Atencion Primaria最新文献

英文中文

Experiencia clínica con el uso de fórmulas para la alergia a proteínas de leche de vaca en consultas de Pediatría 儿科使用牛奶蛋白过敏配方的临床经验

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-21 DOI: 10.1016/j.aprim.2025.103348

Carolina Rubio-Jovani, en representación de los participantes del estudio NOVA-ALLERGY

Objective

To evaluate the use of extensively hydrolyzed formulas (eHF) and hydrolyzed rice formulas (HRF) for the management of cow's milk protein allergy (CMPA) in Pediatric consultations from Primary Care of Spain, paying special attention to their impact on digestive symptoms.

Design

NOVA-ALLERGY was an ecological, descriptive, and multicenter study of national scope.

Location

Pediatric consultations from Primary Care across 17 Autonomous Communities in Spain.

Participants

300 healthcare professionals (Pediatrics or Family Medicine).

Interventions

Specifically designed questionnaire.

Main measurements

The aggregated data derived from the experience of the healthcare professionals on their last 6 infants they attended in their consultations with suspicion or diagnosis of CMPA and received an eHF and/or HRF for its management.

Results

Infants prescribed an eHF or HRF as the first option were predominantly between 0 and 6 months of age and had mild-moderate symptom severity. Main symptoms of CMPA were digestive. At the follow-up visit, infants showed an improvement of the digestive symptoms, such as blood in stools, food refusal, dysphagia, diarrhea, vomiting, colic, abdominal distension, or frequent regurgitation.

Conclusions

In accordance with recommendations from clinical guidelines, eHFs are the first treatment option for mild and moderate cases of CMPA. Nevertheless, this present study also confirms the use of HRFs as first treatment option. Both eHFs and HRFs are associated with an improvement of the digestive symptoms in CMPA.

目的评价广泛水解配方（eHF）和水解大米配方（HRF）在西班牙初级保健儿科会诊中处理牛奶蛋白过敏（CMPA）的应用情况，特别关注其对消化症状的影响。DesignNOVA-ALLERGY是一项全国范围的生态学、描述性、多中心研究。西班牙17个自治区的初级保健儿科咨询。参与者：300名医疗保健专业人员（儿科或家庭医学）。干预措施：特别设计的问卷。主要测量方法：汇总数据来自医疗保健专业人员的经验，这些专业人员在就诊时因怀疑或诊断为CMPA并接受eHF和/或HRF治疗的最后6名婴儿。结果将eHF或HRF作为第一选择的婴儿主要在0 - 6个月大，症状严重程度为轻中度。CMPA的主要症状为消化。在随访中，婴儿的消化系统症状有所改善，如便血、拒食、吞咽困难、腹泻、呕吐、绞痛、腹胀或频繁反流。结论根据临床指南的推荐，体外循环治疗是轻中度CMPA患者的首选治疗方案。然而，目前的研究也证实了hrf作为第一治疗选择的使用。efs和HRFs都与CMPA患者消化症状的改善有关。

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引用次数: 0

Atención primaria ante la epidemia de obesidad y diabetes: un reto integral y preventivo [面对肥胖和糖尿病流行的初级保健：一个综合和预防性的挑战]。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-21 DOI: 10.1016/j.aprim.2025.103330

Teresa Lagrú Romero , Cinthya Lorena Machado Pérez

引用次数: 0

Trombosis venosa superficial, una imagen necesaria [浅静脉血栓形成，必要影像]。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-21 DOI: 10.1016/j.aprim.2025.103338

David Morena López , Laura Calvo Carrasco , María Morena López

引用次数: 0

Cómo hacer el seguimiento de la prediabetes y pacientes en riesgo de diabetes. A propósito de la validez de las pruebas diagnósticas 如何监测糖尿病前期和糖尿病高危患者。关于诊断测试的有效性]。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-21 DOI: 10.1016/j.aprim.2025.103346

Miguel Angel Maria Tablado

引用次数: 0

Mismo año, distinta fuente: variabilidad en las estimaciones de prevalencia de exposición al humo ambiental de tabaco en España [同一年，不同来源：西班牙二手烟暴露率估计的差异]。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-20 DOI: 10.1016/j.aprim.2025.103403

Julia Rey-Brandariz , Ana Blanco-Ferreiro , María Isolina Santiago-Pérez , Anna Schiaffino , Carla Guerra-Tort , Mónica Pérez-Ríos

Objective

The aim of this study was to assess the variability in the prevalence of secondhand smoke (SHS) exposure in Spain estimated from different sources.

Design

Study comparing the prevalence of exposure to SHS using survey data.

Location

Spain, with specific analysis in Galicia and Catalonia.

Participants

General population aged 16 and over included in the following surveys: National Health Survey (NHS), Galicia Risk Behavior Information System (SICRI), and Health Survey of Catalonia (ESCA), corresponding to six editions of each.

Interventions

Questions assessing exposure to SHS were selected from the NHS, SICRI and ESCA.

Main measures

Prevalence of SHS exposure as estimated after homogenizing the definition of exposure. To compare the prevalences estimated with two sources, the absolute differences between them were calculated together with their 95% confidence interval (95%CI).

Results

In Galicia, when comparing ENSE and SICRI, the absolute differences in SHS exposure prevalences exceeded 10 percentage points in five of six editions. In Catalonia, when comparing ENSE and ESCA, the differences ranged from 1.5 to 14.2 points. The 95%CI analysis of the absolute differences showed that for Galicia and Catalonia the differences were significant in four and five of the six years compared, respectively.

Conclusions

In Spain, large differences are observed in the estimation of SHS exposure prevalence depending on the data source. These differences are greater the less specific the area studied. The regional surveys reflect higher prevalences of exposure to SHS.

目的：本研究的目的是评估西班牙二手烟（SHS）暴露率的变异性，估计来自不同来源。设计：研究使用调查数据比较暴露于SHS的流行程度。地点：西班牙，具体分析在加利西亚和加泰罗尼亚。参与者：16岁及以上的一般人群，包括以下调查：国家健康调查（NHS）、加利西亚风险行为信息系统（SICRI）和加泰罗尼亚健康调查（ESCA），每个调查对应六个版本。干预措施：从NHS、SICRI和ESCA中选择评估SHS暴露的问题。主要测量指标：均质化暴露定义后估计的SHS暴露患病率。为了比较两种来源估计的患病率，计算它们之间的绝对差异及其95%置信区间（95% ci）。结果：在加利西亚，当比较ENSE和SICRI时，六个版本中有五个版本的SHS暴露患病率的绝对差异超过10个百分点。在加泰罗尼亚，当比较ENSE和ESCA时，差异在1.5到14.2分之间。绝对差异的95%可信区间分析显示，加利西亚和加泰罗尼亚在6年的比较中分别有4年和5年的差异是显著的。结论：在西班牙，根据数据来源的不同，在估计SHS暴露率方面存在很大差异。研究区域越不具体，这些差异就越大。区域调查反映出接触二手烟的流行率较高。

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引用次数: 0

Evolución del rendimiento académico universitario antes, durante y después de la pandemia de COVID-19: análisis comparativo por facultades y ciclos académicos [新冠肺炎对秘鲁一所大学学生的学术影响]。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-20 DOI: 10.1016/j.aprim.2025.103415

Alberto Valenzuela Muñoz , Maria Rosario Meza Aguirre , Marisel Roxana Valenzuela Ramos , Pedro Miguel Dias Monteiro

引用次数: 0

Seguimiento sintomatológico a largo plazo de pacientes con síndrome de COVID persistente 对持续性2019冠状病毒病患者的长期症状监测

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-16 DOI: 10.1016/j.aprim.2025.103425

Andrés Carrascosa Gil , Miriam Gabella Martín , María del Camino Salazar Lozano , Eduardo Tamayo Gómez , Jesús Rico Feijoo , César Aldecoa Álvarez de Santullano

Objective

The primary aim of the study was to investigate the long-term symptom progression of long COVID. The secondary objective was to assess whether any treatment had an impact on symptom evolution.

Design

Longitudinal, prospective, observational, uncontrolled study.

Setting

Internal Medicine Department, Río Hortega University Hospital (Valladolid).

Participants

40 patients with long COVID (cases) and 40 volunteers (controls) of the same age and sex as the cases, who had experienced acute COVID-19 without developing long COVID.

Main measurements

Scales, indices, and questionnaires were sent by post to evaluate the main symptoms of long COVID. The following were assessed: fatigue (MFIS), emotional disorders (HADS), sleep disturbances (PSQI), cognitive impairments (MFE-30), dyspnea (mMRC), physical exercise (GPAQ), quality of life (SF-36), and pain (CPGS). The cases were reassessed after three years.

Results

After three years, cases showed an improvement in dyspnea (mMRC), which decreased from 1.38 to 1.10 (p = 0.014). Ten cases reported having followed aerobic and/or anaerobic physical exercise as treatment, and it was observed that their pain severity (CPGS) improved from 2.7 to 1.3 (p = 0.039). In the remaining measurements, variations among cases did not reach statistical significance.

Conclusions

After three years of follow-up, patients with long COVID continued to have similar symptom scores to their initial assessments, and worse than those of the control group. Aerobic and/or anaerobic physical exercise may contribute to partially improving symptom evolution.

目的探讨长期COVID患者的长期症状进展情况。次要目的是评估任何治疗是否对症状演变有影响。设计：纵向、前瞻性、观察性、非对照研究。设置Río霍特加大学医院（巴利亚多利德）内科。参与者40例长冠状病毒感染者（病例）和40例与病例年龄和性别相同的志愿者（对照组），均经历过COVID-19急性期，未发生长冠状病毒感染。主要测量方法邮寄量表、指标和问卷，对长冠肺炎的主要症状进行评估。评估如下：疲劳（MFIS）、情绪障碍（HADS）、睡眠障碍（PSQI）、认知障碍（MFE-30）、呼吸困难（mMRC）、体育锻炼（GPAQ）、生活质量（SF-36）和疼痛（CPGS）。这些病例在三年后被重新评估。结果3年后患者呼吸困难（mMRC）由1.38降至1.10 （p = 0.014）。10例患者接受有氧和/或无氧体育锻炼治疗，疼痛严重程度（CPGS）从2.7改善到1.3 （p = 0.039）。在其余的测量中，病例之间的差异没有达到统计学意义。结论经过3年的随访，长冠患者的症状评分与初始评估相似，但低于对照组。有氧和/或无氧体育锻炼可能有助于部分改善症状的演变。

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引用次数: 0

La mirada del alumnado de medicina hacia la tutorización longitudinal en atención primaria 医学学生对初级保健纵向辅导的看法

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-16 DOI: 10.1016/j.aprim.2025.103394

Yoseba Cánovas Zaldúa , Francesc Alòs , Silvia Güell Parnau , Raquel Gayarre Aguado

引用次数: 0

Contraceptive methods: Knowledge and factors influencing their choice among women of reproductive age—A cross-sectional study in Portugal 避孕方法：育龄妇女的知识和影响其选择的因素：葡萄牙横断面研究

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-16 DOI: 10.1016/j.aprim.2025.103381

Séfora Rua , Carlos Cardoso , Inês Silva

Objective

To assess the knowledge women of reproductive age have about contraceptive methods and identify factors influencing both knowledge and method selection.

Design

Descriptive, analytical, cross-sectional, observational study, conducted between November 2024 and April 2025.

Setting

Community and primary healthcare level in Portugal, particularly in the central region.

Participants

490 women aged 15–49 living in Portugal. Inclusion: menstruated. Recruitment was via social media and health centers. No dropouts were recorded.

Main measures

Knowledge of contraceptive methods, method usage and influencing factors, assessed via a structured, validated questionnaire.

Results

The most known methods were the pill and male condom. Only 24.3% correctly identified the most effective methods. Regarding STI protection, 91.6% answered correctly. Most used methods were the pill and male condom. Safety and effectiveness were the most valued criteria. Medical advice was highly influential. Statistically significant associations were found between sociodemographic factors and knowledge/choice.

Conclusions

Despite high general knowledge, gaps remain regarding effectiveness. Educational strategies and counseling, especially during family planning consultations, are essential to improve contraceptive literacy and reduce unplanned pregnancies.

目的了解育龄妇女避孕知识的掌握情况，探讨影响避孕知识和避孕方法选择的因素。设计描述性、分析性、横断面性、观察性研究，于2024年11月至2025年4月进行。背景葡萄牙的社区和初级保健水平，特别是在中部地区。参与者为490名生活在葡萄牙的15-49岁女性。包含:每年。招募是通过社交媒体和健康中心进行的。无退学记录。主要措施避孕方法知识、方法使用情况及影响因素，通过结构化、有效的问卷进行评估。结果最常见的避孕方法是口服避孕药和男用避孕套。只有24.3%的人正确识别出最有效的方法。在性传播感染保护方面，91.6%的人回答正确。最常用的方法是避孕药和男用避孕套。安全性和有效性是最重要的标准。医疗建议的影响力很大。统计上发现社会人口因素与知识/选择之间存在显著关联。结论：尽管有很高的常识，但在有效性方面仍存在差距。教育战略和咨询，特别是在计划生育咨询期间，对于提高避孕知识和减少意外怀孕至关重要。

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引用次数: 0

Chemsex y riesgo sexual en hombres que tienen sexo con hombres: una revisión de alcance Chemsex和男男性行为者的性风险：全面审查

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2026-01-16 DOI: 10.1016/j.aprim.2025.103374

Miguel Ángel Ayuga-Luque , Dolores Torres-Enamorado , Rosa Casado-Mejía

Objective

To determine whether chemsex, by itself, constitutes a sexual risk factor among men who have sex with men (MSM), particularly concerning condomless sex and sexually transmitted infections (STIs).

Design

Scoping review conducted according to PRISMA-ScR guidelines.

Data sources

PubMed®, WOS®, Scopus®, CINAHL®, CUIDEN®, and BV-SSPA were searched between December 2023 and January 2024 using terms such as «Sexual and Gender Minorities», «Chemsex», «Sexual Behavior», and «Sexually Transmitted Diseases».

Study selection

A total of 1,168 records were identified. After removing duplicates and applying eligibility criteria, 19 studies were included. All required an explicit definition of chemsex and direct analysis of its association with condomless sex and/or STI acquisition.

Data extraction

Three reviewers independently extracted data. Variables included study type, chemsex as independent or dependent variable, condom use, HIV/STI screening, PrEP use, and STI prevalence.

Results

Chemsex was associated with increased condomless sex (up to 79%) and higher STI rates (e.g., gonorrhea: 57.4% in chemsexers vs. 39.1%). PrEP use was more common among chemsexers but not clearly linked to lower STI incidence. Confidence intervals and sensitivity analyses were inconsistently reported across studies.

Conclusions

Chemsex is a high-risk sexual practice among MSM, strongly associated with condomless sex and increased STI prevalence. Primary care should implement targeted strategies for prevention, early detection, and sexual health education in this population.

目的确定化学性行为本身是否构成男男性行为（MSM）的性危险因素，特别是涉及无安全套性行为和性传播感染（STIs）。根据PRISMA-ScR指南进行设计范围审查。数据来源pubmed®，WOS®，Scopus®，CINAHL®，CUIDEN®和BV-SSPA在2023年12月至2024年1月期间使用“性和性别少数群体”，“Chemsex”，“性行为”和“性传播疾病”等术语进行检索。研究选择共鉴定了1168份记录。在排除重复项并应用资格标准后，纳入了19项研究。所有这些都需要明确定义化学性，并直接分析其与无安全套性行为和/或性传播感染的关系。数据提取三名审稿人独立提取数据。变量包括研究类型、化学性作为自变量或因变量、避孕套使用、HIV/STI筛查、PrEP使用和STI患病率。结果图式性行为与无安全套性行为增加（高达79%）和性传播感染（例如淋病：化学性别者57.4%对39.1%）相关。PrEP的使用在化学工作者中更为普遍，但与较低的性传播感染发病率没有明确的联系。各研究报告的置信区间和敏感性分析不一致。结论性行为是MSM人群中的高危性行为，与无安全套性行为和性传播感染的增加密切相关。初级保健应在这一人群中实施有针对性的预防、早期发现和性健康教育战略。

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