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Grupo de afrontamiento de la ansiedad en atención primaria: guía revisada.
No full textLos Grupos de Afrontamiento de la Ansiedad en Atención Primaria (GRAFA) son grupos psicoeducativos de intervención psicológica de baja intensidad, recomendados por la 2ª edición del Proceso Asistencial Integrado Ansiedad, Depresión y Somatizaciones, para abordar los trastornos de ansiedad de leve a moderada en Atención Primaria (AP). Estos grupos van dirigidos a las personas con trastornos de ansiedad cuyos síntomas no han mejorado después de haber sido atendidas por su médico/a o enfermero/a de familia en la consulta de Atención Primaria, mediante la intervención dirigida, la entrega de guías de autoayuda y el seguimiento activo en la consulta. El objetivo general es aumentar la capacidad de afrontamiento ante la ansiedad e incrementar el bienestar de las personas incluidas en el programa. El programa GRAFA es un programa altamente estructurado, donde se combina la relajación y la psicoeducación sobre la ansiedad a lo largo de 8 sesiones, una por semana, de 2 horas de duración. La Guía aquí publicada es el documento marco, y en la parte de Consultar Publicación hay materiales complementarios de apoyo a la implementación de los GRAFA.Ye
Vol. 28 nº 01-02. Evaluación HAM (Health Alert Monitoring). Año 2022.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 52/2022 y acumulado desde semana 01/2022. Datos provisionales. Incluye además el artículo titulado "Evaluación HAM (Health Alert Monitoring). Año 2022", de "Julia Romero Barranca; Sofía Villalobos Herrera; Mª Auxiliadora Vergara Díaz; Encarnación Román Casares"Ye
Homocysteine levels, genetic background, and cognitive impairment in Parkinson's disease.
No full textHyperhomocysteinemia is considered an independent risk factor for cognitive impairment. To study the correlation between homocysteine levels and cognitive impairment in patients with PD. We conducted a case-control study that included 246 patients with PD, of whom 32 were cognitively impaired. The levels of homocysteine, folate, and vitamin B12 were measured in peripheral blood. Multivariate logistic regression analysis was applied to determine differences in homocysteine levels between PD patients with and without cognitive impairment. A meta-analysis was performed to clarify the role of Hcy levels in PD with cognitive decline. Five polymorphisms in genes involved in Hcy metabolism, including MTHFR rs1801133 and rs1801131, COMT rs4680, MTRR rs1801394, and TCN2 rs1801198, were genotyped. Our case-control study showed that homocysteine levels were associated with cognitive impairment in PD after adjusting for possible confounding factors such as levodopa equivalent daily dose. The results of our meta-analysis further supported the positive association between homocysteine levels and cognition in PD. We found that the MTHFR rs1801133 TT genotype led to higher homocysteine levels in PD patients, whereas the MTHFR rs1801131 CC genotype resulted in higher folate levels. However, the polymorphisms studied were not associated with cognitive impairment in PD. Increased homocysteine levels were a risk factor for cognitive decline in PD. However, no association was found between polymorphisms in genes involved in homocysteine metabolism and cognitive impairment in PD. Large-scale studies of ethnically diverse populations are required to definitively assess the relationship between MTHFR and cognitive impairment in PD.S
Cancer awareness in older adults: Results from the Spanish Onco-barometer cross-sectional survey.
No full textBackground
About half of all cancers are diagnosed in adults older than 65, making them the age group at highest risk of developing this disease. Nurses from different specialties can support individuals and communities in the prevention and early detection of cancer and should be aware of the common knowledge gaps and perceived barriers among older adults.
Objectives
The goal of the current research was to investigate personal characteristics, perceived barriers, and beliefs related to cancer awareness in older adults, with a special focus on perceptions about the influence of cancer risk factors, knowledge of cancer symptoms, and anticipated help-seeking.
Design
Descriptive cross-sectional study.
Participants
Participants were 1213 older adults (≥ 65 years old) from the representative national Onco-barometer survey conducted in 2020 in Spain.
Methods
Questions on the perceived influence of cancer risk factors, knowledge of cancer symptoms, and the Spanish version of the Awareness and Beliefs about Cancer (ABC) questionnaire were administered in computer-assisted telephone interviews.
Results
Knowledge of cancer risk factors and symptoms was strongly related to personal characteristics and was limited among males and older individuals. Respondents from lower socio-economic background recognized fewer cancer symptoms. Having personal or family history of cancer had opposite effects on cancer awareness: It was related to more accurate symptom knowledge but also to lower perceptions about the influence of risk factors and more delayed help-seeking. Anticipated help-seeking times were strongly influenced by perceived barriers to help-seeking and beliefs about cancer. Worry about wasting the doctor's time (48% increase, 95% CI [25%–75%]), about what the doctor might find (21% increase [3%–43%]) and not having enough time to go to the doctor (30% increase [5%–60%]) were related to more delayed help-seeking intentions. In contrast, beliefs that reflected higher perceived seriousness of a potential cancer diagnosis were related to shorter anticipated help-seeking times (19% decrease [5%–33%]).
Conclusions
These results suggest that older adults could benefit from interventions informing them about how to reduce their cancer risk and addressing emotional barriers and beliefs associated with help-seeking delays. Nurses can contribute to educating this vulnerable group and are in a unique position to address some barriers to help-seeking.Ye
Primary biliary cholangitis and SARS-CoV-2 infection: incidence, susceptibility and outcomes
No full textWe read with interest the work by Mansoor et al 1 regarding the outcomes of COVID-19 in coeliac disease . The impact of pre-existing chronic liver diseases on COVID-19 outcomes has been largely evaluated,2–4 and consequently specific recommendations have been made in these patients .5 However, the relationship between primary biliary cholangitis (PBC) and SARS-CoV-2 remains unknown.6 We aimed to determine (1) the cumulative incidence of SARS-CoV-2 infection in a population of patients with PBC, comparing with the general Spanish cumulative incidence by the end of April 2021; (2) the baseline factors associated with a higher susceptibility to SARS-CoV-2 infection; and (3) the baseline factors associated with COVID-19-related hospitalisation.S
Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)
No full textThe segmentation of patients into homogeneous groups could help to improve eradication therapy effectiveness. Our aim was to determine the most important treatment strategies used in Europe, to evaluate first-line treatment effectiveness according to year and country. Data collection: All first-line empirical treatments registered at AEGREDCap in the European Registry on Helicobacter pylori management (Hp-EuReg) from June 2013 to November 2022. A Boruta method determined the "most important" variables related to treatment effectiveness. Data clustering was performed through multi-correspondence analysis of the resulting six most important variables for every year in the 2013-2022 period. Based on 35,852 patients, the average overall treatment effectiveness increased from 87% in 2013 to 93% in 2022. The lowest effectiveness (80%) was obtained in 2016 in cluster #3 encompassing Slovenia, Lithuania, Latvia, and Russia, treated with 7-day triple therapy with amoxicillin-clarithromycin (92% of cases). The highest effectiveness (95%) was achieved in 2022, mostly in Spain (81%), with the bismuth-quadruple therapy, including the single-capsule (64%) and the concomitant treatment with clarithromycin-amoxicillin-metronidazole/tinidazole (34%) with 10 (69%) and 14 (32%) days. Cluster analysis allowed for the identification of patients in homogeneous treatment groups assessing the effectiveness of different first-line treatments depending on therapy scheme, adherence, country, and prescription year.This project was promoted and funded by the European Helicobacter and Microbiota Study Group (EHMSG), the Spanish Association of Gastroenterology (AEG), and the Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). The Hp- EuReg was co-funded by the European Union programme HORIZON (grant agreement number 101095359) and supported by the UK Research and Innovation (grant agreement number 10058099). The Hp-EuReg was co-funded by the European Union programme EU4Health (grant agreement number 101101252). This study was funded by Richen; however, clinical data were not accessible, and the company was not involved in any stage of the Hp-EuReg study (design, data collection, statistical analysis, or manuscript writing). We want to thank Richen for their support.Ye
Vol. 28, nº 47. Brotes de toxinfección alimentaria (T.I.A) por norovirus en la academia de guardias de la guardia civil de Baeza
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 46/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Brotes de toxinfección alimentaria (T.I.A) por norovirus en la academia de guardias de la guardia civil de Baeza”, de “Juan Pedro Quesada Suárez., Nuria de la Torre López”.Ye
Prognostic Outcomes of Cutaneous Squamous Cell Carcinoma in Solid Organ Transplant Recipients: A Retrospective Comparative Cohort Study
No full textIntroduction: Cutaneous squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm, and its incidence is on the rise. While most cSCCs have an excellent prognosis, certain risk factors, especially immunosuppression, have been associated with higher rates of local recurrence (LR), metastasis, and poor prognosis. This study aims to assess the risk factors for LR and metastasis development in cSCC among solid organ transplant recipients (SOTRs) and compare these rates with those in immunocompetent patients. Materials and Methods: A retrospective observational study included cSCC cases from the University Hospital Reina Sofía in Córdoba, Spain, between 2002 and 2019. Demographic, clinical, and histopathological data were collected. Local recurrence and metastasis rates were analyzed, along with progression-free survival. Univariate analyses were performed to identify prognostic factors in SOTRs. Results: Among 849 cSCC cases, we found higher rates of local recurrence and metastasis in tumors developed by SOTRs compared to those in immunocompetent individuals. However, no significant differences in local recurrence, metastasis, or progression-free survival were observed between the two groups. Risk factors for adverse outcomes in SOTRs included tumor size > 2 cm, depth > 4 mm, and a higher Clark level. A total of 34.4% of SOTRs developed a second primary cSCC during the follow-up. Conclusions: In our study, cSCCs in SOTRs did not exhibit statistically significant differences in the rates of adverse outcomes compared to immunocompetent patients. The prognosis of cSCCs in SOTRs may be more related to other tumor-dependent risk factors than to the immunosuppression status itself. Future studies are needed
to refine risk stratification and follow-up protocols to ensure the optimal management of high-risk cSCC cases, particularly among immunosuppressed patients.Ye
Trastuzumab deruxtecan in patients with central nervous system involvement from HER2-positive breast cancer: The DEBBRAH trial.
No full textTrastuzumab deruxtecan (T-DXd) has shown durable antitumor activity in pretreated patients with HER2-positive advanced breast cancer (ABC), but its efficacy has not yet been evaluated in patients with active brain metastases (BMs). DEBBRAH aims to assess T-DXd in patients with HER2-positive or HER2-low ABC and central nervous system involvement. This ongoing, five-cohort, phase II study (NCT04420598) enrolled patients with pretreated HER2-positive or HER2-low ABC with stable, untreated, or progressing BMs, and/or leptomeningeal carcinomatosis. Here, we report findings from HER2-positive ABC patients with non-progressing BMs after local therapy (n = 8; cohort 1), asymptomatic untreated BMs (n = 4; cohort 2), or progressing BMs after local therapy (n = 9; cohort 3). Patients received 5.4 mg/kg T-DXd intravenously once every 21 days. The primary endpoint was 16-week progression-free survival (PFS) for cohort 1 and intracranial objective response rate (ORR-IC) for cohorts 2 and 3. As of October 20, 2021, 21 patients received T-DXd. In cohort 1, 16-week PFS rate was 87.5% (95%CI, 47.3-99.7; P T-DXd showed intracranial activity with manageable toxicity and maintained the quality of life in pretreated HER2-positive ABC patients with stable, untreated, or progressing BMs. Further studies are needed to validate these results in larger cohorts