Medicina de Familia-SEMERGEN最新文献

英文中文

Úlceras submamarias de etiología yatrogénica. ¿Las sospechamos adecuadamente? 医源性乳腺下溃疡。我们对他们的怀疑正确吗？］

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-09 DOI: 10.1016/j.semerg.2024.102397

M. Rodríguez-Troncoso , G. Vargas-Castillo , R. Ruiz-Villaverde

引用次数: 0

Protective factors and mental health in couples who expect a child in confinement 待产夫妇的保护因素和心理健康。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-09 DOI: 10.1016/j.semerg.2024.102392

M.D. Lanzarote-Fernández, M.M. Aires-González, M. Gómez de Terreros Guardiola, E.M. Padilla-Muñoz

Objective

Adverse situations can affect the mental health and support of pregnant women and their partners, such as the COVID-19 pandemic and the resulting confinement periods. The main objective of this study was to evaluate the protective factors in the mental health of pregnant women and their partners, as well as the interrelationships of these factors, in an adverse situation, through the assessment of resilience, perceived support, anxiety, depression and stress.

Methods

The sample consisted of 38 women with no pregnancy risk and 25 partners evaluated between gestation weeks 24 and 31. This is a cross-sectional, descriptive, correlational study.

Results

The pregnant women presented lower resilience, greater social support (especially family support), and greater intensity of depression, anxiety and stress than their partners. Moreover, a mutual relationship was found, both in depression and general support, between the members of the couple.

Conclusion

During the confinement, pregnant women have presented greater vulnerability in mental health, despite perceiving greater social support than their partners. Greater resilience in the partners could be a relevant factor to cope with situation of adversity during pregnancy, as indicated by the relationship detected between the risk and protective factors. It would be desirable to improve the attention and care of pregnant women during prolonged periods of adversity, including the couple, and to strengthen mutual support.

目的：不利情况会影响孕妇及其伴侣的心理健康和支持，例如COVID-19大流行及其导致的坐月子期。本研究的主要目的是通过评估复原力、感知支持、焦虑、抑郁和压力，评估孕妇及其伴侣在不利情况下的心理健康保护因素，以及这些因素之间的相互关系。方法：38名无妊娠风险的妇女和25名在妊娠24周至31周期间进行评估的伴侣。这是一项横断面、描述性、相关性研究。结果：孕妇的心理韧性较低，社会支持（尤其是家庭支持）较强，抑郁、焦虑和压力的强度高于其伴侣。此外，研究还发现，夫妻双方在抑郁和普遍支持方面都存在相互关系。结论：在坐月子期间，孕妇在心理健康方面表现出更大的脆弱性，尽管她们感受到比伴侣更多的社会支持。从风险因素和保护因素之间的关系可以看出，伴侣更强的适应力可能是应对怀孕期间逆境的一个相关因素。在长期的逆境中，改善对孕妇，包括对夫妇的关注和照顾，并加强相互支持是可取的。

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引用次数: 0

Estudio descriptivo del uso de pantallas recreativas en la población escolar de 0-12 años del Prat de Llobregat [对El Prat de Llobregat 0-12岁学生使用街机屏幕的描述性研究]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-09 DOI: 10.1016/j.semerg.2024.102389

E. Ruiz Mariscal, F. Marín Jiménez, J. Fernández Blanco, S. Domínguez Rovira, C. Rodrigo Durán, N. Rodríguez Bailón

Introduction

There is sufficient scientific evidence that determines a direct relationship between the number of hours of exposure to screens with a sedentary lifestyle, overweight, delayed psychomotor development and mental disorders, among others.

Aim

Know the exposure time of the screens. The main rules of use for school children aged 0-12. Describe the role of tutors in relation to the rules of screen use.

Method

Cross-sectional descriptive study using a self-administered questionnaire to 1583 tutors of children between 0 and 12 years of age enrolled in a city in the metropolitan area of Barcelona. The main variables will include the connection time to the screens of minors from Monday to Friday and the connection time to the screens on public holidays.

Results

1583 surveys were collected (50.9% girls, 48.9% boys and 0.2% non-binary). There was a progressive increase in the number of hours spent on screens as a function of increasing age. 68.21% of the sample began their first contact with screens before the age of 2.

Conclusions

The population under 12 years of age does not comply with the preventive recommendations set out in the Comprehensive Care Plan for people with mental disorders and addictions of the Generalitat de Catalunya (2017-2019) or the WHO recommendations. The results indicate that inappropriate use is made and that limits and rules for the use of screens by tutors are not applied to their minors in charge.

引言：有足够的科学证据表明，在屏幕前暴露的时间与久坐不动的生活方式、超重、精神运动发育迟缓和精神障碍等之间存在直接关系。目的：了解屏幕的曝光时间。0-12岁学龄儿童主要使用规则。描述与屏幕使用规则相关的导师角色。方法：采用横断面描述性研究，采用自填问卷对巴塞罗那市区某城市1583名0 - 12岁儿童的家庭教师进行调查。主要变量包括周一至周五的未成年人院线连接时间和公共假日的院线连接时间。结果：共收集问卷1583份，其中女生50.9%，男生48.9%，非二元性别0.2%。随着年龄的增长，花在屏幕上的时间逐渐增加。68.21%的儿童在2岁前开始接触屏幕。结论：12岁以下人群不符合加泰罗尼亚自治区精神障碍和成瘾者综合护理计划（2017-2019）或世卫组织建议中提出的预防建议。结果表明，教师对屏幕的使用存在不当，对辅导员使用屏幕的限制和规定未适用于其所负责的未成年人。

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引用次数: 0

Latest vaccination trends against herpes zoster within two primary care settings in Crete, Greece: Rates and perception driven determinants 在希腊克里特岛的两个初级保健机构中针对带状疱疹的最新疫苗接种趋势：比率和认知驱动的决定因素。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-09 DOI: 10.1016/j.semerg.2024.102394

M. Kefalogianni , H. Dimitriou , A. Bertsias , G. Marinos , D. Kofteridis , E.K. Symvoulakis

Objectives

This study aims to estimate the vaccination rate against herpes zoster (HZ) among public Primary Health Care (PHC) visitors eligible for vaccination based on the National guidelines. It also aims to explore the determinants associated with vaccination utilizing the health beliefs model (HBM).

Materials and methods

A cross-sectional study was conducted between October and December 2022. The study took place in two public PHC units in the Heraklion prefecture, Crete, Greece. Eligible participants were visitors of the selected health units aged 60–75 years. The questionnaire elicited information on participants’ demographic data, health habits, and chronic illnesses. The HBM tool adapted for HZ vaccination was also used.

Results

Four hundred primary care attendees participated in the study. Most participants were women (58.5%), with a mean age of 68.1 (±4.9) years. Fifteen percent of participants reported a history HZ illness, while 147 (36.8%) reported being vaccinated against HZ. Older age and respiratory illnesses were associated with higher rates of vaccination. Perceived threat (OR: 1.057; 95% CI 1.022–1.093; p = 0.001), perceived vaccination benefits (OR: 1.327; 95% CI 1.179–1.492; p < 0.0001), and motivation for action (OR: 2.601; 95% CI 2.122–3.187; p < 0.0001) increased the odds of receiving HZ vaccination. Conversely, perceived barriers such as safety concerns were found to decrease the odds of HZ vaccination (OR: 0.845; 95% CI 0.803–0.889; p < 0.0001).

Conclusions

This study identified specific determinants positively associated with HZ vaccination, highlighting the need to enhance the education of healthcare professionals in personalized patient counseling.

目的：本研究的目的是估计带状疱疹（HZ）的接种率在公共初级卫生保健（PHC）有资格接种疫苗的游客根据国家指南。它还旨在利用健康信念模型（HBM）探索与疫苗接种相关的决定因素。材料与方法：横断面研究于2022年10月至12月进行。该研究在希腊克里特岛伊拉克利翁州的两个公共初级保健单位进行。符合条件的参与者是选定保健单位的60-75岁来访者。问卷询问了参与者的人口统计数据、健康习惯和慢性疾病等信息。还使用了适用于HZ疫苗接种的HBM工具。结果：400名初级保健参与者参与了这项研究。大多数参与者为女性（58.5%），平均年龄为68.1（±4.9）岁。15%的参与者报告有HZ病史，147人（36.8%）报告接种了HZ疫苗。年龄较大和呼吸道疾病与较高的疫苗接种率有关。感知威胁(OR: 1.057；95% ci 1.022-1.093；p=0.001)，感知疫苗接种益处(OR: 1.327；95% ci 1.179-1.492；结论：本研究确定了与HZ疫苗接种正相关的特定决定因素，强调了在个性化患者咨询中加强医疗保健专业人员教育的必要性。

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引用次数: 0

Carta al editor: evolución de la cotización y demanda de la especialidad de Medicina Familiar y Comunitaria en el examen MIR 2002-2023 [致编者信：MIR 2002-2023年家庭和社区医学的演变、引文和需求]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-09 DOI: 10.1016/j.semerg.2024.102346

M.P. Torres Moreno , R. Blanco Herrera , L. Vegas Fernández , J.J. Alfaro Martínez

引用次数: 0

Uso de la ecografía clínica en atención primaria: hombro doloroso 临床超声在初级保健中的应用：肩部疼痛

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-01 DOI: 10.1016/j.semerg.2024.102385

J.A. López Juan , M. Román Garrido , M.D. Jiménez Cremers , T. Fernández Rodriguez

Shoulder pain is one of the most common conditions in primary care, especially in elderly patients. Ultrasound stands out as an effective and cost-efficient tool for assessing these injuries, allowing real-time dynamic visualization of the affected anatomical structures. There is clear evidence that ultrasound is an effective diagnostic tool in the hands of a properly trained family physician. The tendons of the rotator cuff, especially the supraspinatus, are the most commonly affected. Ultrasound is crucial in detecting its pathology. Generally, the age and degenerative process itself stand out as the most influential factors in the pathogenesis. This review provides an overview of shoulder ultrasound anatomy, its exploration methodology, and the diagnosis of various injuries and pathologies.

肩痛是初级保健中最常见的疾病之一，尤其是老年患者。超声作为评估这些损伤的有效且经济的工具脱颖而出，允许受影响解剖结构的实时动态可视化。有明确的证据表明，在训练有素的家庭医生手中，超声波是一种有效的诊断工具。肩袖肌腱，尤其是冈上肌，是最常见的受累部位。超声是检测其病理的关键。一般来说，年龄和退行性过程本身是影响发病的最重要因素。本文综述了肩关节超声解剖、超声探查方法以及各种损伤和病理的诊断。

引用次数: 0

Uso de la ecografía clínica en atención primaria: nódulo tiroideo [临床超声在初级保健中的应用：甲状腺结节]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-01 DOI: 10.1016/j.semerg.2024.102384

E. Viudas Sainz , A.M. Sánchez Sempere , O. Vicente López , J. Cabrera Gómez

The thyroid nodule is a frequent lesion within the thyroid. Its incidence is between 50%-60% and most of them are asymptomatic and benign (90-95%) and its diagnosis is frequently made as an incidental finding. The main objective of their study is to rule out thyroid cancer.

Cervical ultrasound is the non-invasive diagnostic technique of choice to study the thyroid gland and its pathology, including the thyroid nodule, as it is the technique with the best cost-benefit ratio. Together with the anamnesis, physical examination, personal and family history and laboratory tests, it enables the first diagnostic approach. Ultrasonography allows the description of thyroid nodules according to their structure, morphology, margins, size,echogenicity, vascularization, calcifications and whether or not there are pathological lymph nodes. Subsequently, the application of risk stratification systems, such as the TI-RADS classification, will make it possible to identify those nodules suspected of having a high risk of malignancy, establishing the indication for FNA, which is decisive for the subsequent therapeutic approach. Ultrasound therefore allows the family physician a quick orientation of the patient with a thyroid nodule, especially useful when there is a high suspicion of malignancy. As it is an operator-dependent technique, acquiring knowledge and skills in its use will increase diagnostic reliability.

甲状腺结节是甲状腺内常见的病变。其发病率在50%-60%之间，大多数是无症状和良性的（90-95%），其诊断经常是偶然发现的。他们研究的主要目的是排除甲状腺癌的可能性。宫颈超声是研究甲状腺及其病理包括甲状腺结节的非侵入性诊断技术的首选，因为它具有最佳的成本效益比。与记忆、体格检查、个人和家族史以及实验室测试一起，它使第一个诊断方法成为可能。超声检查可以根据甲状腺结节的结构、形态、边缘、大小、回声性、血管化、钙化以及是否存在病理性淋巴结来描述甲状腺结节。随后，应用风险分层系统，如TI-RADS分类，将有可能识别那些疑似恶性肿瘤高风险的结节，确定FNA的指征，这对随后的治疗方法具有决定性作用。因此，超声使家庭医生能够快速定位甲状腺结节患者，在高度怀疑恶性肿瘤时尤其有用。由于它是一种依赖于操作人员的技术，掌握其使用的知识和技能将提高诊断的可靠性。

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引用次数: 0

La ecografía en atención primaria. Algo nuevo, algo viejo y algo prestado 超声在初级保健中的应用。有新的，有旧的，也有借来的]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-01 DOI: 10.1016/j.semerg.2024.102367

M. Rivera Teijido

引用次数: 0

Cólico biliar ¿sin más? (胆绞痛。这就是全部吗？］

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-01 DOI: 10.1016/j.semerg.2024.102399

M. Sánchez Cambronero, M. Guisasola Cárdenas, A. González Bravo, M.N. Generoso Torres, J.C. Aguirre Rodríguez

引用次数: 0

Uso de la ecografía clínica en atención primaria: disnea 临床超声在初级保健中的应用：disnea

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-01 DOI: 10.1016/j.semerg.2024.102386

M.D. Jiménez Cremers , I. Moreno Sánchez , J. Fidalgo López , M.E. Minguela Puras

Dyspnea is a symptom frequently consulted in primary care and has a wide range of etiologies (respiratory, cardiovascular, obesity, etc.). It causes 3-4 million emergency consultations per year. Approximately 9-13% of the ambulatory population reports dyspnea, getting up to 37% in adults aged ≥ 70 years.

In primary care, where complementary tests are limited, clinical ultrasound is performed at bedside by the doctor directly responsible for the patient, as a complement to a thorough medical assessment and physical examination, that facilitates the early diagnosis of patients with dyspnea as well as their follow-up.

In various studies, it has been shown that lung ultrasound in the hands of a well-trained operator has greater diagnostic accuracy.

呼吸困难是在初级保健中经常咨询的症状，其病因广泛（呼吸、心血管、肥胖等）。每年有300万至400万次紧急咨询。大约9-13%的门诊人口报告呼吸困难，在≥70岁的成年人中高达37%。在补充检查有限的初级保健中，临床超声由直接负责病人的医生在床边进行，作为全面医疗评估和体格检查的补充，有助于对呼吸困难患者的早期诊断及其随访。在各种研究中，已经表明，在训练有素的操作员手中的肺部超声具有更高的诊断准确性。

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