Objetivo: Analizar la evolución y adecuación de las derivaciones de Atención Primaria a Urología tras la implantación de protocolos sobre las enfermedades urológicas más frecuentes y la instauración de un programa de formación continuada. Material y métodos: En el 2011 se creó un grupo de trabajo Atención Primaria-Urología. Se instauraron inicialmente protocolos de actuación y práctica clínica en enfermedad prostática (HBP y PSA), que se apoyaron con sesiones formativas a los médicos de Atención Primaria. Tras analizar su efecto, en el 2015 se añadieron otros 3(enfermedad escrotal, infecciones urinarias e incontinencia urinaria). Analizamos y comparamos las derivaciones y su adecuación antes y después de la instauración. Resultados: El motivo más frecuente de derivación son los síntomas del tracto urinario inferior (STUI) por HBP que, inicialmente, suponían un 22,8% del total, y que han disminuido al 16,9%. Tras la introducción de los demás algoritmos, observamos una disminución de las derivaciones sobre enfermedad escrotal (del 13-14 al 7,8%), que permanecen estables (en torno al 10%) las relacionadas con infecciones urinarias y que aumentan las derivaciones por incontinencia urinaria (del 3 al 10,3%). La adecuación a los protocolos fue mejorando progresivamente en las relacionadas con STUI (del 46 al 65,3%); en PSA (del 55 al 84,4%) y en incontinencia urinaria (del 66,2 al 73,1%). Descendió la adecuación en cuanto a enfermedad escrotal (del 67,1 al 63,3%) y se mantuvo similar en ITU (en torno al 76%). Conclusiones: El trabajo conjunto entre Urología y Atención Primaria consigue mejorar la adecuación de las derivaciones en las enfermedades urológicas más frecuentes
Objective: To analyse the evolution and adequacy of referrals from Primary Care to Urology, after the implementation of referral protocols on the most frequent urological diseases and the establishment of a continuing education program. Material and methods: A Primary Care-Urology work group was created in 2011. Initially, performance and clinical practice protocols in prostatic pathology (BPH and PSA) were established. These were supported by training sessions for primary care physicians. After analysing the effect of the mentioned joint work, 3more (scrotal pathology, urinary tract infections and urinary incontinence) were included. We analysed and compared the referrals and their adequacy before and after the establishment of the protocols. Results: The most common referral causes were symptoms of the lower urinary tract due to BPH, which initially represented 22.8% of the total, and decreased to 16.9%. After the introduction of the new algorithms, we observed a decrease in referrals for scrotal pathology (13-14% to 7.8%), an increase in urinary incontinence referrals (3% al 10.3%) and those related to urinary tract infections remained stable. The adequacy to the protocols improved progressively: LUTS from 46% to 65.3%; PSA from 55% to 84.4% and urinary incontinence from 66.2% to 73.1%. Adequacy in scrotal pathology decreased (de 67.1% a 63.3%), while in UTI it stayed much the same (around 76%). Conclusions: The joint work between Urology and Primary Care achieves an improvement in referrals adequacy regarding the most frequent urological pathologies
Primary Health Care/organization & administration , Education, Continuing/methods , Continuity of Patient Care/organization & administration , Urology Department, Hospital , Referral and Consultation/trends , Primary Health Care/statistics & numerical data , Primary Health Care/standards
OBJECTIVE: To analyse the evolution and adequacy of referrals from Primary Care to Urology, after the implementation of referral protocols on the most frequent urological diseases and the establishment of a continuing education program. MATERIAL AND METHODS: A Primary Care-Urology work group was created in 2011. Initially, performance and clinical practice protocols in prostatic pathology (BPH and PSA) were established. These were supported by training sessions for primary care physicians. After analysing the effect of the mentioned joint work, 3more (scrotal pathology, urinary tract infections and urinary incontinence) were included. We analysed and compared the referrals and their adequacy before and after the establishment of the protocols. RESULTS: The most common referral causes were symptoms of the lower urinary tract due to BPH, which initially represented 22.8% of the total, and decreased to 16.9%. After the introduction of the new algorithms, we observed a decrease in referrals for scrotal pathology (13-14% to 7.8%), an increase in urinary incontinence referrals (3% al 10.3%) and those related to urinary tract infections remained stable. The adequacy to the protocols improved progressively: LUTS from 46% to 65.3%; PSA from 55% to 84.4% and urinary incontinence from 66.2% to 73.1%. Adequacy in scrotal pathology decreased (de 67.1% a 63.3%), while in UTI it stayed much the same (around 76%). CONCLUSIONS: The joint work between Urology and Primary Care achieves an improvement in referrals adequacy regarding the most frequent urological pathologies.
Education, Medical, Continuing/organization & administration , Primary Health Care/statistics & numerical data , Program Development , Referral and Consultation/statistics & numerical data , Urology/statistics & numerical data , Algorithms , Continuity of Patient Care/organization & administration , Electronic Mail/organization & administration , Electronic Mail/statistics & numerical data , Electronic Mail/trends , Female , General Practice/organization & administration , General Practice/statistics & numerical data , Humans , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/epidemiology , Lower Urinary Tract Symptoms/therapy , Male , Referral and Consultation/standards , Referral and Consultation/trends , Retrospective Studies , Spain , Urinary Incontinence/diagnosis , Urinary Incontinence/epidemiology , Urinary Incontinence/therapy , Urinary Tract Infections/diagnosis , Urinary Tract Infections/epidemiology , Urinary Tract Infections/therapy
Hypoplasia and ovarian cysts are the most common ovarian pathologies in cattle. In this genome-wide study we analyzed the signal intensity of 648,315 Single Nucleotide Polymorphisms (SNPs) and identified 1338 genes differentiating cows with ovarian pathologies from healthy cows. The sample consisted of six cows presenting an ovarian pathology and six healthy cows. SNP signal intensities were measured with a genotyping process using the Axiom Genome-Wide BOS 1 SNPchip. Statistical tests for equality of variance and mean were applied to SNP intensities, and significance p-values were obtained. A Benjamini-Hochberg multiple testing correction reveled significant SNPs. Corresponding genes were identified using the Bovine Genome UMD 3.1 annotation. Principal Components Analysis (PCA) confirmed differentiation. An analysis of Copy Number Variations (CNVs), obtained from signal intensities, revealed no evidence of association between ovarian pathologies and CNVs. In addition, a haplotype frequency analysis showed no association with ovarian pathologies. Results show that SNP signal intensity, which captures not only information for base-pair genotypes elucidation, but the amount of fluorescence nucleotide synthetization produced in an enzymatic reaction, is a rich source of information that, by itself or in combination with base-pair genotypes, might be used to implement differentiation, prediction and diagnostic procedures, increasing the scope of applications for Genotyping Microarrays.
Polymorphism, Single Nucleotide , Animals , Cattle , DNA Copy Number Variations , Female , Genome , Genome-Wide Association Study , Genotype , Ovarian Diseases
The addition of rice polishing (RP) and phytase enzyme to poultry diets was tested on 200 1-day-old broilers weighing 42 g. Birds were assigned to a completely random design with a 2 × 2 factorial arrangement with four treatments and five repetitions of ten birds each. The factors evaluated were RP level (0 and 15%) and phytase (0 and 150 g/ton). The trial was divided in two phases of 21 days each (42 days total). In phase 1, no treatment effects were observed (P>0.10) on poultry productive behavior. In the second phase (21 to 42 days) and on the total trial (1 to 42 days), there were no effects of the treatments on weight gain or feed intake (P>0.10). Feed conversion was affected by RP (P<0.01) but not by phytase addition (P>0.10). In conclusion, phytase did not affect broiler production with or without RP. Addition of 15 % RP in poultry diets represents an alternative to reduce feed costs.
6-Phytase/administration & dosage , Animal Feed , Chickens/growth & development , Dietary Supplements , Oryza , Animals , Body Weight/physiology , Chickens/metabolism , Eating/physiology , Mexico , Random Allocation , Tropical Climate
It was evaluated the effect of magnesium oxide (MgO) addition in diets for Holstein cows on milk production and quality. Nineteen Holstein cows in second third of lactation were assigned to two treatments (T), with 9 and 10 animals. Both treatments were similar for days in lactation and milk yield. Cows were assigned at random to two treatments (T) groups: T1 received 0.2% and T2 received 0.4% of MgO. The MgO (alkalinizing agent) was mixed with a commercial concentrate and offered in feed bunk with total diet, which consisted of 9 kg/d of concentrate plus alfalfa hay fed ad libitum. Total diet was offered three times a day (0600; 1200 and 1700 h). The experimental period was of 30 d, with other 30 for adaptation. Milk production (kg/d) and milk quality (fat, protein, and total solids) were evaluated. Data were analyzed using the statistical package SAS through of a randomized block design. Animals on T2 (0.40% MgO) produced 2.85 kg/d more milk (P<0.50) than those on T1 (0.20% MgO). The fat, protein and total solids content in milk were higher (P<0.05) in T1 than in T2. It is concluded that the addition of 0.4% MgO in diets for lactating dairy cows resulted in milk production increased, although there was a small reduction in milk quality, compared with 0.2% MgO supplementation.
Se evaluó el efecto de adición de óxido de magnesio (MgO) en dietas para vacas Holstein sobre la producción y calidad de la leche. Diecinueve vacas Holstein en el segundo tercio de lactancia fueron asignadas a dos tratamientos (T), con 9 y 10 animales. Ambos tratamientos fueron similares para días de lactancia y producción de leche. Las vacas fueron asignadas al azar a dos grupos o tratamientos (T): T1 recibió 0,2%, y T2 recibió 0,4% de MgO. El MgO (agente alcalinizante) se mezcló con un concentrado comercial y se ofreció en el comedero junto con la dieta total, la cual consistió de 9 kg/d del concentrado mas heno de alfalfa ad libitum. La dieta total se ofreció 3 veces al día (06000, 1200 and 1700 h). El periodo experimental fue de 30 d, con otros 30 d de adaptación. Se evaluó la producción de leche (kg/d) y la calidad de la leche (grasa, proteína, y sólidos totales). Los datos se analizaron por medio del paquete estadístico SAS en un diseño de bloques al azar. Los animales en T2 (0,4% MgO) produjeron más leche (2,5 kg/d; P<0,05) que aquellos en T1 (0,20% MgO). El contenido de grasa, proteína, y sólidos totales en leche fue más alto (P<0,05) en T1 que en T2. Se concluye que la adición de 0,40% de MgO en dietas para vacas lactantes incrementa la producción de leche, sin embargo puede haber una pequeña reducción en la calidad de la leche, comparado con la suplementación de 0,20% de MgO.
