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1.
Fisioterapia (Madr., Ed. impr.) ; 41(5): 250-257, sept.-oct. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183934

RESUMO

Introducción: La empatía es un concepto importante en la interacción entre el profesional fisioterapeuta y el paciente, y contribuye a una mejor atención del mismo. La formación empática en estudiantes de fisioterapia debe ser asumida por las universidades desde el primer año de estudio por el carácter complejo de este atributo; sin embargo, cualquier intervención debe estar precedida por un diagnóstico empático exhaustivo. Objetivo: Determinar los niveles de empatía y de sus componentes en estudiantes de fisioterapia según los factores curso y género. Material y métodos: Estudio exploratorio y de corte transversal. Se estudió una muestra de 191 estudiantes. Los datos de empatía fueron recogidos mediante la aplicación de la escala de empatía de Jefferson. Fueron estimadas la mediana, los cuartiles 1 y 3, la diferencia intercuartílica y el intervalo de confianza de la mediana. Se estudiaron las posibles diferencias en la empatía y sus componentes mediante pruebas no paramétricas (mediana de Mood). Resultados: Hubo diferencias en la empatía y en el componente cuidado con compasión en el factor curso. Se manifiesta la declinación empática en el componente cuidado con compasión. La empatía y sus componentes no se diferenciaron en el género. Conclusiones: La diferencia encontrada en la empatía y en el componente cuidado con compasión, la ausencia de diferencias de empatía entre los géneros y la manifestación de declinación empática solo en el componente cuidado con compasión constituyen características específicas en los estudiantes examinados y representan un diagnóstico empático concreto y se constituye en la base para elaborar una estrategia de intervención que debe ser coherente con estos resultados


Introduction: Empathy is an important concept in the interaction between the physiotherapist and the patient, and contributes to a better care of the patient. Empathy training in physiotherapy students must be taught by the universities from the first year of study because of the complex character of this attribute. However, any intervention must be preceded by a comprehensive empathy diagnosis. Objective: To determine the levels of empathy and its components in physiotherapy students according to course and gender factors. Material and methods: Exploratory and cross-sectional study conducted on a sample of 191 students. The empathy data was collected by applying the Jefferson Empathy Scale. The median, 1st and 3rd quartile, interquartile difference and confidence interval of the median were estimated. The possible differences in Empathy and its components were analysed using of non-parametric tests (Mood's median). Results: There were differences in empathy and in the compassionate care component in the course factor. The empathy decline in the compassionate component was observed. Empathy and its components did not differ by gender. Conclusions: The differences found in empathy and in the compassionate care component, the absence of empathy differences in empathy between the genders, and observation of a decline in empathy only in the compassionate care component, were specific characteristics in the students examined. These represent a specific empathy diagnosis, and are the basis for developing an intervention strategy consistent with these results


Assuntos
Humanos , Masculino , Feminino , Fisioterapia , Empatia , Estudantes de Ciências da Saúde/psicologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Estudos Transversais , Estatísticas não Paramétricas , Comportamento Exploratório , Intervalos de Confiança
2.
Hypertension ; 74(5): 1144-1151, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31564161

RESUMO

Preeclampsia is a common cause of acute kidney injury (AKI) in low- and middle-income countries, but AKI incidence in preeclampsia, its risk factors, and renal outcomes are unknown. A prospective observational multicenter study of women admitted with preeclampsia in South Africa was conducted. Creatinine concentrations were extracted from national laboratory databases for women with maximum creatinine of ≥90 µmol/L (≥1.02 mg/dL). Renal injury and recovery were defined by Kidney Disease Improving Global Outcomes creatinine criteria. Predefined risk factors, maternal outcomes, and neonatal outcomes were compared between AKI stages. Of 1547 women admitted with preeclampsia 237 (15.3%) met AKI criteria: 6.9% (n=107) stage 1, 4.3% (n=67) stage 2, and 4.1% (n=63) stage 3. There was a higher risk of maternal death (n=7; relative risk, 4.3; 95% CI, 1.6-11.4) and stillbirth (n=80; relative risk, 2.2; 95% CI, 1.8-2.8) in women with AKI compared with those without. Perinatal mortality was also increased (89 of 240; 37.1%). Hypertension in a previous pregnancy was the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24; 95% CI, 1.21-4.17). Renal recovery rate reduced with increasing AKI stage. A third of surviving women (76 of 230 [33.0%]) had not recovered baseline renal function by discharge. Approximately half (39 of 76; 51.3%) of these women had no further creatinine testing post-discharge. In summary, AKI was common in women with preeclampsia and had high rates of associated maternal and perinatal mortality. Only two-thirds of women had confirmed renal recovery. History of a previous hypertensive pregnancy was an important risk factor.


Assuntos
Lesão Renal Aguda/epidemiologia , Morte Materna/tendências , Morte Perinatal , Pré-Eclâmpsia/epidemiologia , Natimorto/epidemiologia , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/terapia , Adolescente , Adulto , Comorbidade , Intervalos de Confiança , Creatinina/sangue , Países em Desenvolvimento , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Testes de Função Renal , Razão de Chances , Pobreza , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/terapia , Gravidez , Prevalência , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , África do Sul , Análise de Sobrevida
3.
Biochem Med (Zagreb) ; 29(3): 030101, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31624457

RESUMO

Introduction: Quality indicators (QI) based on percentiles are widely used for managing quality in laboratory medicine nowadays. Due to their statistical nature, their estimation is affected by sampling so they should be always presented together with the confidence interval (CI). Since no methodological recommendation has been issued to date, our aim was investigating the suitability of the parametric method (LP-CI), the non-parametric binomial (NP-CI) and bootstrap (BCa-CI) procedures for the CI estimation of 2.5th, 25th, 50th, 75th and 97.5th percentile in skewed sets of data. Materials and methods: Skewness was reproduced by numeric simulation of a lognormal distribution in order to have samples with different right-tailing (moderate, heavy and very heavy) and size (20, 60 and 120). Performance was assessed with respect to the actual coverage probability (ACP, accuracy) against the confidence level of 1-α with α = 0.5, and the median interval length (MIL, precision). Results: The parametric method was accurate for sample size N ≥ 20 whereas both NP-CI and BCa-CI required N ≥ 60. However, for extreme percentiles of heavily right-tailed data, the required sample size increased to 60 and 120 units respectively. A case study also demonstrated the possibility to estimate the ACP from a single sample of real-life laboratory data. Conclusions: No method should be applied blindly to the estimation of CI, especially in small-sized and skewed samples. To this end, the accuracy of the method should be investigated through a numeric simulation that reproduces the same conditions of the real-life sample.


Assuntos
Intervalos de Confiança , Laboratórios , Bioestatística , Qualidade da Assistência à Saúde
4.
Am Surg ; 85(10): 1108-1112, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657304

RESUMO

In patients undergoing bariatric surgery, the presence of metabolic syndrome (MetS) contributes to perioperative morbidity. We aimed to evaluate the utilization and outcome of severely obese patients with MetS who underwent laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB). Using the 2015 and 2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database, data were obtained for patients with MetS undergoing LSG or LRYGB. There were 29,588 MetS patients (LSG: 58.7% vs LRYGB: 41.3%). There was no significant difference in 30-day mortality (0.1% for LSG vs 0.2% for LRYGB, adjusted odds ratio (AOR) 0.58, confidence interval (CI) 0.32-1.05, P = 0.07) or length of stay between groups (2 ± 2 for LSG vs 2.2 ± 2 days for LRYGB, P = 0.40). Compared with LRYGB, LSG was associated with significantly shorter operative time (78 ± 39 vs 122 ± 54 minutes, P < 0.01), lower overall morbidity (2.3% vs 4.4%, AOR 0.53, CI 0.46-0.60, P < 0.01), lower serious morbidity (1.5% vs 2.3%, AOR 0.64, CI 0.53-0.76, P < 0.01), lower 30-day reoperation (1.2% vs 2.3%, AOR 0.52, CI 0.43-0.63, P < 0.01), and lower 30-day readmission (4.2% vs 6.6%, AOR 0.62, CI 0.55-0.69, P < 0.01). In conclusion, LSG is the predominant operation being performed for severely obese patients with MetS, and its popularity may in part be related to its improved perioperative safety profile.


Assuntos
Gastrectomia/métodos , Derivação Gástrica/métodos , Síndrome Metabólica/cirurgia , Obesidade Mórbida/cirurgia , Intervalos de Confiança , Bases de Dados Factuais , Feminino , Gastrectomia/efeitos adversos , Gastrectomia/mortalidade , Derivação Gástrica/efeitos adversos , Derivação Gástrica/mortalidade , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Razão de Chances , Duração da Cirurgia , Complicações Pós-Operatórias , Análise de Regressão , Reoperação/estatística & dados numéricos
5.
Bone Joint J ; 101-B(10): 1248-1255, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564141

RESUMO

AIMS: The aim of this study was to conduct the largest low contact stress (LCS) retrieval study to elucidate the failure mechanisms of the Porocoat and Duofix femoral component. The latter design was voluntarily recalled by the manufacturer. MATERIALS AND METHODS: Uncemented LCS explants were divided into three groups: Duofix, Porocoat, and mixed. Demographics, polyethylene wear, tissue ingrowth, and metallurgical analyses were performed. RESULTS: In 104 implants, a decrease in the odds of loosening and an increase in metallosis and tissue staining in the Duofix group relative to Porocoat group was detected (p = 0.028). There was an increased presence of embedded metallic debris in the Duofix group (p < 0.001). Decreased tissue ingrowth was associated with the Duofix surface (p < 0.001). The attached beads had reduced microhardness, indicative of adverse thermal processing, which resulted in bead shedding, particulate debris, and metallosis. CONCLUSION: Hydroxyapatite coating of the LCS femoral component produced unexpected results and led to its recall. The root cause was likely a combination of retained alumina grit and a reduction in bead microhardness (mechanical strength) resulting in increased particle debris, metallosis, and early revision. The Duofix LCS femoral component was not equivalent to the Porocoat version despite its approval through the Food and Drug Administration (FDA) 510(k) equivalance approval process. Regulation of the introduction of modified existing devices needs to be improved and the Duofix LCS should have been considered to be a new device for which equivalence had not been demonstrated at the point of introduction. Cite this article: Bone Joint J 2019;101-B:1248-1255.


Assuntos
Artroplastia do Joelho/efeitos adversos , Remoção de Dispositivo , Prótese do Joelho/efeitos adversos , Falha de Prótese , Estresse Mecânico , Idoso , Austrália , Intervalos de Confiança , Análise de Falha de Equipamento , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Desenho de Prótese
6.
Bone Joint J ; 101-B(10): 1272-1279, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564147

RESUMO

AIMS: To compare complication-related reoperation rates following primary arthroplasty for proximal humerus fractures (PHFs) versus secondary arthroplasty for failed open reduction and internal fixation (ORIF). PATIENTS AND METHODS: We identified patients aged 50 years and over, who sustained a PHF between 2004 and 2015, from linkable datasets. We used intervention codes to identify patients treated with initial ORIF or arthroplasty, and those treated with ORIF who returned for revision arthroplasty within two years. We used multilevel logistic regression to compare reoperations between groups. RESULTS: We identified 1624 patients who underwent initial arthroplasty for PHF, and 98 patients who underwent secondary arthroplasty following failed ORIF. In total, 72 patients (4.4%) in the primary arthroplasty group had a reoperation within two years following arthroplasty, compared with 19 patients (19.4%) in the revision arthroplasty group. This difference was significantly different (p < 0.001) after covariable adjustment. CONCLUSION: The number of reoperations following arthroplasty for failed ORIF of PHF is significantly higher compared with primary arthroplasty. This suggests that primary arthroplasty may be a better choice for patients whose prognostic factors suggest a high reoperation rate following ORIF. Prospective clinical studies are required to confirm these findings. Cite this article: Bone Joint J 2019;101-B:1272-1279.


Assuntos
Artroplastia do Ombro/efeitos adversos , Redução Aberta/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Amplitude de Movimento Articular/fisiologia , Reoperação/estatística & dados numéricos , Fraturas do Ombro/cirurgia , Idoso , Artroplastia do Ombro/métodos , Estudos de Coortes , Intervalos de Confiança , Feminino , Seguimentos , Humanos , Incidência , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Razão de Chances , Redução Aberta/métodos , Medição da Dor , Complicações Pós-Operatórias/fisiopatologia , Falha de Prótese , Estudos Retrospectivos , Medição de Risco , Fraturas do Ombro/diagnóstico por imagem , Resultado do Tratamento
7.
Bone Joint J ; 101-B(10): 1285-1291, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564154

RESUMO

AIMS: Currently, periprosthetic fractures are excluded from the American Society for Bone and Mineral Research (ASBMR) definition of atypical femoral fracture (AFFs). This study aims to report on a series of periprosthetic femoral fractures (PFFs) that otherwise meet the criteria for AFFs. Secondary aims were to identify predictors of periprosthetic atypical femoral fractures (PAFFs) and quantify the complications of treatment. PATIENTS AND METHODS: This was a retrospective case control study of consecutive patients with periprosthetic femoral fractures between 2007 and 2017. Two observers identified 16 PAFF cases (mean age 73.9 years (44 to 88), 14 female patients) and 17 typical periprosthetic fractures in patients on bisphosphonate therapy as controls (mean age 80.7 years (60 to 86, 13 female patients). Univariate and multivariate analysis was performed to identify predictors of PAFF. Management and complications were recorded. RESULTS: Interobserver agreement for the PAFF classification was excellent (kappa = 0.944; p < 0.001). On univariate analysis compared with controls, patients with PAFFs had higher mean body mass indices (28.6 kg/m2 (sd 8.9) vs 21.5 kg/m2 (sd 3.3); p = 0.009), longer durations of bisphosphonate therapy (median 5.5 years (IQR 3.2 to 10.6) vs 2.4 years (IQR 1.0 to 6.4); p = 0.04), and were less likely to be on alendronate (50% vs 94%; p = 0.02) with an indication of secondary osteoporosis (19% vs 0%; p = 0.049). Duration of bisphosphonate therapy was an independent predictor of PAFF on multivariate analysis (R2 = 0.733; p = 0.05). Following primary fracture management, complication rates were higher in PAFFs (9/16, 56%) than controls (5/17, 29%; p = 0.178) with a relative risk of any complication following PAFF of 1.71 (95% confidence interval (CI) 0.77 to 3.8) and of reoperation 2.56 (95% CI 1.3 to 5.2). CONCLUSION: AFFs do occur in association with prostheses. Longer duration of bisphosphonate therapy is an independent predictor of PAFF. Complication rates are higher following PAFFs compared with typical PFFs, particularly of reoperation and infection. Cite this article: Bone Joint J 2019;101-B:1285-1291.


Assuntos
Artroplastia de Quadril/efeitos adversos , Difosfonatos/efeitos adversos , Osteoporose/tratamento farmacológico , Fraturas Periprotéticas/induzido quimicamente , Fraturas Periprotéticas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Artroplastia de Quadril/métodos , Estudos de Casos e Controles , Intervalos de Confiança , Difosfonatos/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Fraturas do Fêmur/induzido quimicamente , Fraturas do Fêmur/cirurgia , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Variações Dependentes do Observador , Osteoporose/complicações , Fraturas Periprotéticas/diagnóstico por imagem , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Estados Unidos
8.
Br J Radiol ; 92(1104): 20190480, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31596123

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of multiparametric MRI (mpMRI) for detecting extracapsular extension (ECE) in patients with prostate cancer (PCa). METHODS AND MATERIALS: We searched MEDLINE, PubMed, Embase and the Cochrane library up to December 2018. We included studies that used mpMRI to differentiate ECE from organ-confined PCa with a combination of T2 weighted imaging (T2WI), diffusion-weighted imaging, and dynamic contrast-enhanced MRI. All studies included had pathological diagnosis with radical prostatectomy. Two reviewers independently assessed the methodological quality of included studies by using Quality Assessment of Diagnostic Accuracy Studies 2 tool. We calculated pooled sensitivity, specificity, positive and negative predictive values, diagnostic odds ratios and receiver operating characteristic curve for mpMRI from 2 × 2 tables. RESULTS: A total of 17 studies that comprised 3374 participants were included. The pooled data showed a sensitivity of 0.55 (95% confidence interval 0.43, 0.66]) and specificity of 0.87 (95% confidence interval 0.82, 0.91) for extracapsular extension detection in PCa. CONCLUSION: First, our meta-analysis shows moderate sensitivity and high specificity for mpMRI to differentiate ECE from organ-confined prostate cancer before surgery. Second, our meta-analysis shows that mpMRI had no significant differences in performance compared with the former meta-analysis with use of T2WI alone or with additional functional MRI. ADVANCES IN KNOWLEDGE: It is the first meta-analysis to evaluate the accuracy of mpMRI in combination of TWI, diffusion-weightedimaging and dynamiccontrast-enhanced-MRI for extracapsular extension detection.


Assuntos
Imagem por Ressonância Magnética/métodos , Próstata/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Intervalos de Confiança , Meios de Contraste , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Masculino , Cuidados Pré-Operatórios , Próstata/patologia , Próstata/cirurgia , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Curva ROC , Sensibilidade e Especificidade
9.
Hipertens. riesgo vasc ; 36(3): 137-144, jul.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183953

RESUMO

Introducción y objetivos: El objetivo es cuantificar la validez diagnóstica de la medida de la presión arterial en farmacia comunitaria (PAFC) y establecer los puntos de corte de la presión arterial sistólica (PAS) y de la presión arterial diastólica (PAD) que maximicen la citada validez, usando como patrón de oro la monitorización ambulatoria de la presión arterial (MAPA) de 24 h. Material y métodos: Estudio transversal, con selección consecutiva de pacientes usuarios de la farmacia comunitaria andaluza. Se midió la PAFC y, a continuación, una MAPA de 24 h, con lo que se evaluó la validez diagnóstica de PAFC. También se calculó el área bajo la curva ROC para PAS y PAD, los valores predictivos positivos y negativos para diferentes prevalencias, así como la variación de la sensibilidad y de la especificidad para los distintos puntos de corte de PAS/PAD, lo que sirvió para el cálculo de los puntos de corte óptimos. Resultados: Colaboraron 167 farmacias comunitarias, con 1.170 pacientes, de los que 1.110 aportaron datos válidos. La PAFC presenta una sensibilidad del 60,41% (IC 95%: 56,40-64,29), una especificidad del 79,77% (IC 95%: 76,12-82,99), un valor predictivo positivo de 76,96% (IC 95%: 72,89-80,57) y un valor predictivo negativo de 64,31% (IC 95%: 60,55%-67,90%). Por el método de curva ROC, los puntos de corte óptimos para la PAS y para la PAD son, respectivamente, 134/81mm Hg, puntos donde la sensibilidad y la especificidad se equilibran y se maximiza el índice de Youden. Conclusiones: La sensibilidad es relativamente baja. Para mejorarla se propone bajar el punto de corte de PAS y PAD. El óptimo calculado es 134/81mm Hg. Viene ello a aportar datos sobre la conveniencia de revisar a la baja el actual punto de corte (140/90), como propone la guía de 2017 de ACC/AHA


Introduction and objectives: The aim of this study is to determine the diagnostic validity of blood pressure measurement in the community pharmacy (CPBP), and to set the cut-off points in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in order to maximise the aforementioned validity, using 24 hour ambulatory blood pressure monitoring (ABPM) as the reference method. Material and methods: A cross-sectional study with consecutive selection of patient users of the community pharmacy in Andalusia. The CPBP was measured, followed by 24-hour ABPM, which assessed the diagnostic validity of the CPBP. The AUC of the ROC curve was also calculated for SBP and DBP, along with the positive and negative predictive values, for different prevalences and the variation of sensitivity and specificity for the different cut-off points for SBP/DBP. Results: A total of 167 community pharmacy participated with 1,170 patients, of which 1,110 were valid. The CPBP showed a sensitivity of 60.41% (95% CI: 56.40-64.29), and a specificity of the 79.77% (95% CI: 76.12-82.99), a positive predictive values of 76.96% (95% CI: 72.89-80.57), and a negative predictive values of 64.31% (95% CI: 60.55%-67.90%). By using the ROC curve method, the optimal cut-off points are 134/81mm Hg, the point where the sensitivity and specificity and are balanced and the Youden index is maximised. Conclusions: The sensitivity is relatively low. To improve it tends to lower the cut-off points of SBP and DBP. The calculated optimum is 134/81mm Hg. This provides data on the desirability to review the current cut-off points (140/90), as proposed by the ACC/AHA 2017


Assuntos
Humanos , Pressão Arterial/fisiologia , Farmácias/organização & administração , Monitorização Ambulatorial/instrumentação , Monitorização Ambulatorial/métodos , Estudos Transversais , Sensibilidade e Especificidade , Intervalos de Confiança , Curva ROC
10.
Med. clín (Ed. impr.) ; 153(6): 239-242, sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184029

RESUMO

Background/Objectives: To assess the adherence to reporting confidence intervals (CI) for measures of association in multivariable regression models (MRM) in articles with observational design indexed in MEDLINE. Material and methods: A literature search was conducted using the MEDLINE bibliographic database to obtain a representative sample of studies with observational design and applying MRM (logistic, linear, and Cox regression) (n=428). Proportions and 95% CI of articles reporting CI for measures of association in MRM were calculated. Percentage ratios (PRs) were also calculated to describe the change in CI reporting before and after the publication of the STROBE statement. Results: 188 of the 236 abstracts with measures of association (79.7%; 95% CI 74.5, 84.8) and 360 of the 428 main texts (84.1%; 80.6, 87.6) were provided with CI. A non-significant increase of 1% in the abstract, PR=1.01 (0.77, 1.29), and 7% in the main text, PR=1.07 (0.87, 1.28), occurred in the CI reporting after the publication of the STROBE guideline. Conclusions: The STROBE guideline recommendation on reporting CI should be more thoroughly followed


Antecedentes/objetivos: Evaluar la adherencia al reporte de los intervalos de confianza (IC) en medidas de asociación en modelos de regresión multivariable (MRM) en artículos con diseño observacional indexados en MEDLINE. Material y métodos: Se realizó una búsqueda bibliográfica usando la base de datos bibliográfica MEDLINE para obtener una muestra representativa de estudios con diseño observacional y que aplicaran MRM (regresión logística, lineal y Cox) (n=428). Se calcularon las proporciones e IC 95% de los artículos que reportaban IC en las medidas de asociación en MRM. También se calcularon las razones de porcentaje (RP) para describir el cambio en el reporte de los IC antes y después de la publicación de la declaración STROBE. Resultados: 188 de los 236 resúmenes con medidas de asociación (79,7%; IC 95% 74,5-84,8) y 360 de los 428 textos principales (84,1%; 80,6-87,6) estaban provistos de IC. Un incremento no significativo del 1% en el resumen, RP=1,01 (0,77-1,29), y del 7% en el texto principal, RP=1,07 (0,87-1,28), tuvo lugar en el reporte de los IC después de la publicación de la guía STROBE. Conclusiones: La recomendación de reportar IC dada por la guía STROBE debería ser seguida más exhaustivamente


Assuntos
Humanos , Intervalos de Confiança , Análise Multivariada , Bibliometria , MEDLINE/estatística & dados numéricos
11.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 417-424, ago.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182861

RESUMO

Antecedentes y objetivo: La dieta mediterránea (DM) tradicional se asocia a un menor riesgo de padecer numerosos cánceres. Sin embargo, pocos estudios han analizado la relación de la DM con el riesgo de padecer cáncer de cabeza y cuello (CCyC). Se lleva a cabo un estudio de casos y controles en el que se compara la adherencia a la DM en pacientes diagnosticados de CCyC y población sana. Pacientes y método: Mediante el cuestionario Mediterranean Diet Adherence Screener (MEDAS), de 14 ítems, empleado en el estudio PREDIMED, se evalúa el nivel de adherencia a la DM tanto en casos obtenidos de pacientes diagnosticados de CCyC en el hospital 12de Octubre de Madrid, como en controles obtenidos de población sana de un centro de salud del Área, estratificando dicha adherencia en función de la puntuación: baja (≤7puntos), media (8-9puntos) y alta (≥10puntos). Se calcula el odds ratio (OR) para desarrollar CCyC en base a diferentes factores. Resultados: Se analiza una muestra de 168 individuos: 100 controles y 68 casos. El hábito tabáquico (OR: 2,98 [IC95%: 1,44-6,12]; p=0,003) y el consumo de alcohol (OR: 2,72 [IC95%: 1,39-5,33]; p=0,003) demuestran ser factores de riesgo para desarrollar CCyC. Sin embargo, la adherencia media-alta a la DM se asocia a menor riesgo de CCyC (OR: 0,48 [IC95%: 0,20-1,07]; p=0,052). Conclusiones: La adherencia media-alta a la DM se asocia a menor riesgo para desarrollar CCyC


Background and objective: The traditional Mediterranean diet (MD) is associated to a lower risk of suffering multiple tumors. However, few studies have analyzed the relationship between MD and the risk of developing head and neck cancer (HNC). A case-control study comparing adherence to MD was conducted in patients diagnosed with HNC and healthy population. Patients and methods: The level of adherence to MD was assessed using the 14-item MEDAS (Mediterranean Diet Adherence Screener) questionnaire, used in the PREDIMED study, in patients diagnosed with HNC at 12de Octubre Hospital in Madrid (cases) and in healthy subjects enrolled in a nearby primary health care center (controls). Adherence was stratified based on the score as low (≤7points), medium (8-9points), and high (≥10points). The odds ratio (OR) for developing HNC was estimated based on different factors. Results: A sample of 168 subjects (100 controls and 68 cases) was analyzed. Smoking (OR, 2.98 [95%CI: 1.44-6.12]; P=.003) and alcohol consumption (OR, 2.72 [95%CI: 1.39-5.33], P=.003) were strongly associated to HNC. However, medium-high adherence to MD was associated to a lower risk of developing HNC (OR, 0.48 [95%CI: 0.20-1.07], P=.052). Conclusions: Consistent medium-high adherence to MD contributes to decrease the risk of developing HNC


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Dieta Mediterrânea , Neoplasias de Cabeça e Pescoço/dietoterapia , Fatores de Risco , Cooperação e Adesão ao Tratamento , Estudos de Casos e Controles , Inquéritos e Questionários , Fumar Tabaco/efeitos adversos , Alcoolismo/complicações , Análise Estatística , Intervalos de Confiança
12.
Enferm. intensiva (Ed. impr.) ; 30(3): 108-115, jul.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182969

RESUMO

Objetivo: El síndrome de burnout entre los profesionales de cuidados intensivos ha sido ampliamente documentado internacionalmente. Pocos estudios abordan la prevalencia en América Latina, y específicamente en Argentina no existen estudios de peso que aborden esta problemática. El objetivo del presente estudio fue determinar la prevalencia de burnout entre las enfermeras de cuidados intensivos de Argentina y los factores de riesgo relacionados. Materiales y métodos: Encuesta en línea, autoadministrada, para evaluar variables demográficas y puntuación en el Índice de Burnout de Maslach en 486 enfermeras de cuidados críticos entre los meses de junio y septiembre de 2016. Resultados: El 84,4% de los participantes presentan niveles moderados/altos de síndrome de burnout (IC 95% 80,8 a 87,4). No se encontró asociación significativa entre el burnout y el género, la edad, los años de práctica, el grado académico, el rol o la multiplicidad de empleos. No hubo diferencias estadísticamente significativas en la prevalencia de burnout entre los distintos tipos de población de atención (neonatal, pediátrica o de adultos). Se encontró que la variable relación enfermera:paciente de 1:3 o más se encuentra estadísticamente relacionada con las subescalas de agotamiento emocional y despersonalización (p = 0,002 y 0,0039, respectivamente). Conclusión: Más del 80% de las enfermeras que tienen a cargo el cuidado de pacientes críticamente enfermos en Argentina muestran niveles moderados/altos de burnout y esto se relaciona con una relación enfermera:paciente ≥ 1:3


Purpose: Burnout syndrome among intensive care professionals has been widely documented internationally. Few studies address the incidence and prevalence in Latin America. And there are no validated studies about the situation in Argentina. Our goal was to determine burnout prevalence among intensive care nurses in Argentina and related risk factors. Materials and methods: Online self-administered survey evaluating demographic variables and the Maslach Burnout Inventory in 486 critical care nurses between June and September 2016. Results: A percentage of 84.4 of participants show moderate or high levels of burnout syndrome (95% CI 80.8 to 87.4). No significant association was found between burnout and gender, age, years of practice, academic degree, role or multiplicity of jobs. There was no statistical difference in burnout prevalence among different types of populations of care (neonatal, paediatric or adult care). Nurse to patient ratios of 1:3 or higher was found to be a statistically significant risk factor for emotional exhaustion and depersonalization sub-scales (P = .002 and .0039, respectively). Conclusion: More than 80% of nurses caring for critically ill patients in Argentina show moderate or high levels of burnout syndrome and this is related to a high nurse:patient ratio (1:3 or higher)


Assuntos
Humanos , Masculino , Feminino , Adulto , Esgotamento Psicológico/epidemiologia , Cuidados Críticos , Fatores de Risco , Unidades de Cuidados Coronarianos/estatística & dados numéricos , Argentina/epidemiologia , Inquéritos e Questionários , Enfermeiras e Enfermeiros/estatística & dados numéricos , Análise Quantitativa , Estudos Transversais , Intervalos de Confiança , Despersonalização
13.
Hypertension ; 74(5): 1124-1135, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31522621

RESUMO

Preeclampsia is a systemic syndrome that seems to originate from the placenta and is associated with an imbalance between angiogenic factors in the maternal circulation. One of the well-studied and widely used factors is PlGF (placental growth factor), the levels of which drop in women destined to develop preeclampsia. This drop is known to precede the development of actual signs and symptoms of preeclampsia, thus proving to be a useful screening tool in predicting the disease. The literature varies widely in terms of the clinical usefulness of the test. We conducted a meta-analysis to study the predictive accuracy of PlGF in asymptomatic women. Our analysis included 40 studies with 3189 cases of preeclampsia and 89 498 controls. The overall predictive odds ratio of the test was 9 (6-13). Subgroup analysis evaluating various PlGF thresholds demonstrated that the predictive values were highest for PlGF levels between 80 and 120 pg/mL with a high predictive odds ratio of 25 (7-88), a sensitivity of 0.78 (95% CI, 0.67-0.86), a specificity of 0.88 (95% CI, 0.75-0.95), a positive likelihood ratio of 6.3 (95% CI, 2.7-14.7), and a negative likelihood ratio of 0.26 (95% CI, 0.16-0.42). Additionally, the accuracy was higher when the test was performed after 14 weeks of gestation (OR, 10 [7-15]) and for prediction of early onset preeclampsia (OR, 18 [9-37]). We conclude that PlGF is a useful screening tool to predict preeclampsia. Nonetheless, its utility should be judged with caution and randomized controlled trials are warranted to explore if its implementation improves perinatal outcomes in asymptomatic women.


Assuntos
Programas de Rastreamento/métodos , Pré-Eclâmpsia/diagnóstico , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo , Biomarcadores/análise , Estudos de Casos e Controles , Intervalos de Confiança , Feminino , Humanos , Razão de Chances , Pré-Eclâmpsia/metabolismo , Valor Preditivo dos Testes , Gravidez , Proteínas da Gravidez/metabolismo , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Valores de Referência , Sensibilidade e Especificidade , Reino Unido
14.
Hypertension ; 74(5): 1172-1180, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31542965

RESUMO

Blood pressure variability (BPV) has been shown to have predictive value over blood pressure (BP) levels alone in stroke patients. We assessed whether BPV predicts cognitive and functional decline in Alzheimer disease, using data from a randomized trial (NILVAD [A European Multicentre Double-blind Placebo-controlled Phase III Trial of Nilvadipine in Mild to Moderate Alzheimer's Disease]). Patients with mild-to-moderate Alzheimer disease were included if they had ≥3 office BP measurements available to determine visit-to-visit BPV. Day-to-day BPV was assessed using home BP measurements in a subsample. The variation independent of mean was used to calculate BPV. Outcomes were change in Alzheimer's Disease Assessment Scale-cognitive subscale-12 and Disability Assessment for Dementia after 1 and 1.5 years. A total of 460 patients aged 72.1 (SD=8.1) years, with mean BP of 134.0/75.1 (10.9/6.3) mm Hg were included. After 1 year, patients in the highest quartile of BPV had deteriorated more on Alzheimer's Disease Assessment Scale-cognitive subscale compared with patients in the lowest quartile (systolic: ß, 2.24 [95% CI, 0.11-4.38], P=0.040; diastolic: ß, 2.54 [95% CI, 0.33-4.75] P=0.024). This association was still present after 1.5 years (systolic: ß, 2.86 [95% CI, 0.35-5.36], P=0.026; diastolic: ß, 3.30 [95% CI, 0.67-5.93], P=0.014). There was no effect of visit-to-visit BPV on Disability Assessment for Dementia. Day-to-day BPV was available for 46 patients. Significant associations were observed between day-to-day BPV and deterioration on Alzheimer's Disease Assessment Scale-cognitive subscale (systolic: P=0.036) and Disability Assessment for Dementia (systolic: P=0.020; diastolic: P=0.007) after 1 year, but not after 1.5 years. All associations were adjusted for potential confounders, including intervention group. In conclusion, this post hoc analysis indicates that higher visit-to-visit and day-to-day BPV might be associated with progression of Alzheimer disease. Targeting BPV may be a future target to slow decline in patients with Alzheimer disease. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02017340.


Assuntos
Doença de Alzheimer/fisiopatologia , Anti-Hipertensivos/uso terapêutico , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Nifedipino/análogos & derivados , Idoso , Doença de Alzheimer/epidemiologia , Determinação da Pressão Arterial/métodos , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/fisiopatologia , Intervalos de Confiança , Progressão da Doença , Método Duplo-Cego , Feminino , Humanos , Hipertensão/epidemiologia , Modelos Lineares , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Análise Multivariada , Nifedipino/uso terapêutico , Prognóstico , Medição de Risco , Índice de Gravidade de Doença
15.
Cancer Sci ; 110(11): 3603-3614, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31482651

RESUMO

Red meat and processed meat have been suggested to increase risk of colorectal cancer (CRC), especially colon cancer. However, it remains unclear whether these associations differ according to meat subtypes or colon subsites. The present study addressed this issue by undertaking a pooled analysis of large population-based cohort studies in Japan: 5 studies comprising 232 403 participants (5694 CRC cases) for analysis based on frequency of meat intake, and 2 studies comprising 123 635 participants (3550 CRC cases) for analysis based on intake quantity. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model and then pooled using the random effect model. Comparing the highest vs lowest quartile, beef intake was associated with an increased risk of colon cancer in women (pooled HR 1.20; 95% CI, 1.01-1.44) and distal colon cancer (DCC) risk in men (pooled HR 1.30; 95% CI, 1.05-1.61). Frequent intake of pork was associated with an increased risk of distal colon cancer in women (pooled HR 1.44; 95% CI, 1.10-1.87) for "3 times/wk or more" vs "less than 1 time/wk". Frequent intake of processed red meat was associated with an increased risk of colon cancer in women (pooled HR 1.39; 95% CI, 0.97-2.00; P trend = .04) for "almost every day" vs "less than 1 time/wk". No association was observed for chicken consumption. The present findings support that intake of beef, pork (women only), and processed red meat (women only) might be associated with a higher risk of colon (distal colon) cancer in Japanese.


Assuntos
Neoplasias do Colo/etiologia , Carne/efeitos adversos , Neoplasias Retais/etiologia , Animais , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Bovinos , Colo , Intervalos de Confiança , Feminino , Manipulação de Alimentos , Humanos , Japão , Masculino , Carne/classificação , Aves Domésticas , Carne Vermelha/efeitos adversos , Medição de Risco , Fatores Sexuais , Suínos
16.
Br J Radiol ; 92(1104): 20190663, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31559859

RESUMO

OBJECTIVES: To assess whether NHS breast screening programme (NHSBSP) mammogram readers could effectively interpret first post-contrast acquisition subtracted (FAST) MRI, for intended use in screening for breast cancer. METHODS: Eight NHSBSP mammogram readers from a single centre (four who also read breast MRI (Group 1) and four who do not (Group 2)) were given structured FAST MRI reader training (median 4 h: 32 min). They then prospectively interpreted 125 FAST MRIs (250 breasts: 194 normal and 56 cancer) comprising a consecutive series of screening MRIs enriched with additional cancer cases from 2015, providing 2000 interpretations. Readers were blinded to other readers' opinions and to clinical information. Categorisation followed the NHSBSP MRI reporting categorisation, with categories 4 and 5 considered indicative of cancer. Diagnostic accuracy (reference standard: histology or 2 years' follow-up) and agreement between readers were determined. RESULTS: The accuracy achieved by Group 2 (847/1000 (85%; 95% confidence interval (CI) 82-87%)) was 5% less than that of Group 1 (898/1000 (90%; 95% CI 88-92)). Good inter-reader agreement was seen between both Group 1 readers (κ = 0.66; 95% CI 0.61-0.71) and Group 2 readers (κ = 0.63; 95% CI 0.58-0.68). The median time taken to interpret each FAST MRI was Group 1: 34 s (range 3-351) and Group 2: 77 s (range 11-321). CONCLUSION: Brief structured training enabled multiprofessional mammogram readers to achieve similar accuracy at FAST MRI interpretation to consultant radiologists experienced at breast MRI interpretation. ADVANCES IN KNOWLEDGE: FAST MRI could be feasible from a training-the-workforce perspective for screening within NHSBSP.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Confiabilidade dos Dados , Imagem por Ressonância Magnética/métodos , Mamografia , Radiologistas/educação , Intervalos de Confiança , Meios de Contraste , Feminino , Humanos , Estudos Prospectivos , Padrões de Referência , Sensibilidade e Especificidade , Fatores de Tempo
18.
Farm. hosp ; 43(4): 134-139, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183900

RESUMO

Objetivo: Los objetivos del estudio fueron cuantificar la adherencia, determinar los factores predictivos y conocer las consecuencias de una menor adherencia, en la práctica clínica diaria, en pacientes con artropatías inflamatorias crónicas tratados con terapias biológicas. Método: Estudio descriptivo, observacional y retrospectivo. Se incluyeron pacientes con artritis reumatoide, espondilitis anquilosante y artritis psoriásica que iniciaron una terapia biológica entre el 1 de enero de 2009 y el 31 de diciembre de 2016. Se recogieron variables sociodemográficas, relacionadas con la enfermedad, sobre las terapias biológicas y los recursos hospitalarios. La adherencia se calculó mediante la ratio media de posesión. Resultados: Se incluyeron 362 pacientes y 423 líneas de terapia biológica. La media de edad ± desviación estándar fue de 50,3 ± 13,9 años; 228 (53,9%) fueron mujeres. El porcentaje de adherentes fue de 187 de 216 (87%) en artritis reumatoide, 91 de 107 (85%) en espondilitis anquilosante y 84 de 100 (84%) en artritis psoriásica. La adherencia se relacionó con acudir con más frecuencia a la consulta del servicio de farmacia (odds ratio de 1,2; intervalo de confianza 95%: 1,1-1,3 [p < 0,001]) e inversamente con no acudir a las consultas de reumatología en la fecha prevista (odds ratio de 0,2; intervalo de confianza 95%: 0,1-0,9 [p = 0,030]) No hubo diferencias en el número de recursos hospitalarios utilizados por pacientes adherentes y no adherentes. Conclusiones: La adherencia a las terapias biológicas entre las artropatías inflamatorias crónicas es similar. Dicha adherencia se correlaciona con la frecuentación a consultas externas, pero no implica un aumento del consumo de recursos


Introduction: The aims of the study were to quantify adherence, determine the factors that can predict adherence and identify the consequences of poorer adherence in patients with chronic inflammatory arthropathies treated with biological therapies in daily clinical practice. Method: A descriptive, observational and retrospective study was carried out. Patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis who started a biologic therapy between 1 January 2009 and 31 December 2016 were included. Variables related to socioeconomic status, the disease, the biological therapy and hospital resources were included. Adherence was calculated by using the medication possession ratio. Results: Three hundred and sixty-two patients and 423 lines of biological therapy were included. Mean age ± standard deviation was 50.3 ± 13.9 years, and 228 (53.9%) were women. The percentage of adherent patients was 187 out of 216 (87%) in rheumatoid arthritis, 91 out of 107 (85%) in ankylosing spondylitis and 84 out of 100 (84%) in psoriatic arthritis. Greater adherence was associated with more frequent visits to the pharmacy service (odds ratio 1.2, 95% confidence interval: 1.1-1.3 [p < 0.001]) and poorer adherence with a failure to attend scheduled appointments at the rheumatology clinic (odds ratio 0.2, 95% confidence interval: 0.1-0.9 [p = 0.030]). There were no differences between adherent and non-adherent patients in terms of the number of hospital resources used. Conclusions: There are no differences in adherence to biological therapies among patients with chronic inflammatory arthropathies. Adherence correlates with attendance at outpatient appointments, but this does not imply an increase in the use of hospital resources


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Cooperação e Adesão ao Tratamento , Terapia Biológica/métodos , Artropatias/terapia , Estudos Retrospectivos , Artrite Reumatoide/terapia , Espondilite Anquilosante/terapia , Artrite Psoriásica/terapia , Serviço de Farmácia Hospitalar/métodos , Intervalos de Confiança , Razão de Chances
19.
Emergencias (Sant Vicenç dels Horts) ; 31(4): 234-238, ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182763

RESUMO

Objetivo: Cuantificar los episodios asistenciales del servicio de urgencias originados a iniciativa del paciente sin seguimiento posterior en atención pimaria (EIPSS), e identificar factores asociados a ello. Método: Estudio retrospectivo observacional de pacientes atendidos en Urgencias de un hospital de tercer nivel durante 2 años, mediante muestreo sistemático por conglomerados correspondiente al 0,05% de los episodios de cada mes, con alta a domicilio. Se analizaron variables demográficas, tiempos asistenciales, abordaje previo en atención primaria por el mismo episodio (APAP), nivel de triaje, diagnóstico, importe de la prescripción al alta e indicación de seguimiento y realización del mismo. Se utilizó un modelo multivariante de regresión logística para la estimación del grado de asociación. Resultados: Se analizaron 1.277 episodios, encontrándose un EIPSS en el 48,1% de ellos. Estos fueron más frecuentes entre los más jóvenes (p = 0,002), sin APAP (OR: 1,74; IC 95% 1,34-2,28), en los que accedieron de 22-04 h (OR: 2,43; IC 95%: 1,55-3,80%), con un nivel de triaje 4-5 (OR: 1,33; IC 95%: 1,04-1,69), con una urgencia oftalmológica como motivo de consulta (OR: 1,64; IC 95%: 1,12-2,41), con un coste de la prescripción menor de 3 Euros (OR: 2,39; IC 95%: 1,87-3,06) y en quienes fue indicado seguimiento al alta (OR: 1,9; IC 95%: 1,37-2,65). Conclusiones: La mitad de los pacientes que acuden por iniciativa propia al SUH y se van de alta a domicilio no realizan seguimiento posterior por atención primaria (AP). En este grupo de pacientes, el urgenciólogo debería insistir en la importancia de la asistencia previa y posterior por AP


Objective: To estimate the volume of patient-initiated visits to the emergency department without follow-up by a primary care physician, and to identify factors related to this practice. Methods: Retrospective, observational study of patients attended in a tertiary care hospital emergency department. We used a cluster/systematic sampling method to select 0.05% of the episodes discharged home every month. The following data were extracted: demographic variables, care times, prior primary care for the same episode, triage level, diagnosis, cost of prescriptions on discharge, instructions for follow-up, and adherence to those instructions. Associations were explored using multivariate logistic regression modelling. Results: A total of 1277 episodes were analyzed; 48.1% were patient-initiated visits without primary care follow-up. These visits were associated with the following variables: young patients (P = .002) without prior primary care (odds ratio [OR], 1.74; 95% CI, 1.34-2.28); visits between 10 PM and 4 AM (OR, 2.43; 95% CI, 1.55-3.80); triage level 4-5 (OR, 1.33; 95% CI, 1.04-1.69); ophthalmologic emergency (OR, 1.64; 95% CI, 1.12-2.41); a prescription cost of less than Euros3 (OR, 2.39; 95% CI, 1.87-3.06); and instruction to seek follow-up on discharge (OR, 1.9; 95% CI, 1.37-2.65). Conclusions: Half of patients who independently seek care from the emergency department and are discharged home do not later seek care at their primary care clinic. The emergency physician should insist on the importance of ongoing primary care


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Necessidades e Demandas de Serviços de Saúde/organização & administração , Serviços Médicos de Emergência/organização & administração , Atenção Primária à Saúde , Serviços Médicos de Emergência/estatística & dados numéricos , Sobremedicalização/estatística & dados numéricos , Estudos Retrospectivos , Análise por Conglomerados , Análise Multivariada , Técnicas e Procedimentos Diagnósticos/normas , Codificação Clínica , Razão de Chances , Intervalos de Confiança
20.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 22(4): 175-179, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183078

RESUMO

Introducción: La bioestadística es fundamental en la medicina basada en la evidencia. Para un mayor desempeño en el aprendizaje de esta materia pensando en los futuros médicos, es crucial el análisis de la ansiedad experimentada por el estudiante de medicina durante la formación en esta materia en el grado. Objetivos: Documentar la ansiedad hacia la estadística experimentada por los estudiantes de Grado en Medicina y evaluar su relación con el desempeño en la materia de bioestadística. Sujetos y métodos: Estudio observacional, transversal y analítico en estudiantes de primer curso de Grado en Medicina en la Facultad de Ciencias de la Salud y del Deporte de Huesca (Universidad de Zaragoza). Para la medición de la ansiedad hacia la estadística se utilizó la versión en castellano de la Statistical Anxiety Scale (SAS). Resultados: Respondieron el 91,1% (n = 41) de los estudiantes. La puntuación media de la SAS fue de 2,51 ± 0,61. Las puntuaciones en las subescalas indicaron que los estudiantes padecen ansiedad baja o moderada por pedir ayuda e interpretar los resultados estadísticos, y algo más elevada ante el examen de estadística. El estudio de la correlación mostró que aquellos estudiantes con menor nivel de ansiedad por pedir ayuda e interpretar los resultados estadísticos obtuvieron mayor puntuación en el examen de bioestadística. Conclusiones: Los estudiantes presentan una moderada ansiedad hacia la estadística, aunque se necesita más investigación centrada en los cambios en la metodología de enseñanza, desde el comienzo del Grado en Medicina, para disminuir dicha ansiedad


Introduction: Biostatistics is fundamental in evidence-based medicine. For a greater performance in the learning of this subject thinking about the future doctors, it is crucial the analysis of the anxiety experienced by the medical student during the training in this subject in degree. Aims: To document the anxiety towards the statistics experienced by the students of Degree in Medicine and to assess its relation with the performance in biostatistics. Subjects and methods: Observational, transversal and analytical study in students of the first year of Degree in Medicine at the Faculty of Health Sciences and Sports of Huesca (University of Zaragoza). For the measurement of anxiety towards statistics, the Spanish version of the Statistical Anxiety Scale (SAS) survey was used. Results: They answered 91.1% (n = 41) of the students. The average SAS score was 2.51 ± 0.61. The sub-scale scores indicated that students suffer from low or moderate anxiety for asking for help and interpreting the statistical results, and somewhat higher for the statistical test. The study of the correlation showed that those students with a lower level of anxiety for asking for help and interpreting the statistical results obtained a higher score in biostatistics test. Conclusions: Medical students show a moderate anxiety towards statistics, although more research is needed focusing on changes in teaching methodology, since the beginning of the degree, to reduce this anxiety


Assuntos
Humanos , Bioestatística/métodos , Ansiedade , Estudantes de Medicina/psicologia , Estudos Transversais , Inquéritos e Questionários , Análise Estatística , Estatísticas não Paramétricas , Intervalos de Confiança
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