Parents' perspectives on dental team as advisors to promote HPV vaccination among Spanish adolescents.

PURPOSE: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention. METHODS: Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis. RESULTS: In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05). CONCLUSION: Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed.

Awareness Levels of the Link Between Oropharyngeal Cancer and HPV Infection Among Spanish Women: a Hospital-Based Cross-sectional Study.

Several observational studies have demonstrated the increased awareness of human papillomavirus (HPV) as an etiological factor of oropharyngeal cancers (OPCs). The incidence of OPCs has increased in recent times, particularly among younger women, and the efficacy of the HPV vaccine in preventing these cancers has gained attention among the medical community. The aim of this study was to explore the health literacy of Spanish adult women regarding factors associated with HPV and its link to OPCs, as well as their awareness of the HPV vaccination. A survey was distributed to 508 women, and 409 (70.5%) were considered as valid participants. The majority of the participants were Caucasian (97.8%) with a mean age of 44.1 ± 11.6. Out of all the participants, only 48.9% women identified HPV as a possible etiology of OPC. The most common sources of information regarding this association were the internet (31.3%), video media (28.9%), and healthcare professionals (28.9%), whereas 16.1% of the participants reported that they had obtained information from three or more sources. The average number of correct answers in the 16-item survey which was used to determine the participants' knowledge of HPV-related diseases was 8.7 ± 4.2, and the average number of correct answers in the 6-item survey regarding the usefulness of the HPV vaccination was 3.3 ± 1.6. According to bivariate models, the variables associated with a poorer level of awareness were related mainly to education (p < 0.001), sexual behavior (p < 0.001), and employment status (p < 0.001). This study contributes toward the discovery of the previously unforeseen psychosocial burden of HPV and its related diseases among Spanish women.

Resultados de la cirugía de prolapsos vaginales con mallas de polipropileno / Results of polypropylene mesh surgery for genital prolapse

Objetivo. Describir los resultados de la cirugía de prolapsos genitales con mallas de polipropileno y evaluar el grado de satisfacción de las pacientes. Material y métodos. Estudio descriptivo y retrospectivo de 94 mujeres con prolapsos genitales sintomáticos operadas con mallas de polipropileno. Resultados. La edad media era de 66,6 años y el 96,8% eran posmenopáusicas. Los prolapsos más frecuentes fueron: 47 casos solo cistocele, 14 con rectocele y 21 con cistocele y rectocele. La media del seguimiento fue de 26,7 meses. Las complicaciones fueron 4 casos con sangrado intraoperatorio, 8 infecciones urinarias, 12 incontinencias urinarias postoperatorias y 7 erosiones vaginales de la malla. El porcentaje de curación fue del 93,6%. Un 81,4% de las pacientes se sentían satisfechas y volverían a operarse. Conclusión. Esta cirugía presenta escasas complicaciones, consigue alta tasa de curación y alto grado de satisfacción de las pacientes (AU)

Objective: To describe the results of polypropylene mesh surgery for genital prolapse and to assess patient satisfaction with this procedure. Materials and methods: Descriptive and retrospective study of 94 women with symptomatic genital prolapse who underwent polypropylene mesh surgery. Results: The mean age of the patients was 66.6 years and 96.8% were postmenopausal. The most common prolapses were as follows: cystocele alone in 47 patients, rectocele in 14, and cystocele and rectocele in 21. The mean follow-up was 26.7 months. Complications consisted of intraoperative bleeding in 4 patients, urinary tract infections in 8, postoperative urinary incontinence in 12, and erosion of the mesh in the vagina in 7. The percentage of healing was 93.6%. A total of 81.4% of patients felt satisfied and would undergo the intervention again. Conclusion: This intervention produces few complications and achieves a high rate of healing. Patient satisfaction with this procedure was high (AU)

Adecuación del tratamiento inhalado en pacientes diagnosticados de Enfermedad Pulmonar Obstructiva Crónica / Suitability of inhaled therapy in patients diagnosed with chronic obstructive pulmonary disease (COPD)

Objetivo: Valorar la adecuación a las guías clínicas (GOLD) del tratamiento por vía inhalada de los pacientes diagnosticados de Enfermedad Pulmonar Obstructiva Crónica (EPOC). Diseño del estudio: Estudio observacional transversal de indicación-prescripción. Emplazamiento: Atención Primaria en la provincia de Orense. Participantes: Todos los casos de EPOC incluidos en el registro de pacientes crónicos de 28 cupos de 9 Centros de Salud de la provincia de Orense. Mediciones principales: Se determinó: edad, sexo, datos espirométricos, adecuación diagnóstica según resultados espirométricos y tratamiento farmacológico por vía inhalada (anticolinérgicos de larga duración, corticoides inhalados, beta-2 de larga duración y beta-2 de corta duración). Resultados: Eran varones 297 (77,7%) casos, con una media de edad de 77,0 (DE 11,0) años. El índice VEF1/CVF estaba registrado en 174 (45,5%) pacientes, siendo menor de 0,7 en 138 casos (36,1%), y figurando el VEF1 en 125 casos (90,6%). Fueron clasificados como Graves o Muy graves 71 pacientes (56,8%). El tratamiento era conforme a las recomendaciones en el 26,4% de los casos. En el 19,2% era incorrecto por defecto y en el 54,4% por exceso de medicación, relacionado fundamentalmente con el uso de corticoides inhalados, que estaban correctamente indicados en el 9% de los casos. No existían diferencias en el uso de fármacos en asociación en función de la gravedad de la EPOC. Conclusiones: En la terapia de la EPOC con fármacos inhalados existe una baja adecuación a los criterios recomendados en las principales guías de práctica clínica, sobre todo en el uso de corticoides (AU)

Objective: To assess the compliance of inhaled therapy in patients diagnosed with chronic obstructive lung disease to clinical guidelines (GOLD) Design: Indication/prescription cross-sectional observational study Location: Primary care in the province of Orense Participants: All cases of COPD included in the register for 28 chronic patients in 9 health centres in the province of Orense. Main Surveyed Data. The following were determined: age, sex, spirometric data, adjustment of diagnosis based on spirometric results, and inhaled drug therapy (long-acting anticholinergics, inhaled corticosteroids, long-acting beta-2 and short-acting beta-2) Results: 297 cases (77.7%) were male, with an average age of 77.0 years. The FEV1/ FVC ratio was registered in 174 (45.5%) patients. It was lower than 0.7 in 138 cases (36.1%) and FEV1 appeared in 125 cases (90.6%). 71 patients (56.8%) were classified as severe or very severe. The treatment was in accordance with recommendations in 26,4% of the cases. In 19.2% it was incorrect by default and in 54.4%, through over-medication, related primarily to the use of inhaled corticosteroids, which were correctly indicated in 9% of cases. There were no differences in the use of associated drugs based on the severity of the COPD. Conclusions: In COPD therapy with inhaled drugs, there is a low level of compliance with criteria recommended in the main clinical practice guidelines, especially regarding the use of corticosteroids (AU)

[Survival of patients diagnosed with prostate cancer and monitored in primary care]. / Supervivencia de pacientes diagnosticados de cáncer de próstata seguidos en atención primaria.

OBJECTIVE: To study survival of patients with prostate cancer and its relationship with diagnostic delay. DESIGN: Retrospective cohort study. SETTING: Six rural primary care practices. PARTICIPANTS: All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. MAIN MEASUREMENTS: Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. RESULTS: A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. CONCLUSIONS: Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer.

Supervivencia de pacientes diagnosticados de cáncer de próstata seguidos en atención primaria / Survival of patients diagnosed with prostate cancer and monitored in primary care

Objetivo. Analizar la supervivencia de los pacientes afectados de cáncer de próstata y su relación con la demora diagnóstica. Diseño. Estudio de cohortes retrospectivo. Emplazamiento. Seis consultas rurales de atención primaria. Participantes. La totalidad de pacientes diagnosticados de cáncer de próstata entre 1992 y 2005 atendidos en dichas consultas. Mediciones principales. Se determinaron la edad en el momento del diagnóstico de confirmación, las fechas de diagnóstico de sospecha y confirmación, el método diagnóstico, la estrategia terapéutica y la fecha de fallecimiento cuando procedía. Se utilizó el método de Kaplan-Meier en la determinación de la probabilidad de supervivencia y el análisis de regresión de Cox en la investigación de los factores pronósticos. Resultados. Se estudiaron 84 casos. La edad media ± desviación estándar (DE) en el momento del diagnóstico fue de 75,8 ± 8,6 años. La mediana del retraso en la confirmación diagnóstica fue de 31 días. El diagnóstico se realizó mediante biopsia en 38 casos (45,2%). Se realizó tratamiento potencialmente curativo en 18 casos (21,4%) y recibieron tratamiento paliativo 66 pacientes (78,6%). La edad media de los fallecidos era de 82,6 ± 9,1 años. Entre los 49 fallecidos en el momento del cierre del estudio, 22 (44,9%) murieron por el cáncer de próstata. La mediana de la supervivencia fue de 72,1 ± 6,1 meses. La probabilidad de supervivencia global a los 10 años tras el diagnóstico fue del 33,3%, y la específica, del 57,5%. No se encontraron diferencias en la supervivencia en función del retraso en la confirmación diagnóstica. Conclusiones. La supervivencia tras el diagnóstico de cáncer de próstata se puede considerar alta. No hay relación entre la supervivencia y el retraso en la confirmación del diagnóstico en el conjunto de los pacientes afectados de cáncer de próstata

Objective. To study survival of patients with prostate cancer and its relationship with diagnostic delay. Design. Retrospective cohort study. Setting. Six rural primary care practices. Participants. All patients diagnosed with prostate cancer and monitored in these practices between 1992 and 2005. Main measurements. Patient age at definite diagnosis, dates of definite and suspected diagnosis, diagnostic method, treatment strategy, and date of death, if it occurred, were determined. Kaplan-Meier analysis was used to estimate survival probability; and Cox's regression, to examine prognostic factors. Results. A total of 84 patients were identified. Mean (SD) age at diagnosis was 75.8 (8.6) years. Median delay until definite diagnosis was 31 days. The diagnosis was carried out through biopsy in 38 cases (45.2%). Eighteen patients were given possibly curative treatment (21.4%) and 66 patients (78.6%) received palliative treatment. Mean age of the deceased was 82.6 (9.1) years. Of 49 patients who died by the end of the study, 22 (44.9%) died from prostate cancer. Mean survival was 72.1 months (SE, 6.1). The probability of overall survival 10 years after diagnosis was 33.3%, and specific survival was 57.5%. There were no differences in survival due to delay in definite diagnosis. Conclusions. Survival after diagnosis of prostate cancer can be considered high. There is no relationship between survival and delay in definite diagnosis in patients with prostate cancer

Influencia de la edad y el sexo en la información del paciente en fase terminal / Influence of age and sex on information for terminal-stage patients

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[Compliance with the metabolic goals in diabetes mellitus treatment in the rural area of Ourense, Spain]. / Cumplimiento de los objetivos de control metabólico en diabetes mellitus en el medio rural de ourense.

BACKGROUND: To evaluate the degree to which the metabolic check-up objectives among Type II diabetes patients were met in rural primary care by comparing them to the values recommended by the American Diabetes Association (ADA) and the Diabetes in Primary Care Study Group (GEDAPS). METHODS: Descriptive cross-sectional study. A sample size was calculated based on the glycosolated hemoglobin (HbA1c) test in 119 individuals. A total of 253 patients with Type II diabetes followed up for at least two years at their healthcare facility took part. The patients in question were selected at random from among 17 medical lists at 11 rural healthcare facilities in the province of Ourense (Spain). Demographic variables, cardiovascular risk factors, pharmacological treatment, self-analyses, eye fundus, tactile sensitivity, HbA1c, lipid profile, blood pressure and body mass index data were taken from the patients' clinical records. RESULTS: A total of 44.3% of those in the sample had undergone an HbA1c test within the immediately prior six-month period, showing a value of under seven percent (7%). A total of 21.2% had a blood pressure of under 130/80, and 19.8% a LDL cholesterol level of under 100 mg/dl. A total of 40.7% of those patients with a LDL cholesterol level over 100 were not undergoing any hypolipemiant treatment. A total of 20.4% of the patients showing high blood pressure readings were not undergoing any blood pressure lowering treatment. On the basis of these three factors, a total of 2.5% met the check-up objectives. Thirty-six percent (36%) were antiaggregated with AAS. CONCLUSIONS: A major deficit is revealed both in the frequency of the check-ups conducted by the healthcare professionals as well as the number of interventions performed for achieving the proposed objectives, showing results far below what is recommended in the clinical practice guidelines.

Cumplimiento de los objetivos de control metabólico en diabetes mellitus en el medio rural de Ourense / The diabetes mellitus metabolic check-up objectives met in the rural area of Ourense, Spain

Fundamento: Valorar el cumplimiento de los objetivos de controlmetabólico en el paciente diabético tipo 2 en la atención primariade ámbito rural, comparándolo con los valores recomendados porla American Diabetes Association (ADA) y el Grupo de estudio de ladiabetes en atención primaria de salud (GEDAPS).Métodos: Estudio descriptivo transversal. Se calculó un tamañomuestral, basándose en la determinación de la hemoglobina glicosilada(HbA1c), de 119 individuos. Participaron 253 personas diabéticastipo 2 con al menos 2 años de seguimiento en su centro de salud.Fueron seleccionados de forma aleatoria de 17 cupos médicos de 11centros de salud rurales de la provincia de Ourense. A partir de la historiaclínica se recogieron variables demográficas, factores de riesgocardiovascular, tratamiento farmacológico, realización de autoanálisis,fondo de ojo, sensibilidad táctil, HbA1c, perfil lipídico, presiónarterial e índice de masa corporal.Resultados: En el 44,3% de las personas de la muestra se habíadeterminado HbA1c en los últimos 6 meses y presentaba un valorinferior a 7%. Un 21,2% tenía la presión arterial por debajo de130/80, y el 19,8% un colesterol LDL menor de 100 mg/dl. Entre lospacientes con colesterol LDL mayor de 100 el 40,7% no recibía tratamientohipolipemiante. El 20,4% de los que tenían cifras elevadasde presión arterial no recibía tratamiento hipotensor. Considerandoestos tres factores el 2,5% alcanzaba los 3 objetivos de control. Un36% realizaba tratamiento antiagregante con ácido acetil salicilico.Conclusiones: Se constata un importante déficit tanto en la frecuenciade los controles realizados por los profesionales sanitarioscomo en el número de intervenciones realizadas para conseguir losobjetivos propuestos, con resultados muy inferiores a lo recomendadoen las guías de práctica clínica

Background: To evaluate the degree to which the metaboliccheck-up objectives among Type II diabetes patients were met inrural primary care by comparing them to the values recommendedby the American Diabetes Association (ADA) and the Diabetes inPrimary Care Study Group (GEDAPS).Methods: Descriptive cross-sectional study. A sample size wascalculated based on the glycosolated hemoglobin (HbA1c) test in119 individuals. A total of 253 patients with Type II diabetes followedup for at least two years at their healthcare facility took part. Thepatients in question were selected at random from among 17 medicallists at 11 rural healthcare facilities in the province of Ourense(Spain). Demographic variables, cardiovascular risk factors, pharmacologicaltreatment, self-analyses, eye fundus, tactile sensitivity,HbA1c, lipid profile, blood pressure and body mass index data weretaken from the patients´ clinical records.Results: A total of 44.3% of those in the sample had undergonean HbA1c test within the immediately prior six-month period, showinga value of under seven percent (7%). A total of 21.2% had ablood pressure of under 130/80, and 19.8% a LDL cholesterol levelof under 100 mg/dl. A total of 40.7% of those patients with a LDLcholesterol level over 100 were not undergoing any hypolipemianttreatment. A total of 20.4% of the patients showing high blood pressurereadings were not undergoing any blood pressure lowering treatment.On the basis of these three factors, a total of 2.5% met thecheck-up objectives. Thirty-six percent (36%) were antiaggregatedwith AAS.Conclusions: A major deficit is revealed both in the frequencyof the check-ups conducted by the healthcare professionals as well asthe number of interventions performed for achieving the proposedobjectives, showing results far below what is recommended in theclinical practice guidelines

[Impact of the format of presentation of results in clinical trials on the intention of prescription in primary care. A crossed clinical trial in Ourense]. / Efecto de la forma de presentación de los resultados en los ensayos clínicos en la intención de prescripción en atención primaria. Un ensayo clínico cruzado en Ourense.

BACKGROUND: Given that there are different ways of setting out clinical test results, this study is aimed at ascertaining whether the way in which these results are set out has any bearing on the intention to prescribed on the part of Primary Care physicians. METHODS: Randomized, multi-center cross-study. Following a random sampling of Eight Primary Care Teams in the province of Ourense (Spain), two groups of family physicians (nA = 45 and nB = 51) were surveyed by means of a questionnaire on which the data from five published clinical tests (three on heart disease preventation, one on cognitive benefit in a dementia syndrome and another on preventing fractures among the elderly) was shown. One of the groups was shown the data as a relative lowering of the risk, and the other as the necessary number of individuals to be treated. Age, gender and years of practice were also asked. Following a three-week blanking period, the intervention was reversed. The intention of prescribing was gathered on a 0-10 Likert scale. The chi 2, simple Student t were used, or the Pearson test for paired data and correlation, according to whether an error a de 0.05 were to be achieved. RESULTS: Test A: C195% (-1.55-0.17); B: C195% (-2.75-1.20); C: CI95% (-0.16-1.65); D: C195% (-0.30-1.44); E:C195% (-1.22-0.35). No difference with regard to gender, age or professional experience were found. Regarding the overall effect, with the exception of one of the tests presented, no significant differences were found concerning the intention of prescribing the drugs involved in terms of the way in which the data was set out. CONCLUSIONS: The way in which clinical test data is set out has no bearing in itself on the intention to prescribe medications.

Opinión de los médicos de atención primaria de ourense sobre algunos aspectos de su prescripción farmacéutica / Opinion of the primary care physicians of Ourense with respect to certain aspects of their prescription of medicines

Fundamento: Conocer la opinión de los médicos de atención primaria de Ourense (España) con respecto a algunos aspectos de su prescripción como el conocimiento del precio de los fármacos, la prescripción inducida percibida, la relación con la industria farmacéutica y la opinión del médico sobre posibles medidas reductoras del gasto farmacéutico. Métodos: En este estudio transversal descriptivo, se entrevistó mediante un cuestionario postal, previamente probado, a todos los médicos de atención primaria (MAP) de la provincia de Ourense (243). En él se recogían características demográficas de los facultativos, influencia del coste en la prescripción, estimación del precio de 15 fármacos de uso habitual y la opinión sobre diversos aspectos relacionados con la prescripción inducida, la industria farmacéutica y diversas estrategias para contener el gasto en farmacia. Para el análisis de los resultados se utilizaron pruebas de X2, t de Student y análisis de la varianza, así como el coeficiente de correlación de Spearman según cumpliera con un error a de 0,05. Resultados. El nivel de participación de los encuestados fue del 42,8 por ciento (104). La duración media diaria de la visita de los delegados farmacéuticos fue de 13,6 minutos, siendo las novedades el punto de mayor interés. Casi un 27 por ciento admitía participar en ensayos clínicos patrocinados por la industria. El 23 por ciento consideraba el precio una prioridad al prescribir. La prescripción inducida suponía el 39,7 por ciento del total. Los facultativos eligieron mayoritariamente el copago para reducir el gasto farmacéutico. En la estimación del precio el porcentaje de error global fue del 45,7 por ciento, subestimando los más caros y sobrestimando los más baratos. Conclusiones. Existe un desconocimiento importante del precio de los fármacos entre los MAP. La mayor parte de los médicos no consideran que el precio del fármaco deba ser una prioridad al prescribir. Hay un porcentaje elevado de prescripción inducida percibida. Respecto al gasto farmacéutico, la mayor parte de los MAP considera las medidas económicas, en concreto el copago, como las más efectivas para su contención (AU)

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