Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102383
C. Montero Peña , F.J. Palma Maldonado , J. Fidalgo López , C. Casanova García
The patient with heart failure (HF) is a frequent scenario in primary care consultations. The presence of subclinical congestion is a predictor of rehospitalization and adverse events in these patients. The assessment of congestion is complex due to the low sensitivity of classic symptoms and signs, which leads to underdiagnosis, delayed initiation of treatment and a greater likelihood of complications. The family doctor should be familiar with new techniques for congestion assessment, such as the study of venous congestion with ultrasound and pulmonary ultrasound. This makes it possible to know the existence of subclinical congestion in a more realistic way. Clinical ultrasound in the hands of the family doctor individualizes decongestive therapy in patients with HF in an accurate, fast and safe way.
{"title":"Uso de la ecografía clínica en atención primaria: marcadores de congestión en la insuficiencia cardiaca congestiva","authors":"C. Montero Peña , F.J. Palma Maldonado , J. Fidalgo López , C. Casanova García","doi":"10.1016/j.semerg.2024.102383","DOIUrl":"10.1016/j.semerg.2024.102383","url":null,"abstract":"<div><div>The patient with heart failure (HF) is a frequent scenario in primary care consultations. The presence of subclinical congestion is a predictor of rehospitalization and adverse events in these patients. The assessment of congestion is complex due to the low sensitivity of classic symptoms and signs, which leads to underdiagnosis, delayed initiation of treatment and a greater likelihood of complications. The family doctor should be familiar with new techniques for congestion assessment, such as the study of venous congestion with ultrasound and pulmonary ultrasound. This makes it possible to know the existence of subclinical congestion in a more realistic way. Clinical ultrasound in the hands of the family doctor individualizes decongestive therapy in patients with HF in an accurate, fast and safe way.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102383"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102382
A. Segura Grau , C.A. Soto Castro , A.M. Sánchez Sempere , M. Mejías Gil
Hematuria is a frequent entity in primary care. The differential diagnosis covers multiple causes: physiological, pharmacological, false hematuria and urological pathologies, being fundamental in its study to assess the possible malignant neoplastic causes.
Urologic ultrasound is a non-invasive technique, using a 3.5-5 MHz concave probe, with the patient lying supine and the bladder full. After anamnesis, physical examination, study of urinarium sediment and laboratory analysis to determine renal function, ultrasound allows the family doctor to confirm or rule out a large number of processes related to the etiology of hematuria: cysts and kidney masses, renal lithiasis, nephrocalcinosis, benign prostatic hyperplasia, polyps or vesical masses... However, this alone is not sufficient to establish a firm diagnosis in all cases.
Currently, there is no general consensus about the most appropriate diagnostic sequence in the study of hematuria, and several clinical guidelines were chosen for the application of different strategies depending on the risk factors. However, ultrasound together with cystoscopy has been positioned as the most cost-effective diagnostic strategy in most cases.
The use of ultrasound in the evaluation of the patient with hematuria in primary care allows a valuable diagnostic approach to be made, detecting warning signs and properly orienting the patient's referral to other levels, if necessary, early.
{"title":"Uso de la ecografía clínica en atención primaria: hematuria","authors":"A. Segura Grau , C.A. Soto Castro , A.M. Sánchez Sempere , M. Mejías Gil","doi":"10.1016/j.semerg.2024.102382","DOIUrl":"10.1016/j.semerg.2024.102382","url":null,"abstract":"<div><div>Hematuria is a frequent entity in primary care. The differential diagnosis covers multiple causes: physiological, pharmacological, false hematuria and urological pathologies, being fundamental in its study to assess the possible malignant neoplastic causes.</div><div>Urologic ultrasound is a non-invasive technique, using a 3.5-5<!--> <!-->MHz concave probe, with the patient lying supine and the bladder full. After anamnesis, physical examination, study of urinarium sediment and laboratory analysis to determine renal function, ultrasound allows the family doctor to confirm or rule out a large number of processes related to the etiology of hematuria: cysts and kidney masses, renal lithiasis, nephrocalcinosis, benign prostatic hyperplasia, polyps or vesical masses... However, this alone is not sufficient to establish a firm diagnosis in all cases.</div><div>Currently, there is no general consensus about the most appropriate diagnostic sequence in the study of hematuria, and several clinical guidelines were chosen for the application of different strategies depending on the risk factors. However, ultrasound together with cystoscopy has been positioned as the most cost-effective diagnostic strategy in most cases.</div><div>The use of ultrasound in the evaluation of the patient with hematuria in primary care allows a valuable diagnostic approach to be made, detecting warning signs and properly orienting the patient's referral to other levels, if necessary, early.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102382"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102387
M. Román Garrido , I. Salcedo Joven , C. Montero-Peña , P. Madrigal Laguía
From primary care we work on the prevention and treatment of cardiovascular risk in our patients. The physical examination, the electrocardiogram and the analysis are the classic parameters and continue being the most efficient way to estimate the presence and control of cardiovascular factors and target organ damage, to optimize the cardiovascular risk stratification. The use of ultrasound by the primary care doctor to complete the clinical information is a reality that helps to strengthen the diagnostic suspicion, monitorize the clinical evolution and even decide the best therapeutic plan. This work proposes to establish the bases for the use of ultrasound for the diagnosis of carotid/femoral atheromatosis, the use of echocardioscopy, screening for abdominal aortic aneurysm, the assessment of hepatic steatosis and the study of the kidney in patients with chronic kidney disease.
{"title":"Uso de la ecografía clínica en atención primaria: riesgo cardiovascular","authors":"M. Román Garrido , I. Salcedo Joven , C. Montero-Peña , P. Madrigal Laguía","doi":"10.1016/j.semerg.2024.102387","DOIUrl":"10.1016/j.semerg.2024.102387","url":null,"abstract":"<div><div>From primary care we work on the prevention and treatment of cardiovascular risk in our patients. The physical examination, the electrocardiogram and the analysis are the classic parameters and continue being the most efficient way to estimate the presence and control of cardiovascular factors and target organ damage, to optimize the cardiovascular risk stratification. The use of ultrasound by the primary care doctor to complete the clinical information is a reality that helps to strengthen the diagnostic suspicion, monitorize the clinical evolution and even decide the best therapeutic plan. This work proposes to establish the bases for the use of ultrasound for the diagnosis of carotid/femoral atheromatosis, the use of echocardioscopy, screening for abdominal aortic aneurysm, the assessment of hepatic steatosis and the study of the kidney in patients with chronic kidney disease.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102387"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102381
M.D. Jiménez Cremers , M.E. Montes Belloso , E. Viudas Sainz , E. Pejenaute Labari
Lymphadenopathy is the alteration in the consistency or size of a lymph node. It is often associated with benign diseases, although factors such as gender, location, comorbidities, and the patient's age can increase the percentage of malignancy. Infections, tumors, and systemic diseases are its most common causes. Ultrasound allows the study of superficial and some deep lymph nodes through transverse and longitudinal planes, also using color Doppler to examine their vascularization. The ultrasound characteristics of a normal lymph node include an oval shape, well-defined borders, a long/short axis ratio > 2 cm, hypoechoic and homogeneous cortex, echogenic and vascularized central hilum, and short axis < 1 cm, except in certain cases.
Ultrasound is a useful tool that, in conjunction with the medical history, physical examination, and laboratory tests, allows for a diagnostic approach in the study of lymphadenopathy. It helps differentiate them from other processes and to make an early referral if necessary.
{"title":"Uso de la ecografía clínica en atención primaria: adenopatías","authors":"M.D. Jiménez Cremers , M.E. Montes Belloso , E. Viudas Sainz , E. Pejenaute Labari","doi":"10.1016/j.semerg.2024.102381","DOIUrl":"10.1016/j.semerg.2024.102381","url":null,"abstract":"<div><div>Lymphadenopathy is the alteration in the consistency or size of a lymph node. It is often associated with benign diseases, although factors such as gender, location, comorbidities, and the patient's age can increase the percentage of malignancy. Infections, tumors, and systemic diseases are its most common causes. Ultrasound allows the study of superficial and some deep lymph nodes through transverse and longitudinal planes, also using color Doppler to examine their vascularization. The ultrasound characteristics of a normal lymph node include an oval shape, well-defined borders, a long/short axis ratio<!--> <!-->><!--> <!-->2<!--> <!-->cm, hypoechoic and homogeneous cortex, echogenic and vascularized central hilum, and short axis<!--> <!--><<!--> <!-->1<!--> <!-->cm, except in certain cases.</div><div>Ultrasound is a useful tool that, in conjunction with the medical history, physical examination, and laboratory tests, allows for a diagnostic approach in the study of lymphadenopathy. It helps differentiate them from other processes and to make an early referral if necessary.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102381"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102403
E. Minguela Puras , C.A. Soto Castro , C. Vale Varela , J. Lafuente Pérez
Back leg pain is a common complaint in primary care and is especially linked to the sports and work field. The most common cause is trauma, which can lead to injuries that can range from tendinosis to ruptures, although other causes may imply more complex and serious pathology, such as venous thrombosis or arterial injuries. This type of pathology is also important because it can be the manifestation of neoplastic, infectious, or rheumatic disease.
Current technical advances in ultrasound equipment, added to increased availability, good cost-effectiveness ratio, good patient tolerance, and the chance to execute a real-time dynamic assessment, have made ultrasonography the technique of choice in leg pathology evaluation. For this reason, our current objective is to carry out a clear description of the technique that allows it to extend its use in routine clinical practice.
{"title":"Uso de la ecografía clínica en atención primaria: ecografía en dolor cara posterior de la pierna","authors":"E. Minguela Puras , C.A. Soto Castro , C. Vale Varela , J. Lafuente Pérez","doi":"10.1016/j.semerg.2024.102403","DOIUrl":"10.1016/j.semerg.2024.102403","url":null,"abstract":"<div><div>Back leg pain is a common complaint in primary care and is especially linked to the sports and work field. The most common cause is trauma, which can lead to injuries that can range from tendinosis to ruptures, although other causes may imply more complex and serious pathology, such as venous thrombosis or arterial injuries. This type of pathology is also important because it can be the manifestation of neoplastic, infectious, or rheumatic disease.</div><div>Current technical advances in ultrasound equipment, added to increased availability, good cost-effectiveness ratio, good patient tolerance, and the chance to execute a real-time dynamic assessment, have made ultrasonography the technique of choice in leg pathology evaluation. For this reason, our current objective is to carry out a clear description of the technique that allows it to extend its use in routine clinical practice.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102403"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.semerg.2024.102400
Nerea Sánchez-Varela, Miguel Vidal-Gómez, Manuel Portela-Romero
{"title":"Quiste de Nuck: un caso clínico en atención primaria","authors":"Nerea Sánchez-Varela, Miguel Vidal-Gómez, Manuel Portela-Romero","doi":"10.1016/j.semerg.2024.102400","DOIUrl":"10.1016/j.semerg.2024.102400","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102400"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-29DOI: 10.1016/j.semerg.2024.102343
A.A. Syed , F. Eqbal , H.R. Shamsi , A.R.S. Syed , S.J. Zakir , M. Fawzy , K.S. Khan
Background
Moderna, Pfizer, and AstraZeneca SARS-CoV-2 vaccines for preventing COVID-19 have regulatory approval in most countries. We conducted a network meta-analysis to compare their effectiveness.
Methods
We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ICTRP, and Clinicaltrials.gov for the randomized controlled trials (RCTs) published between 1st January 2020 and 1st February 2024. Eligible RCTs evaluated the Moderna, Pfizer or AstraZeneca vaccines among healthy individuals and reported the effectiveness of vaccination versus control measured with the outcome occurrence of COVID-19. We performed study selection, data extraction, and quality (risk of bias) assessment in duplicate. Network meta-analysis with random effects models was used to generate odds ratios (OR) with 95% confidence intervals (CI), evaluating heterogeneity statistically using I2 for direct comparisons and ranking vaccines hierarchically using the surface under the cumulative ranking curve (SUCRA). This study was registered on PROSPERO, CRD42023457957.
Findings
Of the 1954 initial citation, 18 RCTs (272,724 participants; 151,034 received one of the vaccines and 121,690 controls) that reported the outcome occurrence of COVID-19 were selected. Of these, 2 (11%) were moderate and 5 (28%) were high in quality. In network meta-analysis, all three vaccines were effective compared directly with control (Moderna OR 0.13, 95% CI 0.07–0.26, I2 97%; Pfizer OR 0.10, 95% CI 0.05–0.19, I2 78%; AstraZeneca OR 0.38, 95% CI 0.25–0.59, I2 63%). Indirect comparison of vaccines using control as the common comparator showed that AstraZeneca was less effective than Moderna (OR 2.84, 95% CI 1.32–6.12) and Pfizer (OR 3.94, 95% CI 1.80–8.60), while Moderna versus Pfizer showed no difference (OR 1.39, 95% CI 0.56–3.46). Vaccine SUCRA probabilities were higher for Pfizer than Moderna and AstraZeneca (92%, 75% and 33% respectively compared to control).
Interpretations
Pfizer ranks highest followed by Moderna (without a statistically significant difference) and AstraZeneca vaccines for preventing symptomatic COVID-19.
现代（moderna）、辉瑞（Pfizer）和阿斯利康（AstraZeneca）用于预防COVID-19的SARS-CoV-2疫苗已在大多数国家获得监管机构的批准。我们进行了网络荟萃分析来比较它们的有效性。方法检索PubMed、Cochrane Central Register of Controlled Trials （Central）、ICTRP和Clinicaltrials.gov，检索2020年1月1日至2024年2月1日发表的随机对照试验（RCTs）。符合条件的随机对照试验在健康个体中评估了Moderna、辉瑞或阿斯利康疫苗，并报告了以COVID-19的结果发生率衡量的疫苗接种与对照的有效性。我们一式两份进行了研究选择、数据提取和质量（偏倚风险）评估。使用随机效应模型的网络荟萃分析生成95%置信区间（CI）的优势比（OR），使用I2进行直接比较，在统计上评估异质性，并使用累积排序曲线下的曲面（SUCRA）对疫苗进行分层排序。本研究注册号为PROSPERO， CRD42023457957。1954年首次引用，18项随机对照试验(272,724名受试者；报告结果发生COVID-19的151,034名接种了其中一种疫苗，121,690名对照)被选中。其中，2个（11%）为中等质量，5个（28%）为高质量。在网络荟萃分析中，与对照组直接比较，这三种疫苗均有效(Moderna OR 0.13, 95% CI 0.07-0.26, I2 97%；辉瑞OR 0.10, 95% CI 0.05-0.19, I2 78%；阿斯利康OR 0.38, 95% CI 0.25-0.59, I2 63%)。以对照作为共同比较物的疫苗间接比较显示，阿斯利康的有效性低于Moderna （OR 2.84, 95% CI 1.32-6.12）和辉瑞（OR 3.94, 95% CI 1.80-8.60），而Moderna和辉瑞没有差异（OR 1.39, 95% CI 0.56-3.46）。辉瑞的疫苗SUCRA概率高于Moderna和阿斯利康（分别为92%、75%和33%）。InterpretationsPfizer排名最高，其次是Moderna（无统计学差异）和阿斯利康（AstraZeneca）预防症状性COVID-19疫苗。
{"title":"Comparative effectiveness of three common SARS-COV-2 vaccines: A network meta-analysis of randomized trials","authors":"A.A. Syed , F. Eqbal , H.R. Shamsi , A.R.S. Syed , S.J. Zakir , M. Fawzy , K.S. Khan","doi":"10.1016/j.semerg.2024.102343","DOIUrl":"10.1016/j.semerg.2024.102343","url":null,"abstract":"<div><h3>Background</h3><div>Moderna, Pfizer, and AstraZeneca SARS-CoV-2 vaccines for preventing COVID-19 have regulatory approval in most countries. We conducted a network meta-analysis to compare their effectiveness.</div></div><div><h3>Methods</h3><div>We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ICTRP, and Clinicaltrials.gov for the randomized controlled trials (RCTs) published between 1st January 2020 and 1st February 2024. Eligible RCTs evaluated the Moderna, Pfizer or AstraZeneca vaccines among healthy individuals and reported the effectiveness of vaccination <em>versus</em> control measured with the outcome occurrence of COVID-19. We performed study selection, data extraction, and quality (risk of bias) assessment in duplicate. Network meta-analysis with random effects models was used to generate odds ratios (OR) with 95% confidence intervals (CI), evaluating heterogeneity statistically using <em>I</em><sup>2</sup> for direct comparisons and ranking vaccines hierarchically using the surface under the cumulative ranking curve (SUCRA). This study was registered on PROSPERO, CRD42023457957.</div></div><div><h3>Findings</h3><div>Of the 1954 initial citation, 18 RCTs (272,724 participants; 151,034 received one of the vaccines and 121,690 controls) that reported the outcome occurrence of COVID-19 were selected. Of these, 2 (11%) were moderate and 5 (28%) were high in quality. In network meta-analysis, all three vaccines were effective compared directly with control (Moderna OR 0.13, 95% CI 0.07–0.26, <em>I</em><sup>2</sup> 97%; Pfizer OR 0.10, 95% CI 0.05–0.19, <em>I</em><sup>2</sup> 78%; AstraZeneca OR 0.38, 95% CI 0.25–0.59, <em>I</em><sup>2</sup> 63%). Indirect comparison of vaccines using control as the common comparator showed that AstraZeneca was less effective than Moderna (OR 2.84, 95% CI 1.32–6.12) and Pfizer (OR 3.94, 95% CI 1.80–8.60), while Moderna <em>versus</em> Pfizer showed no difference (OR 1.39, 95% CI 0.56–3.46). Vaccine SUCRA probabilities were higher for Pfizer than Moderna and AstraZeneca (92%, 75% and 33% respectively compared to control).</div></div><div><h3>Interpretations</h3><div>Pfizer ranks highest followed by Moderna (without a statistically significant difference) and AstraZeneca vaccines for preventing symptomatic COVID-19.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102343"},"PeriodicalIF":0.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.semerg.2024.102366
C. Montero Peña , M. Carmona González , G. Rodríguez Parejo , I. de Miguel Silvestre , M. Rivera Teijido
{"title":"Uso de la ecografía clínica en el ámbito extrahospitalario y la sospecha de fractura de cadera","authors":"C. Montero Peña , M. Carmona González , G. Rodríguez Parejo , I. de Miguel Silvestre , M. Rivera Teijido","doi":"10.1016/j.semerg.2024.102366","DOIUrl":"10.1016/j.semerg.2024.102366","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"50 9","pages":"Article 102366"},"PeriodicalIF":0.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.semerg.2024.102342
M.J. Pérez Taboada , A. Rodríguez Núñez , R. Bugarín González
Objective
Analyze the notifications made by Primary Care (PC) professionals of Galicia, in the Notification and Learning system for Patient Safety (SiNASP), of the Ministry of Health of Spain, its variables and the factors that contribute to its appearance for thus characterize security incidents in this healthcare field.
Materials and methods
This is a retrospective descriptive study of notifications made in PC, between October 2010 and December 2019, in the SiNASP, in the Autonomous Community of Galicia. The data are presented using absolute and relative frequencies. Incidents are determined on the total number of personnel of different professional categories. To contrast the relationship between different variables, the Chi-square test was used.
Results
1863 notifications corresponded to PC (10% of the total). There were no differences in terms of sex, but it was observed that the incidence increases with age.
The largest number of notifications was made by doctors, although, in percentage terms, pharmacists are the professionals who report the most incidents.
The largest number of safety events occurred in consultations, with the most frequent being those due to a problem related to medication. Approximately 1 in every 200 incidents that reached the patient were classified as catastrophic.
Conclusions
Even though there are fewer notifications and possibly having a lower incidence than in hospitals, security incidents in PC are frequent and, sometimes, serious. Therefore, measures that influence the promotion of safety culture and raise awareness, in this sense, among managers and professionals in this healthcare field are essential.
目的分析加利西亚初级保健（PC）专业人员在西班牙卫生部患者安全通知和学习系统（SiNASP）中发出的通知、其变量以及导致其出现的因素，从而确定该医疗保健领域安全事件的特征：这是一项回顾性描述性研究，研究对象是加利西亚自治区在 2010 年 10 月至 2019 年 12 月期间向 SiNASP 发送的 PC 通知。数据采用绝对频率和相对频率表示。事件是根据不同专业类别的人员总数确定的。为了对比不同变量之间的关系，采用了卡方检验法：有 1863 份通知与 PC 有关（占总数的 10%）。在性别方面没有差异，但随着年龄的增长，发病率也在增加。尽管从百分比来看，药剂师是报告事件最多的专业人员，但医生报告的事件数量最多。咨询中发生的安全事件最多，其中最常见的是与药物有关的问题。大约每 200 起发生在患者身上的事件中就有 1 起被归类为灾难性事件：尽管 PC 中的安全事件通知较少，发生率也可能比医院低，但 PC 中的安全事件频繁发生，有时甚至很严重。因此，必须采取措施促进安全文化的发展，并从这个意义上提高医疗保健领域管理人员和专业人员的安全意识。
{"title":"Análisis de las notificaciones realizadas en el Sistema de Notificación y Aprendizaje para la Seguridad del Paciente en una comunidad autónoma","authors":"M.J. Pérez Taboada , A. Rodríguez Núñez , R. Bugarín González","doi":"10.1016/j.semerg.2024.102342","DOIUrl":"10.1016/j.semerg.2024.102342","url":null,"abstract":"<div><h3>Objective</h3><div>Analyze the notifications made by Primary Care (PC) professionals of Galicia, in the Notification and Learning system for Patient Safety (SiNASP), of the Ministry of Health of Spain, its variables and the factors that contribute to its appearance for thus characterize security incidents in this healthcare field.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective descriptive study of notifications made in PC, between October 2010 and December 2019, in the SiNASP, in the Autonomous Community of Galicia. The data are presented using absolute and relative frequencies. Incidents are determined on the total number of personnel of different professional categories. To contrast the relationship between different variables, the Chi-square test was used.</div></div><div><h3>Results</h3><div>1863 notifications corresponded to PC (10% of the total). There were no differences in terms of sex, but it was observed that the incidence increases with age.</div><div>The largest number of notifications was made by doctors, although, in percentage terms, pharmacists are the professionals who report the most incidents.</div><div>The largest number of safety events occurred in consultations, with the most frequent being those due to a problem related to medication. Approximately 1 in every 200 incidents that reached the patient were classified as catastrophic.</div></div><div><h3>Conclusions</h3><div>Even though there are fewer notifications and possibly having a lower incidence than in hospitals, security incidents in PC are frequent and, sometimes, serious. Therefore, measures that influence the promotion of safety culture and raise awareness, in this sense, among managers and professionals in this healthcare field are essential.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102342"},"PeriodicalIF":0.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.semerg.2024.102349
N. Echepare Oraá , L. Gómez Bernardo , L. Gordo Murillo , E. Cobos López , A. Alonso Hernán
{"title":"¿Qué pasa cuando el paciente dice «no»? Traslado involuntario a un servicio de urgencias hospitalarias: a propósito de un caso","authors":"N. Echepare Oraá , L. Gómez Bernardo , L. Gordo Murillo , E. Cobos López , A. Alonso Hernán","doi":"10.1016/j.semerg.2024.102349","DOIUrl":"10.1016/j.semerg.2024.102349","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102349"},"PeriodicalIF":0.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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