Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 69
Filtrar
1.
Semergen ; 50(5): 102208, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38471366

RESUMO

OBJECTIVE: This study aimed to characterize the prevalence as well as clinical and epidemiological features of persistent symptoms after acute COVID-19, focusing on gender-specific differences in a primary care setting. METHODS: A total of 1542 individuals with confirmed SARS-CoV-2 infection were enrolled. The study population comprised 55.77% females (mean age: 45.04 years). Risk factors for persistent COVID-19 were analyzed, revealing disparities between men and women. Symptom clusters and their prevalence were assessed over time, along with functional status using the post-COVID-19 functional status scale. RESULTS: The prevalence of persistent COVID-19 was 12.38%, with females exhibiting a 1.5 times higher risk. Females displayed a higher number of visits and persistent symptoms at 90 days, decreasing after one year. Symptom clusters varied between genders, with females experiencing more dermatological issues. Functional status analysis revealed that females had a better pre-infection status, similar status to males at 90 days, and improved status at 180-, 270-, and 365-days post-infection. Logistic regression analysis showed significant associations between persistence, gender, hospitalization, radiological abnormalities, age, and immunosuppression. CONCLUSION: This study provides insights into the prevalence and clinical characteristics of persistent COVID-19 in a primary care population. Females exhibited a higher risk of persistent symptoms and displayed distinct patterns in symptom clusters and functional status compared to males. These findings contribute to a better understanding of the long-term effects of COVID-19 and highlight the importance of gender-specific considerations in post-acute care.

3.
Rev. esp. anestesiol. reanim ; 70(6): 362-365, Jun-Jul. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-221252

RESUMO

Paciente de 26 años afecto de ataxia de Friederich con una miocardiopatía hipertrófica no obstructiva sometido a una tiroidectomía total por una tirotoxicosis secundaria a amiodarona persistente (a pesar de elevadas dosis de antitiroideos y corticoides), que intraoperatoriamente presentó un episodio sugestivo de tormenta tiroidea.La tormenta tiroidea es una urgencia endocrinológica que asocia una elevada morbimortalidad. Para mejorar la supervivencia es de vital importancia un diagnóstico temprano y un tratamiento precoz que incluya: un tratamiento sintomático, el tratamiento de las manifestaciones cardiovasculares, neurológicas y/o hepáticas y de la tirotoxicosis, así como suprimir o evitar estímulos desencadenantes y practicar un tratamiento definitivo.(AU)


A 26-year-old patient with Friederich's ataxia with hypertrophic obstructive cardiomyopathy undergoing a total thyroidectomy due to persistent amiodarone-induced thyrotoxicosis (despite high doses of antithyroid drugs and corticosteroids), presented an intraoperative episode suggestive of thyroid storm.Thyroid storm is an endocrine emergency that is associated with high morbimortality. Early diagnosis and treatment, which is of vital importance to improve survival. Treatment includes: symptomatic treatment, treatment of cardiovascular, neurological, and/or hepatic manifestations and thyrotoxicosis, measures to suppress or avoid triggering stimuli, and definitive treatment.(AU)


Assuntos
Humanos , Masculino , Adulto , Ataxia de Friedreich/complicações , Ataxia de Friedreich/tratamento farmacológico , Crise Tireóidea/complicações , Crise Tireóidea/tratamento farmacológico , Cardiomiopatia Hipertrófica , Tireotoxicose , Amiodarona , Anestesia , Anestesiologia , Resultado do Tratamento , Pacientes Internados , Exame Físico , Avaliação de Sintomas
4.
Artigo em Inglês | MEDLINE | ID: mdl-37276964

RESUMO

A 26-year-old patient with Friederich's ataxia with hypertrophic obstructive cardiomyopathy undergoing total thyroidectomy due to persistent amiodarone-induced thyrotoxicosis (despite high doses of antithyroid drugs and corticosteroids), presented an intraoperative episode suggestive of thyroid storm. Thyroid storm is an endocrine emergency that is associated with high morbidity and mortality. Early diagnosis and treatment, which is of vital importance to improve survival, includes symptomatic treatment, treatment of cardiovascular, neurological, and/or hepatic manifestations and thyrotoxicosis, measures to suppress or avoid triggering stimuli, and definitive treatment.


Assuntos
Anestésicos , Crise Tireóidea , Tireotoxicose , Humanos , Adulto , Crise Tireóidea/complicações , Crise Tireóidea/diagnóstico , Crise Tireóidea/tratamento farmacológico , Tireotoxicose/complicações , Tireotoxicose/cirurgia , Tireotoxicose/induzido quimicamente , Ataxia/complicações , Ataxia/tratamento farmacológico , Antitireóideos/efeitos adversos , Anestésicos/efeitos adversos
5.
Sanid. mil ; 78(3): 151-158, septiembre 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-214635

RESUMO

Antecedentes y objetivo: La concepción actual de la discapacidad, donde las características físicas de una persona son contempladas en su interacción con el entorno, requiere de estudios actitudinales de la población que faciliten la identificación de las barreras que limitan el ejercicio de los derechos en igualdad de oportunidades para las personas con discapacidad en contextos profesionales. El objetivo principal del estudio ha sido el diseño, construcción y validación de un instrumento de evaluación de las actitudes hacia la discapacidad en personal militar.Método:En el estudio han participado 204 militares de diferentes empleos y escalas, donde un 11,76 % fueron mujeres y un 88,24 % hombres. El desarrollo del trabajo estuvo dividido en dos fases. En la primera fase, se construye la escala y se somete a juicio de expertos analizando la concordancia entre los mismos con el fin de valorar la validez de contenido del cuestionario. En la segunda fase, se valoran las cualidades psicométricas de fiabilidad y validez (constructo y concurrente) de la escala.Resultados:Los resultados obtenidos reflejan propiedades psicométricas adecuadas y ajustadas del instrumento. En el análisis de la fiabilidad se observa que, tanto la escala en su conjunto (.87), como las dos subescalas que la conforman (.88 y .89), presentan una adecuada consistencia interna. En los análisis exploratorio y confirmatorio realizados, se obtiene un modelo con una solución de dos factores cuyos datos de bondad de ajuste (NFI = 0.94, GFI = 0.94, CFI = .97, RMSEA = .06 (IC 90 % = .048 - .070), RMR estandarizado = .091) garantizan una adecuada validez de constructo. Asimismo, se observa una adecuada validez concurrente (.76; p< .01).Conclusiones:Se concluye el uso justificado y óptimo del instrumento para la evaluación de las actitudes hacia la discapacidad en personal militar. (AU)


Background and objective: Currently, the conception of disability considers the physical characteristics of the person in their interaction with the environment. This understanding makes it necessary for the development of attitudinal studies of the population that facilitate the identification of barriers that limit the exercise of people with disabilities’ rights in equal opportunities in the professional field. The main objective of the study was the design, construction, and validation of an instrument to assess attitudes towards disability in the Armed Forces.Method:204 soldiers of different positions and scales participated in the study, where 11.76 % were women and 88.24 % were men. The study was divided into two phases. In the first phase, the scale was constructed and evaluated by a group of experts. The concordance between them was also analyzed in order to evaluate the validity of the content of the questionnaire. In a second phase, the psychometric qualities of reliability and validity (construct and concurrent) of the scale were evaluated.Results:The results obtained reflect appropriate psychometric properties adjusted to the instrument. The reliability analysis, shows that both, the scale as a whole (.87), and the two subscales that make it up(.88 and .89), present adequate internal consistency. In the exploratory and confirmatory analyses performed, it is obtained a model with a two-factor solution. Its goodness-of-fit data (NFI = 0.94, GFI = 0.94, CFI = .97, RMSEA = .06 (90 % CI = .048 - .070), standardized RMR = .091) guarantee adequate construct validity. Likewise, an appropriate concurrent validity is observed (.76; p<.01).Conclusions:In conclusion, the use of the instrument for the evaluation of attitudes towards disability in the Armed Forces is justified and optimal. (AU)


Assuntos
Humanos , Estudos sobre Deficiências , Veteranos , 51708
6.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 48(1): 14-22, Ene. - Feb. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-205196

RESUMO

Objetivos: Conocer las actitudes y conocimientos de los usuarios respecto a cómo y dónde se desechan los inhaladores tras finalizar su uso, y describir su opinión sobre el uso de inhaladores recargables. Métodos: Estudio transversal, multicéntrico y de opinión, diseñado para conocer el comportamiento y actitudes respecto al circuito de desecho de los inhaladores y a la utilización de inhaladores recargables. La información se obtuvo mediante la aplicación de un cuestionario ad hoc de conocimientos y actitudes, conteniendo datos de uso y reciclado de inhaladores. Resultados: Se incluyeron 303 sujetos (57,5 ± 19,9 años; tiempo de empleo de inhaladores 9,6±9,8 años; asma/EPOC: 46,2/25,7%). El inhalador más empleado fue el aerosol presurizado en suspensión (30,5%). La mayoría otorgaban una elevada importancia al reciclado de inhaladores (7,75±2,76, sobre 10), y a disponer cada seis meses del mismo inhalador recargable mensualmente (7,77±2,79, sobre 10). El 33% refería haber sido informado alguna vez sobre dónde depositar el inhalador. En cuanto al reciclado, el 42,9% lo hacía en el punto SIGRE de la farmacia. Respecto al destino final de los inhaladores, el 43,6% creía que los dispositivos entregados se reciclaban o destruían y un 35,3% desconocía qué ocurre con los inhaladores después de depositarlos en el punto SIGRE. Conclusiones: A pesar de que los usuarios consideran importante el reciclado de inhaladores y disponer de inhaladores recargables, un porcentaje significativo no los deposita en el punto SIGRE, no han sido informados sobre el lugar correcto de depósito, y desconocen qué ocurre con los inhaladores desechados. Son necesarias campañas de información (AU)


Objectives: To assess users’ attitudes and knowledge of users about how and where inhalers are removed after finalizing their use, and to describe their opinion about utilizing re-usable inhalers. Methods: Cross-sectional, multi-center, and opinion survey, conducted to assess behavior and attitudes regarding the disposal of inhalers recycling and the use of re-usable inhalers, through the application of an ad hoc questionnaire about the knowledge and attitudes, with data about the use and recycling of inhalers. Results: A total of 303 subjects (57.5±19.9 years; time of inhalers’ use 9.6±9.8 years; asthma/COPD: 46.2%/25.7%) were included. Pressurized metered-dose inhalers were the most commonly used inhalers (30.5%). Most users considered the recycling of inhalers to be very important (7.75±2.76, out of 10), and rated highly the availability of having a monthly rechargeable inhaler every 6 months (7.77±2.79, out of 10). Only 33% of users had been informed by their healthcare professionals about the place of delivering the inhaler. With respect to recycling, 42.9% of all users recycled in the SIGRE point of the pharmacy. Regarding the final destination of inhalers, 43.6% thought that the removed inhalers were recycled or destroyed, but 35.3% did not know what would happen to the inhalers after placing in the SIGRE point. Conclusions: Despite users considered the importance of inhalers recycling and the availability of re-usable inhalers, a significant proportion does not recycle in the SIGRE point, has not been informed about the appropriate place of delivering the inhaler and ignores what happens to inhalers. Information campaigns are warranted (AU)


Assuntos
Humanos , Asma/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Administração por Inalação , Sprays Orais , Estudos Transversais
7.
Semergen ; 48(1): 14-22, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34479795

RESUMO

OBJECTIVES: To assess users' attitudes and knowledge of users about how and where inhalers are removed after finalizing their use, and to describe their opinion about utilizing re-usable inhalers. METHODS: Cross-sectional, multi-center, and opinion survey, conducted to assess behavior and attitudes regarding the disposal of inhalers recycling and the use of re-usable inhalers, through the application of an ad hoc questionnaire about the knowledge and attitudes, with data about the use and recycling of inhalers. RESULTS: A total of 303 subjects (57.5±19.9 years; time of inhalers' use 9.6±9.8 years; asthma/COPD: 46.2%/25.7%) were included. Pressurized metered-dose inhalers were the most commonly used inhalers (30.5%). Most users considered the recycling of inhalers to be very important (7.75±2.76, out of 10), and rated highly the availability of having a monthly rechargeable inhaler every 6 months (7.77±2.79, out of 10). Only 33% of users had been informed by their healthcare professionals about the place of delivering the inhaler. With respect to recycling, 42.9% of all users recycled in the SIGRE point of the pharmacy. Regarding the final destination of inhalers, 43.6% thought that the removed inhalers were recycled or destroyed, but 35.3% did not know what would happen to the inhalers after placing in the SIGRE point. CONCLUSIONS: Despite users considered the importance of inhalers recycling and the availability of re-usable inhalers, a significant proportion does not recycle in the SIGRE point, has not been informed about the appropriate place of delivering the inhaler and ignores what happens to inhalers. Information campaigns are warranted.


Assuntos
Asma , Doença Pulmonar Obstrutiva Crônica , Administração por Inalação , Asma/tratamento farmacológico , Estudos Transversais , Humanos , Nebulizadores e Vaporizadores , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
9.
Semergen ; 47(4): 215-223, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-33359382

RESUMO

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is considered a public health issue which affects 10.2% of Spanish population between 40 and 80 years of age. Many patients do not perform well the inhalation technique. Error rates vary between 50-80% depending on the device under study. These values haven been proven to decrease with educational interventions. OBJECTIVE: To ascertain whether a group educational intervention is superior to an individual intervention or to a conventional approach in these patients as regards quality of life measured by means of the total score of the COPD Assessment Test (CAT),of adherence to treatment, exacerbations and hospitalizations. MATERIAL AND METHODS: A multicenter, multidisciplinary cluster-randomized controlled clinical trial with three branches (conventional intervention, individual intervention and group intervention) in a cohort of COPD-patients. Sociodemographic data and risk factors were collected and several questionnaires were completed (CAT, BODEx, Barthel, Lawton y Brody). A descriptive analysis of qualitative and quantitative variables and a multiple linear regression were conducted. OUTCOMES: 149 patients of average age 69.08 (SD 1.26). Significant differences were observed in CAT in the different intervention groups according to the level of severity on BODEx. The rate of patients performing well the inhalation technique was significantly lower at the beginning of the study and the number of exacerbations was lower after the intervention. Last year's exacerbations were linearly related to post-intervention suffering. CONCLUSIONS: Better results are obtained using the traditional and individual interventions. There is a decrease in number of exacerbations, hospitalizations, CAT score and post-intervention inhalation technique.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Estudos de Coortes , Hospitalização , Humanos , Inquéritos e Questionários
12.
J Assist Reprod Genet ; 37(9): 2081-2092, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32578032

RESUMO

PURPOSE: Intracytroplasmatic sperm injection (ICSI) is a common procedure used to improve reproductive results, even among couples without male factor infertility. However, the evidence available is still uncertain on the possible advantages and deficiencies that this procedure may have in patients with no formal indication for ICSI. METHODS: A SWOT (strengths, weaknesses, opportunities, threats) analysis examines the possible advantages and deficiencies of performing ICSI in these patients with no formal indication. RESULTS: The evidence suggests that ICSI is not justified for non-male factor infertile couples requiring in vitro conception. One of the major strengths associated to the procedure is the virtual elimination of cases further complicated by total fertilization failure and a combination between IVF and ICSI on sibling oocytes has been advised in the literature. Greater technical difficulties, higher costs and performing an unnecessary invasive technique in some cases represent some of the weaknesses of the procedure, and questions regarding safety issues should not be ruled out. CONCLUSION: Despite the widespread use of ICSI in patients without a formal diagnosis of male factor infertility, evidence demonstrating its effectiveness in this population is still lacking. Additional large and well-designed randomized controlled trials are needed to clarify definitive indications for ICSI in non-male factor infertility.


Assuntos
Fertilização in vitro/tendências , Infertilidade Masculina/genética , Injeções de Esperma Intracitoplásmicas/tendências , Espermatozoides/crescimento & desenvolvimento , Adulto , Transferência Embrionária , Feminino , Humanos , Infertilidade Masculina/terapia , Masculino , Oócitos/citologia , Oócitos/crescimento & desenvolvimento , Gravidez , Taxa de Gravidez , Sêmen/metabolismo
13.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 45(7): 449-457, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189277

RESUMO

INTRODUCCIÓN: El asma es un importante problema de salud pública que afecta a más de 300 millones de personas en el mundo. La importancia de una enfermedad se puede medir por su prevalencia, la carga asistencial, la morbimortalidad. OBJETIVOS: Conocer la carga asistencial o la morbimortalidad por asma en España en el periodo 1990-2015. MATERIAL Y MÉTODOS: Se han obtenido del Instituto Nacional de Estadística el número de defunciones atribuidas al asma por sexo y grupos quinquenales junto con la población a 1 de julio entre los años 1990-2015. A partir de los datos se calcula la tasa de mortalidad bruta por 100.000 habitantes globales, por sexo y grupos etarios. RESULTADOS: En 2015 fallecieron en España con diagnóstico de asma como causa principal 1.134 personas (195 varones y 939 mujeres), con tasas del 0,82/100.000 habitantes frente a 2,58, respectivamente. Las tasas de mortalidad por asma en España se mantienen estables en los últimos 25 años y son ligeramente superiores a las de los países de nuestro entorno. Mientras que la mortalidad por asma ha disminuido en varones más de un 67%, se han incrementado en un 32% en las mujeres. Los fallecimientos se concentran en mayores de 65 y sobre todo 80 años en los que el valor de los certificados de defunción es más limitado. La mortalidad en los grupos de 5-35 años está entre las más bajas de Europa


INTRODUCTION: Asthma is a major public health problem affecting more than 300 million people worldwide. The importance of a disease can be measured by its prevalence, burden of care, and its morbidity and mortality. OBJECTIVE: To determine the mortality rates for asthma in Spain in the period 1990-2015. MATERIAL AND METHODS: The number of deaths attributed to asthma by gender and five-year age groups, together with the population as of July 1 between the years 1990-2015 were obtained from the National Institute of Statistics. Based on these data, the gross mortality rate per 100,000 global inhabitants was calculated, by gender and age groups. RESULTS: In 2015, 1,134 people (195 men and 939 women) died in Spain with a diagnosis of asthma as the main cause, with rates of 0.82 / 100,000 inhabitants compared to 2.58, respectively. The asthma mortality rates in Spain have remained stable for the last 25 years, and are slightly higher than those in the surrounding countries. While asthma mortality has declined by over 67% in males, it has increased by 32% in females. The deaths are concentrated in those over 65 years, and particularly over 80 years, where the value of death certificates is more limited. Mortality in the 5-35 years age groups is among the lowest in Europe


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Asma/mortalidade , Causas de Morte/tendências , Distribuição por Idade , Distribuição por Sexo , Espanha/epidemiologia
14.
Semergen ; 45(7): 449-457, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31105029

RESUMO

INTRODUCTION: Asthma is a major public health problem affecting more than 300 million people worldwide. The importance of a disease can be measured by its prevalence, burden of care, and its morbidity and mortality. OBJECTIVE: To determine the mortality rates for asthma in Spain in the period 1990-2015. MATERIAL AND METHODS: The number of deaths attributed to asthma by gender and five-year age groups, together with the population as of July 1 between the years 1990-2015 were obtained from the National Institute of Statistics. Based on these data, the gross mortality rate per 100,000 global inhabitants was calculated, by gender and age groups. RESULTS: In 2015, 1,134 people (195 men and 939 women) died in Spain with a diagnosis of asthma as the main cause, with rates of 0.82 / 100,000 inhabitants compared to 2.58, respectively. The asthma mortality rates in Spain have remained stable for the last 25 years, and are slightly higher than those in the surrounding countries. While asthma mortality has declined by over 67% in males, it has increased by 32% in females. The deaths are concentrated in those over 65 years, and particularly over 80 years, where the value of death certificates is more limited. Mortality in the 5-35 years age groups is among the lowest in Europe.


Assuntos
Asma/mortalidade , Causas de Morte/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Espanha/epidemiologia , Adulto Jovem
15.
J Investig Allergol Clin Immunol ; 29(6): 422-430, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931918

RESUMO

Asthma is one of the most prevalent chronic diseases in Spain. Current treatments ensure that the disease is controlled in most cases. However, disease is often uncontrolled in daily clinical practice, mainly owing to underdiagnosis, loss to follow-up, and poor adherence to therapy. In order to improve this situation, we must coordinate all those health professionals who intervene in patient care. Therefore, the Spanish Society of Allergology and Clinical Immunology (SEAIC), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), the Spanish Society of General and Family Physicians (SEMG), and the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) have drawn up a consensus document in which they establish criteria for referral and guidelines for the diagnosis, control, and follow-up of patients with asthma. The document aims to facilitate continuing and improved care in this area.


Assuntos
Asma , Encaminhamento e Consulta , Asma/diagnóstico , Asma/terapia , Consenso , Humanos , Atenção Primária à Saúde
16.
J. investig. allergol. clin. immunol ; 29(6): 422-430, 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-189778

RESUMO

Asthma is one of the most prevalent chronic diseases in Spain. Current treatments ensure that the disease is controlled in most cases. However, disease is often uncontrolled in daily clinical practice, mainly owing to underdiagnosis, loss to follow-up, and poor adherence to therapy. In order to improve this situation, we must coordinate all those health professionals who intervene in patient care. Therefore, the Spanish Society of Allergology and Clinical Immunology (SEAIC), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), the Spanish Society of General and Family Physicians (SEMG), and the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) have drawn up a consensus document in which they establish criteria for referral and guidelines for the diagnosis, control, and follow-up of patients with asthma. The document aims to facilitate continuing and improved care in this area


El asma es una de las enfermedades crónicas más prevalentes en España. Los tratamientos disponibles permitirían tener controlados a la mayoría de los pacientes; aunque, en la práctica diaria, no se alcanza en muchos casos debido, fundamentalmente, al infradiagnóstico, pérdida de seguimiento y escasa adhesión terapéutica. Para mejorar esta situación es fundamental la coordinación de todos los profesionales que intervienen en la atención del paciente asmático. La Sociedad Española de Alergología e Inmunología Clínica (SEAIC), la Sociedad Española de Médicos de Atención Primaria (SEMERGEN), la Sociedad Española de Medicina Familiar y Comunitaria (semFYC), la Sociedad Española de Médicos Generales y de Familia (SEMG) y la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) han consensuado un documento donde se establecen criterios de derivación y pautas de actuación en el diagnóstico, control y seguimiento del paciente asmático que faciliten la continuidad asistencial y una mejor atención en cada ámbito


Assuntos
Humanos , Asma , Encaminhamento e Consulta , Asma/diagnóstico , Asma/terapia , Consenso , Primeiros Socorros
17.
Reprod Biomed Online ; 37(6): 709-715, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30527061

RESUMO

Hysteroscopic septum resection in women with unfavourable reproductive and clinical outcomes has become common practice worldwide to improve reproductive results. No clear evidence on the possible advantages and drawbacks of this procedure has been published. In this opinion paper, based on a SWOT (strengths, weaknesses, opportunities, threats) analysis, the different aspects of this strategy are evaluated. Currently, no level 1 published evidence supports uterine resection in women with septate uterus. Clinical evidence from the studies analysed matches the more recent guidelines and suggests an improvement in reproductive outcomes after hysteroscopic resection of the septum, particularly in infertile women and women who have experienced recurrent miscarriages. In a patient with no history of infertility or prior pregnancy loss, it may be reasonable to consider septum incision after counselling about the potential risks and benefits of the procedure. Published clinical data in favour of the intervention, however, are based on studies with important methodological limitations. In this situation, the clinician and patient should reach an agreement together, based on the pros and cons of this intervention. Well-designed randomized controlled trials are required to confirm the clinical benefits and cost-effectiveness of this procedure.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Infertilidade Feminina/cirurgia , Útero/cirurgia , Aborto Habitual , Aborto Induzido , Adulto , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Humanos , Histeroscopia , Guias de Prática Clínica como Assunto , Reprodução , Medicina Reprodutiva , Resultado do Tratamento , Útero/anormalidades
18.
Reprod Biomed Online ; 37(5): 549-554, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30482725

RESUMO

RESEARCH QUESTION: Can predictors of twin and high-order multiple pregnancy among women with multiple cycles of ovarian stimulation intrauterine insemination (IUI) be identified? DESIGN: Retrospective cohort study of IUI cycles carried out between January 2014 and December 2015 in a private clinic in Spain. The 4879 women and 6552 cycles analysed in this study include single IUI with ovarian stimulation using recombinant FSH. RESULTS: Number of follicles and follicle size were the only factors with a significant effect (P < 0.001) on the likelihood of achieving a twin or multifetal pregnancy. Follicles 12 mm or wider greatly increase the chances of achieving a twin or multifetal pregnancy. A total of 73 out of 127 (57.5%) twin pregnancies occurred in cycles with at least one additional follicle measuring 12 mm or wider, and 102 out of 127 twin pregnancies (80.3%) occurred in cycles with at least one additional follicle measuring 14 mm or wider. Cancellation criteria should consider the presence of follicles 12 mm or wider. CONCLUSION: Follicles measuring 12 mm or wider increase the risk of having a twin or a high-order multiple pregnancy rate. These data may help clinicians balance decision-making between cancelling and performing the cycle within an IUI procedure.


Assuntos
Inseminação Artificial/métodos , Folículo Ovariano/citologia , Gravidez Múltipla , Adulto , Feminino , Humanos , Razão de Chances , Folículo Ovariano/diagnóstico por imagem , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Resultado do Tratamento
19.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 44(3): 174-179, abr. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-173469

RESUMO

Introducción. El objetivo del presente trabajo es estudiar la prevalencia y las características clínicas y epidemiológicas de la enfermedad hipotiroidea en el adulto, a través del registro de datos electrónicos de la historia clínica. Material y métodos. Estudio observacional, descriptivo y transversal. La población diana eran los pacientes de los centros de salud de Lucena I y II (Córdoba). Criterios de inclusión: pacientes que tuvieran 14 años o más, diagnosticados de hipotiroidismo, nacidos y con residencia en Lucena. Se seleccionaron 214 pacientes a través de un muestreo aleatorio, los cuales se sometieron a una entrevista clínica mediante un cuestionario. Resultados. La edad media de los pacientes fue de 49,71 años (DT 17,03; IC 95% 47,34-51,98), siendo el 85,5% mujeres. El 74,8% son diagnosticados de hipotiroidismo subclínico frente al 18,7% de hipotiroidismo primario y un 6,5% de hipotiroidismo secundario. El 53,7% (IC 95% 46,81-60,59) de los pacientes diagnosticados de hipotiroidismo no tienen pedidos los anticuerpos tiroideos; sin embargo, un 75,2% (IC 95% 68,89-80,86) están recibiendo tratamiento con levotiroxina. La prevalencia de hipotiroidismo fue de un 5,7% (IC 95% 5,46-5,96). Conclusiones. El hipotiroidismo subclínico es muy frecuente en las consultas de Atención Primaria. Muchos pacientes no están correctamente diagnosticados y otros están sobremedicados, por lo que sería preciso revisar el diagnóstico


Introduction. The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. Material and methods. Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). Inclusion criteria: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. Results. The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). Conclusions. Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Autoanticorpos/imunologia , Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Tiroxina/administração & dosagem , Hipotireoidismo/epidemiologia , Inquéritos e Questionários , Espanha , Atenção Primária à Saúde , Prevalência
20.
Semergen ; 44(3): 174-179, 2018 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-28863875

RESUMO

INTRODUCTION: The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). INCLUSION CRITERIA: Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. RESULTS: The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). CONCLUSIONS: Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis.


Assuntos
Autoanticorpos/imunologia , Hipotireoidismo/epidemiologia , Tiroxina/administração & dosagem , Adulto , Estudos Transversais , Feminino , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prevalência , Espanha , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...