Search

Objectives: To evaluate the effect of eliminating the traditional preparatory fasting policy before contrast-enhanced CT on acute adverse reactions and to identify potential risk factors in a Spanish population sample, since many European patients still experience this unnecessary measure in clinical practice., Methods: Outpatients who underwent non-emergency CT to either 6 h of solid food fasting (control group) or an unrestricted consumption of solids (intervention group). Adverse reactions during contrast media administration and up to 30 min afterward were recorded and their incidence was calculated. Using univariate and multivariate logistic regression analyses, various patient-related and technical factors were evaluated to identify risk factors for nausea and vomiting., Results: One thousand one hundred three patients were evaluated, 560 patients in the control group, and 543 patients in the intervention group. Moderate and severe acute adverse reactions were not identified in either group. No statistical difference was found in the overall acute adverse reactions (hypersensitivity and chemotoxicity) incidence between groups (3.21% vs 2.30% p = 0.36). The total incidence of emetic adverse reactions (nausea and vomiting) was significantly lower in the intervention group than in the control group (0.92% vs 2.86% p = 0.02). Multivariate logistic regression analysis revealed that fasting, age, allergies, neurological diseases, and contrast media concentration were independent risk factors for nausea and vomiting., Conclusion: Unrestricted food intake did not increase the overall incidence of acute adverse reactions and diminished the incidence of nausea and vomiting., Trial Registration: ANZCTR, ACTRN12623000071628. Registered 23 January 2023-retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384985&showOriginal=true&isReview=true ., Critical Relevance Statement: This randomized clinical trial carried out in adults undergoing a non-emergent CT scan demonstrates that fasting as a preparation before a contrast-enhanced CT scan should be discontinued and reserved only for certain specific imaging tests., Key Points: Despite low osmolar CT contrast media becoming ubiquitous, preparatory fasting is still widely practiced. The overall incidence of acute adverse reactions was unchanged after abolishing preparative fasting. Traditional preparatory fasting should be discontinued and reserved only for certain specific imaging tests., (© 2024. The Author(s).)

Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations. This study aimed to compare the short-term effects of UCS manipulation versus a combination of CCT spine manipulations on pain intensity, disability, and cervical range of motion (CROM) in CNNP patients. In a private physiotherapy clinic, 186 participants with CNNP were randomly assigned to either the UCS (n = 93) or CCT (n = 93) manipulation groups. Neck pain, disability, and CROM were measured before and one week after the intervention. No significant differences were found between the groups regarding pain intensity and CROM. However, there was a statistically significant difference in neck disability, with the CCT group showing a slightly greater decrease (CCT: 16.9 ± 3.8 vs. UCS: 19.5 ± 6.8; p = 0.01). The findings suggest that a combination of manipulations in the CCT spine results in a slightly more pronounced decrease in self-perceived disability compared to UCS manipulation in patients with CNNP after one week. However, no statistically significant differences were observed between the groups in terms of pain intensity or CROM.

Asphyxia during birth is one of the three leading causes of neonatal morbidity and mortality among newborns carried to term. The objective of this study was to evaluate the measurement of the foetal scalp blood pH as a measure of foetal status, evaluating: cord gases, meconium-stained fluid, APGAR score or the need for neonatal resuscitation in pregnant women undergoing caesarean sections. A cross-sectional study was carried out over a period of 5 years (2017-2021) at the Hospital de Poniente (southern Spain). A total of 127 pregnant women participated from whom a foetal scalp blood pH sample was taken and used to indicate the need for an urgent caesarean section. The results showed a correlation between the pH of the scalp blood and the pH of the umbilical cord artery, umbilical cord vein (Rho of Spearman arterial pH: 0.64, p < 0.001; Rho of Spearman venous pH: 0.58, p < 0.001) and the APGAR test one minute after delivery (Spearman's Rho coefficient of 0.33, p < 0.01). These results suggest that the foetal scalp pH should not be considered a foolproof method to indicate an urgent caesarean section. Foetal scalp pH sampling can be used as a complementary test, in conjunction with cardiotocography, to indicate whether an emergency caesarean section is necessary due to loss of foetal well-being.

Inadequate sleep has been linked to a variety of impairments in bodily functions, including endocrine, metabolic, higher cortical function, and neurological disorders. For this reason, the aim of this study was to analyze the link between occupational pesticide exposure and sleep health among farmers in Almeria. A cross-sectional study was conducted among a population living on the coast of Almeria (southeastern Spain), where about 33,321 hectares of land are used for intensive agriculture in plastic greenhouses. A total of 380 individuals participated in the study: 189 greenhouse workers and 191 control subjects. The participants were contacted during their annual scheduled occupational health survey. Data on sleep disturbances were collected using the Spanish version of the Oviedo Sleep Questionnaire. Agricultural workers were found to be at a significantly higher risk of insomnia, especially among those who did not wear protective gloves (OR = 3.12; 95% C.I. = 1.93-3.85; p = 0.04) or masks (OR = 2.43; 95% C.I. = 1.19-4.96; p = 0.01). The highest risk of insomnia related to pesticide applicators was observed in those who did not wear a mask (OR = 4.19; 95% C.I. = 1.30-13.50; p = 0.01) or goggles (OR = 4.61; 95% C.I. = 1.38-10.40; p = 0.01). This study supports previous findings indicating an increased risk of sleep disorder in agricultural workers exposed to pesticides at work.

Pregnancy monitoring is vital to guaranteeing that both the foetus and the mother are in optimal health conditions. WHO protocols recommend at least eight medical examinations during the pregnancy period. While the cancellation or reduction of appointments during pregnancy due to the pandemic may help reduce the risk of infection, it could also negatively influence perinatal outcomes and the birthing process. The aim of this research was to analyse the differences in perinatal outcomes and birth characteristics in two groups of pregnant women: women who gave birth before and during the pandemic, and whether these differences are due to changes in pregnancy monitoring because of the COVID-19 situation. A retrospective study was carried out from July 2018 to December 2021, at the Santo Domingo Hospital (Dominican Republic). A total of 1109 primiparous pregnant women were recruited for this study during the birthing process and perinatal visits. The results describe how women who gave birth before the pandemic had greater control and monitoring of their pregnancy, more doctor visits ( p = 0.001), fewer caesarean sections ( p = 0.006), and more skin-to-skin contact after birth ( p = 0.02). During the COVID-19 pandemic, pregnant women's attendance at routine pregnancy monitoring, both doctor visits and ultrasound scans, has decreased, leading to an increase in the number of caesarean and instrumental deliveries. At the perinatal level, processes such as skin-to-skin contact after birth between mother and newborn or the introduction of early breastfeeding in the delivery room have also been reduced.

Background: This research aimed to develop a questionnaire to analyze perceived aspects of using digital technology among nursing students as a collaborative tool. We further sought to evaluate the psychometric reliability of the instrument., Methods: A cross-sectional observational study was performed using a questionnaire developed from scratch. Psychometric studies and univariate and bivariate analyses were performed., Results: 132 nursing students participated. The exploratory and confirmatory analyses of the questionnaire excluded 4 of the initial 18 items and established four domains, and internal consistency was found. The mean global score of the answers to the questionnaire was 4.67 on a scale of 1-5 points, and all the domains obtained high scores. Men scored higher on the usefulness and the global score, while no differences were found regarding age., Conclusions: Nursing students positively assess the use of digital technology as a collaborative tool, regardless of age. Digital technology as a collaborative tool is perceived as beneficial, improves their involvement, and allows nursing students to obtain a better knowledge of their partners. These findings can help develop group projects and tools based on technology to train future nursing professionals. The questionnaire developed is a valid tool to assess this.

Background: For healthcare personnel, biohazard accidents pose a significant risk to their health. These exposures can enable the transmission of pathogens such as Hepatitis B, Hepatitis C, and human immunodeficiency virus (HIV)., Objective: To indicate and quantify the risk associated with higher threatening situations, such as biohazard accidents on repeated occasions or incorrect notifications to injured healthcare professionals., Methods: A cross-sectional study was conducted at the Poniente Hospital in Almeria (Spain). In total, 592 participants reported 1062 accidents and their characteristics and notifications were analyzed., Results: It was found that women (OR = 1.29) working in the surgical area (OR = 2.92), those on indefinite contracts (OR = 1.67), and those with high work experience (OR = 1.14) were the main risk factors for multiple biohazard accidents. Concerning the incorrect notification of these accidents, the main risk factors were work performance during the afternoon shift (OR = 1.72) and the fact that the accident was caused by the injured worker himself (OR = 1.53)., Conclusions: This study outlined the main factors that can contribute to healthcare professionals suffering these accidents. As a result, corrective measures must be taken against these risk factors to improve safety for healthcare workers in the future.

Those infected by COVID-19 develop various kinds of complications with varying degrees of severity. For this reason, it is necessary to evaluate its analytical values to predict and reduce the risks and complications derived from this pathology. A cross-sectional study was carried out a population in Almeria (south-eastern Spain) who had a positive Polymerase Chain Reaction test result from 1 March 2020 to 30 November 2020. The study involved 4575 patients, with 1346 who were asymptomatic, 1653 mildly symptomatic (no hospitalisation needed) and 1576 severely symptomatic (symptomatic patients hospitalised). Laboratory values for D-dimer, glucose, serum ferritin, and C-reactive protein were analysed. The mean age of the participants in the study was 53.60 (16.89) years old. A total of 70.6% of the patients were symptomatic, of which 36.1% had mild symptoms. For all of the laboratory predictors analysed (D-dimer, glucose, serum ferritin, and C-reactive protein), it was found that severe alterations in the parameters were more frequent in severely symptomatic patients with statistically significant differences (p < 0.001), although these alterations also occurred in asymptomatic patients. Age correlated with analytical values (D-dimer, glucose, serum ferritin, and C-reactive protein) with statistically significant differences. Patients with severe symptoms presented alterations in the analytical values of D-dimer, glucose, serum ferritin, and C-reactive protein. Asymptomatic patients presented alterations in the analysed parameters, though with less frequency and severity than patients with severe symptoms.

Background: Nursing research promotes quality care and is essential. Thus, it is important to acknowledge the main motivations and barriers that nursing professionals find in their work, the aim of this study was to establish the main aspects that motivate and make nursing research difficult, for nursing professionals; Methods: a descriptive cross-sectional study was carried out on 91 nursing professionals. A validated structured questionnaire composed of 42 items that defined five domains was used. Descriptive and bivariant analyses were performed; Results: the highest scores were obtained for the domain of Knowledge and Preparation (33.79 ± 3.38), while the domain of Available Resources and Support obtained lower mean values (22.60 ± 5.61). Significant differences were found in two domains: Knowledge and Preparation and Professional Development domains, when regarding the service in which the participants were working (p < 0.05); in the Available Resources and Support domain, when regarding sex (p < 0.05), in the Motivations domain, regarding the number of children (p < 0.05); Conclusions: nursing professionals show a positive attitude towards nursing research. The nurses find motivation in their work environment, in the economic incentives, or in the possibility to improve their curriculum vitae. The main barriers are the lack of time, the lack of institutional support, and the lack of training, especially in languages, such as English. These findings could be useful to design programs to overcome these barriers.

The coronavirus 2019 (COVID-19) pandemic has had a significant impact on the economy and health, especially for the most vulnerable social groups. The social determinants of health are one of the most relevant risks for becoming infected with COVID-19, due to the health consequences for those who are exposed to it. The objective of this study was to analyze the influence of social determinants in health on COVID-19 infection in vulnerable social groups. A transversal epidemiological study was carried out on 746 individuals in vulnerable situations living in conditions of extreme poverty in disadvantaged areas in the province of Almeria (southeast of Spain). Social determinants of health such access to drinking water ( p < 0.001) and economic income ( p = 0.04) influenced the infection of COVID-19. A binary logistic regression model showed that the significant predictors of COVID-19 infection were the lack of economic income and inaccessible drinking water. The government and social health services must be aware of this problem in order to play an active role in searching for solutions and implementing public health prevention measures to eliminate social inequalities in health.

The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal-familial relationships as a factor risk for alexithymia.

Objectives: To compare the possible benefits of the combination of dexamethasone-bupivacaine with articaine-epinephrine as an anaesthetic block after third molar surgery. Materials and Methods: Triple-blind, randomized, controlled, parallel, phase 3 clinical trial. Two groups: experimental (93 patients) with standard anaesthetic block: 40/0.005 mg/mL articaine-epinephrine and submucosal reinforcement with 0.8 mg dexamethasone-5% bupivacaine; and control group (91 patients) with standard block: 40/0.005 mg/mL articaine-epinephrine. The surgery consisted of the extraction of the impacted mandibular third molar by performing a procedure following the same repeatable scheme. The visual analogue scale (VAS) was used to analyse postoperative pain. Results: Groups were homogeneous, without significant differences related to epidemiological variables. Postoperative pain among the first, second, and seventh postoperative days was statistically significantly lower in the experimental group compared to the control group ( p < 0.001). Drug consumption was lower in the experimental group throughout the study period ( p < 0.04). Conclusion: Bupivacaine is an alternative to articaine in oral surgery, being more effective in reducing postoperative pain by reducing patients' scores on the VAS as well as their consumption of analgesic drugs after surgery.

Occupational exposure to respirable crystalline silica (SiO 2 ) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable crystalline silica dust. A cross-sectional epidemiological study was carried out to assess the occupational risk factors that may contribute to the onset of silicosis in workers carrying out work activities with the inhalation of silica compact dust. The study population consisted of 311 artificial stone workers from the province of Almeria (southeast of Spain). Among them, 64 were previously diagnosed with silicosis and the rest of the participants (n = 247 workers) were not diagnosed with such a disease. The workers showing a greater risk of developing silicosis were those who installed kitchen worktops at consumers' homes, as they did not use face-masks or were not provided with personal protective equipment (PPE) by their business. The results of this study provide support for the evidence indicating that silicosis is a major emerging health concern for workers in the artificial stone sector. Exposure to crystalline silica dust thus can influence the development of silicosis in those cases where individual and collective protection measures are not used or adequately applied.

Hepatitis B (HBV) is a pathogen virus with transmission mechanisms that include contact with the infected blood or bodily fluids of the infected organism. Nowadays, healthcare workers are one of the most exposed groups to HBV. Conventionally, completing a vaccine series dosage with Engerix B ® lowers this risk by providing workers with immunity to the virus. However, through the years, we have encountered nonresponsive health personnel to the Engerix B ® vaccine; hence, the Occupational Health Service of Poniente Hospital studied the Fendrix ® adjuvanted vaccine as an alternative vaccine to develop immunological responses in healthcare workers who do not respond to vaccination with Engerix B ® . In our study, we employed a vaccination schedule with the Fendrix ® vaccine, performing serology tests on the cases after the application of each dose. The results obtained showed humoral immunity in 92.3% of the cases, with a remarkable increase in antibody titer after the first doses. These encouraging results support the future inclusion of this vaccine as one possible alternative for the immunization to HBV for healthcare workers nonresponsive to Engerix B ® .

Training in basic life support (BLS) using clinical simulation improves compression rates and the development of cardiopulmonary resuscitation (CPR) skills. This study analyzed the learning outcomes of undergraduate nursing students taking a BLS clinical simulation course. A total of 479 nursing students participated. A pre-test and post-test were carried out to evaluate theoretical knowledge of BLS through questions about anatomical physiology, cardiac arrest, the chain of survival, and CPR. A checklist was used in the simulation to evaluate practical skills of basic CPR. The learning outcomes showed statistically significant differences in the total score of the pre-test and after completing the BLS clinical simulation course (pre-test: 12.61 (2.30), post-test: 15.60 (2.06), p < 0.001). A significant increase in the mean scores was observed after completing the course in each of the four parts of the assessment protocol ( p < 0.001). The increase in scores in the cardiac arrest and CPR sections were relevant (Rosenthal's r: -0.72). The students who had prior knowledge of BLS scored higher on both the pre-test and the post-test. The BLS simulation course was an effective method of teaching and learning BLS skills.

Introduction: Most pregnancies in adolescents and young adults are unwanted and many are the consequence of inconsistent contraception use., Objective: To analyze the risk factors that may influence on female adolescents with unwanted pregnancies., Method: Cross-sectional, descriptive study in Ecuadorian female medical students, where the 2013 National Sexual and Reproductive Health Survey, the family APGAR scale, and the Graffar-Méndez Castellanos socio-economic scale were used., Results: There was statistically significant difference in the age of active sexual life initiation between those who became pregnant (18.11 ± 1.45) and those who did not (19.22 ± 2.28). Average age at pregnancy was 20.41 ± 2.18; 59.3 % of those who had a pregnancy and 32% of those without pregnancy did not use protection in their first intercourse. Pregnancy was more common in city residents (100%), Catholic females (85.2%), who belonged to middle-high (55.6%) and middle-high socioeconomic strata (29.6%) and to families with moderate dysfunction (40.7%)., Conclusions: A significant percentage of adolescents in our study had an unwanted pregnancy at an early age despite being young undergraduate medical students, coming from moderately dysfunctional families and belonging to a middle-high socioeconomic status., (Copyright: © 2019 Permanyer.)

Background: Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy., Material and Methods: A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study., Results: There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series., Conclusions: Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique., (Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)

Objective: This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas., Material and Methods: Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2)., Results: From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery., Conclusion: This study demonstrates that there is a clear benefit to the use of Vivostat PRF® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.