Estimulación percutánea del nervio tibial en la incontinencia urinaria de urgencia: estudio prospectivo / Percutaneous tibial nerve stimulation in urge urinary incontinence: a prospective study

OBJETIVO: Evaluar la eficacia de la estimulación percutánea del nervio tibial y su efectividad mantenida en el tiempo en la incontinencia urinaria de urgencia. MATERIALES Y MÉTODO: Se efectuó un diseño longitudinal observacional prospectivo sin grupo control, cuyos sujetos fueron los pacientes con incontinencia urinaria de urgencia que cumplían los criterios de inclusión y exclusión. Se realizaron 12 sesiones de estimulación percutánea del nervio tibial mediante electroacupuntura. Los datos de la situación basal y postratamiento fueron recogidos mediante historias clínicas y se les evaluó tiempo después mediante entrevista telefónica. Se registraron variables sociodemográficas, tiempo hasta entrevista, cuestionarios Sandvick e ICIQ-SF, frecuencia miccional diurna, nocturia, material absorbente y uso de tratamiento farmacológico. Se realizó análisis descriptivo de las variables y se analizó la evolución de los pacientes mediante modelos mixtos lineales generalizados, utilizando el paquete estadístico SPSS V. 25. RESULTADOS: Treinta y dos mujeres con 58,69±8,96 años. Todas las variables mejoraron tras el tratamiento significativamente: Sandvick 4,38 puntos (IC 95%: 2,68-6,08, p < 0,001), ICIQ-SF 8,55 puntos (IC 95%: 5,89-11,22, p < 0,001), frecuencia miccional diurna 2,10 puntos (IC 95%: 1,04-3,16, p < 0,001) y nocturia 1,31 puntos (IC 95%: 0,58-2,04, p < 0,001). Sin embargo, en entrevista tras 16,34±9,72 meses después del tratamiento, empeoraron ligeramente sin alcanzar los valores basales. CONCLUSIONES: La estimulación percutánea del nervio tibial mediante electroacupuntura es eficaz para el tratamiento de la incontinencia urinaria de urgencia. Aunque su efecto disminuye con el tiempo, la mejoría respecto de la situación basal se mantiene durante el periodo de seguimiento

OBJECTIVE: To assess the efficacy of percutaneous tibial nerve stimulation and its effectiveness over time in urge urinary incontinence. MATERIALS AND METHODS: We performed a longitudinal, observational, prospective study without a control group that included patients diagnosed with urge urinary incontinence who met the inclusion/exclusion criteria. Patients were treated with 12 sessions of percutaneous tibial nerve stimulation by electroacupuncture. Baseline and post-treatment data were collected from medical records. Patients were assessed by a telephone interview after the treatment. The variables studied were sociodemographic variables, time until interview, the Sandvick and ICIQ-SF questionnaires, daytime urinary frequency, night-time urinary frequency, use of absorbent material and drug treatment. A descriptive analysis of the variables was performed and patient outcomes were analysed with generalised linear mixed models by SPSS V. 25 statistics software. RESULTS: A total of 32 women were included (mean age 58.69±8.96). All variables significantly improved after treatment: Sandvick by 4.38 points (95% CI: 2.68-6.08, P<.001), ICIQ-SF by 8.55 points (95% CI: 5.89-11.22, P<.001), daytime urinary frequency by 2.10 points (95% CI: 1.04-3.16, P<.001) and night-time urinary frequency by 1.31 points (95%CI: 0.58-2.04, P<.001). However, 16.34±9.72 months after treatment, these improvements diminished but without reaching baseline levels. CONCLUSIONS: Percutaneous tibial nerve stimulation by electroacupuncture is effective for the treatment of urge urinary incontinence. Although its effect diminishes over time, the improvement over the baseline situation is maintained during the follow-up period

[Percutaneous tibial nerve stimulation in urge urinary incontinence: A prospective study]. / Estimulación percutánea del nervio tibial en la incontinencia urinaria de urgencia: estudio prospectivo.

OBJECTIVE: To assess the efficacy of percutaneous tibial nerve stimulation and its effectiveness over time in urge urinary incontinence. MATERIALS AND METHODS: We performed a longitudinal, observational, prospective study without a control group that included patients diagnosed with urge urinary incontinence who met the inclusion/exclusion criteria. Patients were treated with 12 sessions of percutaneous tibial nerve stimulation by electroacupuncture. Baseline and post-treatment data were collected from medical records. Patients were assessed by a telephone interview after the treatment. The variables studied were sociodemographic variables, time until interview, the Sandvick and ICIQ-SF questionnaires, daytime urinary frequency, night-time urinary frequency, use of absorbent material and drug treatment. A descriptive analysis of the variables was performed and patient outcomes were analysed with generalised linear mixed models by SPSS v. 25 statistics software. RESULTS: A total of 32 women were included (mean age 58.69±8.96). All variables significantly improved after treatment: Sandvick by 4.38 points (95% CI: 2.68-6.08, P<.001), ICIQ-SF by 8.55 points (95% CI: 5.89-11.22, P<.001), daytime urinary frequency by 2.10 points (95% CI: 1.04-3.16, P<.001) and night-time urinary frequency by 1.31 points (95%CI: 0.58-2.04, P<.001). However, 16.34±9.72 months after treatment, these improvements diminished but without reaching baseline levels. CONCLUSIONS: Percutaneous tibial nerve stimulation by electroacupuncture is effective for the treatment of urge urinary incontinence. Although its effect diminishes over time, the improvement over the baseline situation is maintained during the follow-up period.

Influence of clinical and psychological variables upon the oral health-related quality of life in patients with temporomandibular disorders.

BACKGROUND: To analyze the association between the OHIP-14 and the different subtypes making up the clinical and psychological axis obtained using the RDC/TMD. MATERIAL AND METHODS: 407 patients treated at the TMD unit of the Andalusian Healthcare Service were administered the Spanish version of the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire (RDC/TMD), together with the Oral Health Impact Profile questionnaire (OHIP-14). The degree of association between the patients' score in the OHIP-14 and the clinical and biopsychosocial variables was analyzed through bivariate and multivariate analyses, specifically through linear regression. RESULTS: 89.4% of the treated patients were women, while 10.6% were men, with an average age of 42.08 ± 14.9 years. The mean score and standard deviation for the OHIP-14 was 20.57 ± 10.73. A significant association (p < 0.05) was observed with the following variables: Axis I, jaw disability checklist, depression, somatization, perceived pain duration, and pain interference with activities of daily living. CONCLUSIONS: The analysis of the relation between self-perceived health in patients with TMD, as measured by the OHIP-14, showed a R2 of 0.3979, with a higher Beta value for the association between the OHIP and patients with both myofascial pain and arthopathy, jaw disability, depression, a higher pain duration and a higher pain interference with activities of daily living.

Morbility, clinical data and proteomic analysis of IUGR and AGA newborns at different gestational ages.

The data are related to the proteomic analysis of 43 newborns with intrauterine growth retardation (IUGR) and 45 newborns with appropriate weight for gestational age (AGA) carried out by separation via 2DE and analyzed by MS-TOF/TOF. All newborns were separated into three gestational age groups, "Very Preterm" 29-32 weeks, "Moderate Preterm" 33-36 weeks, and, "Term" ≥37weeks. From each newborn, blood was drawn three times from birth to 1 month life. High-abundant serum proteins were depleted, and the minority ones were separated by 2DE and analyzed for significant expression differences. The data reflect analytic and clinic variables analyzed globally and categorized by gestational age in relation to IUGR and the optimization of conditions for 2-DE separation. The data from this study are related to the research article entitled "Alterations of Protein Expression in Serum of Infants with Intrauterine Growth Restriction and Different Gestational Ages" (M.D. Ruis-González, M.D. Cañete, J.L. Gómez-Chaparro, N. Abril, R. Cañete, J. López-Barea, 2015) [1]. The present dataset of serum IUGR newborn proteome can be used as a reference for any study involving intrauterine growth restriction during the first month of life.

Analisis de la prescripción farmacológica en pacientes institucionalizados / Analysis of the medical prescription in institutionalised patients

Objetivos. Valorar la concordancia terapéutica de fármacos prescritos con sus diagnósticos en pacientes institucionalizados en 2 periodos de tiempo, así como las características de esta prescripción. Material y métodos. Estudio observacional, descriptivo y cuasiexperimental. Se analiza la prescripción y diagnósticos clínicos de pacientes institucionalizados y al cuidado de un mismo profesional médico en 2 periodos de tiempo y con un intervalo de un año (2010-2011), ofreciendo en ese intervalo información sobre la prescripción. Resultados. Se estudió a 81 pacientes (78% mujeres), con edad media de 84 ± 7 años y con 5 ± 2 diagnósticos por paciente. El número de fármacos distintos por paciente fue más de 8 en los 2 periodos, siendo superior en el 2011 frente al 2010. De todos los fármacos prescritos, nos encontramos que en el año 2010 el 8,88% y en el 2011 el 9,38% están incluidos en el grupo de fármacos de utilidad terapéutica baja. En el año 2010 se aprecia una concordancia del 86,71 ± 13,75 frente a 87,17 ± 14,58 en el año 2011, es decir, el 87% de los pacientes tienen fármacos acordes a sus diagnósticos, lo que supone una mejora del 0,47 de un periodo con respecto al otro. No existen diferencias estadísticamente significativas entre ambos años. Conclusiones. La prescripción en pacientes institucionalizados es muy elevada y el número de fármacos por paciente aumentó tras la información. Cuando analizamos los fármacos prescritos destaca un alto porcentaje de medicamentos incluidos en el grupo de utilidad terapéutica baja (citicolina). Un porcentaje significativo de prescripciones no se corresponden con los diagnósticos presentes en su historia clínica (AU)

Objectives. To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. Material and methods. Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. Results. A total of 81 patients (78% women), mean age 84 ± 7 years, and 5 ± 2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as “limited clinical value” drugs. In 2010, it sees a concordance of 86.71 ± 13.75 against 87.17 ± 14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. Conclusions. The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don’t correspond with diagnoses avaiable in their clinical history (AU)

[Analysis of the medical prescription in institutionalised patients]. / Analisis de la prescripción farmacológica en pacientes institucionalizados.

OBJECTIVES: To evaluate/assess the therapeutic concordance/agreement with prescribed medication in patients institutionalized diagnoses in two periods of time as well as the characteristics of this prescription. MATERIAL AND METHODS: Observational and descriptive study. Prescribing and clinical diagnoses of institutionalized patients were analyzed. These patients were treated by the same physicians during the period of time with a one-year interval (2010-2011), offering prescribing information in this period. RESULTS: A total of 81 patients (78% women), mean age 84±7 years, and 5±2 diagnoses per patient. The number of drugs per patient was more than 8 in the 2 periods, being higher in 2011 compared to 2010. From all the prescription, we found that 8.88% in 2010 and 9.3% in 2011 are included as "limited clinical value" drugs. In 2010, it sees a concordance of 86.71±13.75 against 87.17±14.58 in 2011, it means, 87% of patients are treated with drugs in agreement with their diagnoses, representing an increase of 0.47 in 2011 regarding 2010. No statistically significant differences between the 2 years. CONCLUSIONS: The prescriptions in institutionalized patients are very high and the number of drugs per patient increased after information. When we analyzed prescriptions we underline a high percentage of drugs included in the group of limited clinical value (citicoline). A significant percentage of prescriptions don't correspond with diagnoses avaiable in their clinical history.

Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders.

The aim of this study was to evaluate the association between self-reported sleep bruxism and the age, gender, clinical subtypes of temporomandibular disorders (TMD), pain intensity and grade of chronic pain in patients previously diagnosed with TMD. Thousand two-hundred and twenty patients of the Andalusian Health Service were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire. The inclusion and exclusion criteria were those included in the RDC/TMD criteria. The bruxism diagnosis was drawn from the question, 'Have you been told, or do you notice that you grind your teeth or clench your jaw while sleeping at night?' in the anamnestic portion of the questionnaire. A bivariate analysis was conducted, comparing the presence of perceived parafunctional activity with age (over age 60 and under age 60), gender, different subtypes of TMD, pain intensity, grade of chronic pain and presence of self-perceived locked joints. The overall prevalence of self-reported sleep bruxism (SB) was 54.51%. A statistically significant association was found between the presence of SB and patients under age 60, women, greater pain intensity, greater pain interference with activities of daily living, and the axis-I groups affected by both muscular and articular pathology. There is a statistically significant association between self-reported sleep bruxism and women under age 60 who have painful symptoms of TMD. There is also a positive association between this parafunctional habit and the presence of chronic pain. However, more studies that cover larger samples and differentiate between sleep bruxism and awake bruxism are needed.

[Influence of health centers and social class in the prevalence of breast feeding]. / Influencia de los centros de salud y la clase social en la prevalencia de la lactancia materna.

AIMS: To find out the prevalence of breastfeeding in the Health District of Córdoba, taking into account the basic health areas it is composed of; to find out if breastfeeding is less frequent in lower social classes than in high ones and the influence of health centers on breastfeeding. DESIGN: Cross-sectional descriptive study. Home survey. SITE: Health District of Córdoba, urban area. SUBJECTS: 1, 3, 6 months old babies taken from the computerized newborn register of the Health District of Córdoba. MEASUREMENTS AND RESULTS: Age of the babies; breastfeeding, social class, primary care model (basic health areas attended by Health Centers or not attended by Health Centers), weight at birth, parents' jobs, pregnancy control, maternal education and number of visits. 77.2% of the mothers start breastfeeding. 51.7% of one month-old babies are breastfed. One out of four three-month-old babies are breastfed and one out of ten six-month-old babies are breastfed. Low weight at birth has a negative influence on breastfeeding. The prevalence of breastfeeding is higher in favoured classes, and in the basic health areas attended by health centers. The rest of variables analyzed are not significant. CONCLUSIONS: The health centers improve the prevalence and duration of breastfeeding.

[Two systems of persuasion to quit smoking. A controlled trial]. / Dos sistemas de persuasión para la deshabituación tabáquica. Un ensayo controlado.

The effectiveness of two systems of persuasion for persons willing to quit smoking was compared in the context of health educational activities: the traditional method (TN), based on the warning of the risk of disease and death, and a method of positive reinforcement focused on the better quality of life and health level (TP. The study had a controlled trial format, with three randomized groups: One with TN, receiving the traditional negative approach; other with TP, the positive treatment; and another group without therapy. After a 15, 30, 60 and 90 days of follow-up it could not be shown that TP is superior to TN. The former appeared as more effective but without significant differences.

[Socioeconomic factors: do they influence the demand for care and the degree of satisfaction in primary care?]. / Los factores socioeconómicos: influyen en la demanda asistencial y grado de satisfacción en atención primaria?

A survey of 248 individuals was carried out. They included both males and females aged between 16 and 80 years, and they were selected as a representative sample of the population on care in the health center "Huerta de la Reina" for an error margin of 5% and p less than 0.05. The possible influence of cultural and socioeconomic factors on the opinion of the population about the received attention and the degree of use of health care services was evaluated. 76.2% of our patients are not working, 68.5% are females and 57% are older than 46 years. These two groups show the highest rate of consultation for administrative purposes. The educational level, profession, sex, age and the district of origin do not influence the evaluation of the received care. The patients from the quarter with the lowest socioeconomic status consider that the physician pays less attention to them and have a poorer understanding of the latter's explanations (p less than 0.05). Both factors exert an influence on the evaluation of the new model of care. It was concluded that the socioeconomic characteristics of a population are very important for the development of an integrated type of attention by primary care teams.

[The vascular risk factors in patients with adult ischemic necrosis of the femur head]. / Factores de riesgo vascular en pacientes con necrosis isquémica de cabeza femoral del adulto.

The authors studied 23 patients affected by ischemic necrosis of the femoral head, following a common standardised protocol, highlighting the habit (smoking and alcohol intake), lipids and biochemist parameters, as vascular risk factors to sufferers of this disease. They found that with the smoking habit, the high intake of lipids and the excess of alcohol ingestion were significant in the studied group. Neither obesity nor blood hypertension were significant. This supports the vascular etiology of ischemic necrosis of femoral head in adults.