decision should also take into account other criteria, such as gender-related equality.

Cost-effectiveness analysis of a surveillance program to prevent hip dislocation in children with cerebral palsy / Análisis de coste-utilidad de un programa de vigilancia para prevenir la luxación de cadera en niños y niñas con parálisis cerebral

OBJECTIVE: In this study we conducted an economic evaluation of a surveillance programme to prevent hip dislocation in children with cerebral palsy. METHOD: We developed a model that compared costs and health outcomes of children with cerebral palsy with and without a surveillance programme. Information from a number of sources was combined into a decision analytical model, primarily based on data from a comparative study with a 20-year follow-up. Effectiveness was measured using Quality-Adjusted Life Years (QALYs). The analysis took the perspective of the Spanish National Health Service. We undertook extensive sensitivity analyses including a probabilistic sensitivity analysis. RESULTS: The surveillance programme led to higher QALYs and higher health care costs, with an estimated incremental cost per QALY gained of 12,282€. The results were robust to model assumptions. The probability that the programme was cost-effective was estimated to be over 80% at the threshold of 25.000€/QALY recommended in Spain. CONCLUSION: This study indicates that surveillance programmes to prevent hip dislocation in children with cerebral palsy are likely to be cost-effective

OBJETIVO: En este estudio se realiza una evaluación económica de un programa de vigilancia para prevenir la luxación de cadera en niños y niñas con parálisis cerebral. MÉTODO: Se desarrolló un modelo que comparó los costes y los resultados en salud de niños y niñas con parálisis cerebral incluidas y no incluidas en un programa de vigilancia. Se combinó la información proveniente de diversas fuentes en un modelo analítico de decisión, principalmente basado en datos de un estudio comparativo con 20 años de seguimiento. La efectividad se midió empleando los años de vida ajustados por calidad (AVAC). El análisis tomó la perspectiva del Sistema Nacional de Salud de España. Se realizó un extenso análisis de sensibilidad, incluyendo un análisis de sensibilidad probabilístico. RESULTADOS: El programa de vigilancia estuvo asociado a más AVAC y mayores costes sanitarios, con un coste incremental por AVAC ganado estimado en 12.282 €. Los resultados fueron robustos a los supuestos del modelo. La probabilidad de que el programa fuera coste-efectivo se estimó en un valor por encima del 80% para el umbral de 25.000 € por AVAC recomendado en España. CONCLUSIÓN: Este estudio indica que es probable que los programas de vigilancia para prevenir la luxación de cadera en niños y niñas con parálisis cerebral sean coste-efectivos

Cost-effectiveness analysis of a surveillance program to prevent hip dislocation in children with cerebral palsy.

OBJECTIVE: In this study we conducted an economic evaluation of a surveillance programme to prevent hip dislocation in children with cerebral palsy. METHOD: We developed a model that compared costs and health outcomes of children with cerebral palsy with and without a surveillance programme. Information from a number of sources was combined into a decision analytical model, primarily based on data from a comparative study with a 20-year follow-up. Effectiveness was measured using Quality-Adjusted Life Years (QALYs). The analysis took the perspective of the Spanish National Health Service. We undertook extensive sensitivity analyses including a probabilistic sensitivity analysis. RESULTS: The surveillance programme led to higher QALYs and higher health care costs, with an estimated incremental cost per QALY gained of 12,282€. The results were robust to model assumptions. The probability that the programme was cost-effective was estimated to be over 80% at the threshold of 25.000€/QALY recommended in Spain. CONCLUSION: This study indicates that surveillance programmes to prevent hip dislocation in children with cerebral palsy are likely to be cost-effective.

Comparison of the age-adjusted and clinical probability-adjusted D-dimer to exclude pulmonary embolism in the ED.

BACKGROUND: Diagnosing pulmonary embolism (PE) in the emergency department (ED) can be challenging because its signs and symptoms are non-specific. OBJECTIVE: We compared the efficacy and safety of using age-adjusted D-dimer interpretation, clinical probability-adjusted D-dimer interpretation and standard D-dimer approach to exclude PE in ED patients. DESIGN/METHODS: We performed a health records review at two emergency departments over a two-year period. We reviewed all cases where patients had a D-dimer ordered to test for PE or underwent CT or VQ scanning for PE. PE was considered to be present during the emergency department visit if PE was diagnosed on CT or VQ (subsegmental level or above), or if the patient was subsequently found to have PE or deep vein thrombosis during the next 30 days. We applied the three D-dimer approaches to the low and moderate probability patients. The primary outcome was exclusion of PE with each rule. Secondary objective was to estimate the negative predictive value (NPV) for each rule. RESULTS: 1163 emergency patients were tested for PE and 1075 patients were eligible for inclusion in our analysis. PE was excluded in 70.4% (95% CI 67.6-73.0%), 80.3% (95% CI 77.9-82.6%) and 68.9%; (95% CI 65.7-71.3%) with the age-adjusted, clinical probability-adjusted and standard D-dimer approach. The NPVs were 99.7% (95% CI 99.0-99.9%), 99.1% (95% CI 98.3-99.5%) and 100% (95% CI 99.4-100.0%) respectively. CONCLUSION: The clinical probability-adjusted rule appears to exclude PE in a greater proportion of patients, with a very small reduction in the negative predictive value.

Effectiveness of a decision aid for patients with depression: A randomized controlled trial.

BACKGROUND: Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices. OBJECTIVE: The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79). INTERVENTION: Patients in the decision aid group reviewed the decision aid accompanied by a researcher. OUTCOME MEASURES: Knowledge about treatment options, decisional conflict, treatment intention and preference for participation in decision making. We also developed a pilot measure of concordance between patients' goals and concerns about treatment options and their treatment intention. RESULTS: Intervention significantly improved knowledge (P<.001) and decisional conflict (P<.001), and no differences were observed in treatment intention, preferences for participation, or concordance. One of the scales developed to measure goals and concerns showed validity issues. CONCLUSION: The decision aid "Decision making in depression" is effective improving knowledge of treatment options and reducing decisional conflict of patients with unipolar depression. More research is needed to establish a valid and reliable measure of concordance between patients' goals and concerns regarding pharmacological and psychological treatment, and the choice made.

Presentación de un neonato con absceso hepático / Presentation of a Neonate with Liver Abscess

En el período neonatal el absceso hepático es infrecuente, generalmente es de mal pronóstico. Se presentó un neonato masculino, pretérmino tardío de buen peso, con un absceso hepático único que se diagnosticó clínica y ultrasonográficamente a los quince días de edad, secundario a un cateterismo venoso umbilical, realizado para una exanguineotransfusión debido a una isoinmunización RH. Se describió su evolución clínica, ultrasonográfica y la terapéutica antimicrobiana utilizada. No se realizó drenaje quirúrgico del absceso.

During neonatal period the liver abscess is not frequent, generally with bad prognosis. A male late preterm neonate of good weight, with one hepatic abscess, secondary to a venous umbilical catheterization was presented in this paper, which was diagnosed by ultrasound and clinical method after 15 days of age, performed for a blood exchange transfusion due to isoinmunization Rh. His clinical and untrasonographic evolution and the used antimicrobic therapy were described. The abscess surgical drain was not performed.

Presentación de un neonato con absceso hepático / Presentation of a Neonate with Liver Abscess

En el período neonatal el absceso hepático es infrecuente, generalmente es de mal pronóstico. Se presentó un neonato masculino, pretérmino tardío de buen peso, con un absceso hepático único que se diagnosticó clínica y ultrasonográficamente a los quince días de edad, secundario a un cateterismo venoso umbilical, realizado para una exanguineotransfusión debido a una isoinmunización RH. Se describió su evolución clínica, ultrasonográfica y la terapéutica antimicrobiana utilizada. No se realizó drenaje quirúrgico del absceso.(AU)

During neonatal period the liver abscess is not frequent, generally with bad prognosis. A male late preterm neonate of good weight, with one hepatic abscess, secondary to a venous umbilical catheterization was presented in this paper, which was diagnosed by ultrasound and clinical method after 15 days of age, performed for a blood exchange transfusion due to isoinmunization Rh. His clinical and untrasonographic evolution and the used antimicrobic therapy were described. The abscess surgical drain was not performed.(AU)

La influencia del apoyo social en el estado emocional y las actitudes hacia la vejez y el envejecimiento en una muestra de ancianos / The influence of social support on the emotional state and attitudes towards old age and ageing in a sample of elderly

No disponible

The stage of old age is marked by situations of dependency, isolation and loneliness. For this reason, this study attempts to analyse the role played by social networks in old people and their relationship with their emotional state and their attitudes towards their old age and aging. This study involved 117 people over the age of 50, without physical or psychological deterioration. The results were obtained through analysis of frequencies, gender differences and matrices of correlations. The sample presents a suitable social network, where the family nucleus is represented by the sons and daughters and the spouse who are the greatest social support for the old man. His emotional state is perceived as satisfactory and their attitudes towards his old age and aging are positive and favourable. The results indicate a positive relationship between social support, emotional state, and attitudes towards old age, which is reflected in an appropriate adjustment in the physical and psychological health (AU)

Análisis de la relación entre las actitudes hacia la vejez y el envejecimiento y los índices de bienestar en una muestra de personas mayores / An analysis of the relationship between the attitudes towards old age and ageing, and well-being indicators in a sample of old people

Introducción: En la última etapa del ciclo vital las personas mayores pueden disfrutar de un envejecimiento satisfactorio gracias a la mejora de su calidad de vida. Este estudio analiza las relaciones entre 2 variables relevantes en esta etapa: las actitudes que la persona mayor posee sobre su propia vejez y envejecimiento, y su estado de bienestar físico y psicológico. Material y método: La muestra la componen personas mayores de 50 a˜nos, sin deterioro cognitivo y con independencia funcional en su vida diaria (N = 117). Los análisis incluyen datos estadísticos descriptivos, diferencias entre géneros y matrices de correlaciones. Resultados: Los resultados indican que los factores de las actitudes que son positivos hacia la vejez y el envejecimiento se relacionan con el bienestar físico y psicológico; y a su vez, los factores de las actitudes de tipo negativo conllevan un estado de malestar general. La muestra presenta una relativa satisfacción con la vida y un bajo malestar físico y emocional. Conclusiones: Los resultados de este estudio reflejan la relevancia que ostentan las actitudes positivas en el estado de bienestar de las personas mayores, con consecuencias directas en su calidad de vida (AU)

Introduction: In the last stage of their life cycle, old people can enjoy a satisfactory ageing thanks to the improvement of their quality of life. The present study analyses the links between 2 relevant variables at this life stage: the attitudes of the elderly towards their own ageing and their own physical and psychological state of well-being. Material and method: The sample consisted of people over the age of 50 without cognitive impairment and with functional independence in their daily life (N = 117). The analyses include descriptive statistical data, gender differences and correlation matrices. Results: The results of this study indicate that the positive attitude factors towards the old age and the ageing are related to the physical and psychological well-being, whilst negative attitude factors lead to a general state of malaise. The population sample showed a relative satisfaction with their life, as well as a low physical and psychological malaise. Conclusions: The results of this study reflect the significance of positive attitudes in the well-being of old people, with a direct impact on their quality of life (AU)

[An analysis of the relationship between the attitudes towards old age and ageing, and well-being indicators in a sample of old people]. / Análisis de la relación entre las actitudes hacia la vejez y el envejecimiento y los índices de bienestar en una muestra de personas mayores.

INTRODUCTION: In the last stage of their life cycle, old people can enjoy a satisfactory ageing thanks to the improvement of their quality of life. The present study analyses the links between 2 relevant variables at this life stage: the attitudes of the elderly towards their own ageing and their own physical and psychological state of well-being. MATERIAL AND METHOD: The sample consisted of people over the age of 50 without cognitive impairment and with functional independence in their daily life (N = 117). The analyses include descriptive statistical data, gender differences and correlation matrices. RESULTS: The results of this study indicate that the positive attitude factors towards the old age and the ageing are related to the physical and psychological well-being, whilst negative attitude factors lead to a general state of malaise. The population sample showed a relative satisfaction with their life, as well as a low physical and psychological malaise. CONCLUSIONS: The results of this study reflect the significance of positive attitudes in the well-being of old people, with a direct impact on their quality of life.

Presentación de un recién nacido prétermino con perforación intestinal espontánea / Presentation of a Preterm Newborn with Spontaneous Intestinal Perforation

La perforación intestinal espontánea es una afección infrecuente en el periodo neonatal. Se describió la evolución de un recién nacido, masculino de 28 semanas de edad, 1 000 g de peso al nacer, con perforación intestinal espontánea. A las 50 h de vida presentó signos clínicos de distensión abdominal y compromiso del estado general, se le realizó radiografía simple de abdomen donde se observó neumoperitoneo, que se evacuó mediante drenaje peritoneal. Evolucionó de forma satisfactoria. En este caso el tratamiento conservador fue efectivo.

The spontaneous intestinal perforation is a rare affection in the neo-natal period. The evolution of a 28- week- old male newborn weighing 1000 g at birth with spontaneous intestinal perforation was described. The patient showed abdominal distension at 50 h of life and pneumoperitoneum was observed through radiography and peritoneal drainage was performed. A satisfactory evolution was observed in this patient. The conservative treatment was effective in this case.

Presentación de un recién nacido prétermino con perforación intestinal espontánea / Presentation of a Preterm Newborn with Spontaneous Intestinal Perforation

La perforación intestinal espontánea es una afección infrecuente en el periodo neonatal. Se describió la evolución de un recién nacido, masculino de 28 semanas de edad, 1 000 g de peso al nacer, con perforación intestinal espontánea. A las 50 h de vida presentó signos clínicos de distensión abdominal y compromiso del estado general, se le realizó radiografía simple de abdomen donde se observó neumoperitoneo, que se evacuó mediante drenaje peritoneal. Evolucionó de forma satisfactoria. En este caso el tratamiento conservador fue efectivo(AU)

The spontaneous intestinal perforation is a rare affection in the neo-natal period. The evolution of a ,28, week old male newborn weighing ,1000 g, at birth with spontaneous intestinal perforation was described. The patient showed abdominal distension at ,50 h, of life and pneumoperitoneum was observed through radiography and peritoneal drainage was performed. A satisfactory evolution was observed in this patient. The conservative treatment was effective in this case(AU)

El consumo de agua como medida higiénico-dietética para el reflujo gastroesofágico / Water Consumption as Dietary Hygienic Measure for Gastroesophageal Reflux

Se analizó el estado actual del conocimiento sobre el consumo de agua como medida higiénico-dietética para la enfermedad del reflujo gastroesofágico, desde la perspectiva del conocimiento clásico de la medicina occidental de esta afección y la visión de la medicina natural y bioenergética. Se realizó una búsqueda bibliográfica sobre el tema en Medline, en la Biblioteca Virtual de Salud y en los sitios de especialidades de Infomed de Medicina Natural y Gastroenterología. La información recolectada se estructuró en siete acápites: enfermedad de reflujo gastroesofágico, fisiología gástrica, equilibrio hidromineral, modelos de ingestión de bebidas y comidas, alimentación y obesidad, terapias hidropónicas e implicaciones en gastroenterología. No se encontraron publicaciones cubanas que aborden la temática sobre la modificación del consumo de líquidos como medida higiénico-dietética para esta enfermedad. Se recomendó realizar investigaciones que permitan obtener evidencias del estudio del tema, así como desarrollar un modelo de consumo de agua para pacientes con enfermedad de reflujo gastroesofágico.

A literature review was carried out aimed at updating about water consumption as a hygienic and dietary measure and its relation to the esophageal reflux disease. Taking into account the classical knowledge about this condition, the theoretical aspects of the bioenergetics and traditional natural medicine were included. Bibliography published in the last five year by MEDLINE and Health Library and specialty sites of INFOMED and Natural Medicine and Gastroenterology. The opinions were classified into: gastroesophageal reflux disease, gastric physiology, hydro mineral balance, food and liquid consumption patterns, feeding and obesity, hydroponic therapies and implication in gastroenterology. There were no Cuban publications on the topic. The authors recommended to carry out investigations on this topic and to develop a design of water consumption for those patients with gastroesophageal reflux disease.

Evaluación del componente afectivo de las actitudes viejistas en ancianos: escala sobre el Prejuicio hacia la Vejez y el Envejecimiento (PREJ-ENV) / Assessing affective component of ageist attitudes in the elder people: Scale on the Prejudice towards the Oldness and the Aging (PREJ-ENV)

The study of the attitudes towards the oldness and the aging is important due to its repercussion in the behavior of the aged people and their physical and psychological health. In this study an instrument adapted to the old population is elaborated to measure the ageist attitudes that have the old people about their own process of the oldness and the aging. The sample composes 117 resident greater people in the island of Tenerife, with an average age of 68 years, without cognitive deterioration and with functional autonomy in their daily life. The results indicate a bifactorial structure for the Scale on the Prejudice Towards the Oldness and the Aging (PREJ-ENV), as well as a positive significant relation between the index of well-being and the factors of positive prejudice, and between the malaise and the negative factors of prejudice. The clinical utility for the evaluation of the ageist attitudes in its affective component is discussed (AU)

El estudio de las actitudes hacia la vejez y el envejecimiento es importante debido a su repercusión en la conducta de los ancianos y en su salud tanto física como psicológica. En este estudio se elabora un instrumento adaptado a la población anciana para medir el componente afectivo-emocional de las actitudes viejistas que poseen las personas ancianas acerca de la vejez y su propio proceso de envejecimiento. La muestra la componen 117 personas mayores residentes en la isla de Tenerife, con una edad media de 68 años, sin deterioro cognitivo y con autonomía funcional en su vida diaria. Los resultados indican una estructura bifactorial para la Escala sobre el Prejuicio hacia la Vejez y el Envejecimiento (PREJ-ENV), así como una relación positiva significativa entre los índices de bienestar y los factores positivos del prejuicio, y también relación positiva entre el malestar y los factores negativos del prejuicio. Se discute la utilidad clínica del instrumento para la evaluación de las actitudes viejistas en su componente afectivo (AU)