Análisis de las desigualdades en salud de la población adulta española en 2011

Treballs Finals del Grau de Sociologia, Facultat d'Economia i Empresa, Universitat de Barcelona, Curs: 2016-2017 , Tutor: Sandra Fachelli Oliva(cast) En el presente estudio se realiza un análisis de los principales determinantes de la salud en la población española de quince o más años diferenciando por sexos, con el objetivo de descubrir si existen desigualdades en este ámbito. Se aborda la necesidad de descubrir qué perfiles presentan mayor vulnerabilidad a tener un peor estado de salud según varias características sociodemográficas, como la edad, la clase social, el nivel educativo logrado o la actividad económica. Para ello, se analizan tres grandes bloques que hacen referencia a las enfermedades y el estado de salud, los hábitos de vida y el uso de servicios sanitarios. Asimismo, se mostrarán qué factores incrementan y disminuyen la probabilidad de tener una autopercepción de la salud deficiente teniendo en cuenta todos los determinantes de la salud.(eng) In this study, I have carried out an analysis of the main determinants of the health of the Spanish population of fifteen years or more differentiated by gender. The main goal is to find out if there are any inequalities in this area. I have addressed the need to establish which profiles are more vulnerable to have a worse health state according to sociodemographic characteristics such as age, social class, the level of education accomplished or the economic activity. To do this, I have analyzed three main combinations which make reference to the diseases and the health state, the lifestyle habits and the use of healthcare services. Additionally, I have shown which factors increase and which ones reduce the possibility of having a self-perception of poor health, taking into account the health determinants

Acetaminophen, a therapeutic or an extremely toxic remedy – a review

When a new coronavirus appeared in the late 2019, identified as the cause of several cases of pneumonia in Wuhan, Paracetamol was initially reported to be the preferable antipyretic medication, choice which was detrimental to the use of other drugs. People have resorted to buying large stocks of Paracetamol and some have used it in large doses, regardless of the consequences. However, the Paracetamol (Acetaminophen) overdose remains the leading cause of death or transplantation due to acute liver failure in many parts of the world. This review aims at presenting the pharmacokinetics, the clinical signs, and the risk factors for systemic toxicity associated with Paracetamol overdose, as well as the current therapeutic approach. Paracetamol is primarily metabolized in the liver, by glucuronidation and sulfation. In case of a Paracetamol overdose, a large amount of NAPQI is conjugated with glutathione, and this process is due to a major depletion of glutathione, thus leading to hepatic necrosis, renal failure, and encephalopathy. The evaluation of serum acetaminophen levels by analytical methods is extremely useful both for the diagnosis and the therapy monitoring

Esophageal atresia associating gastrointestinal malformations: a study of clinical approach

Digestive tract malformations requiring surgical repair in association with esophageal atresia are rare occurrences. Because of this uncommon presentation of esophageal atresia, its evaluation and management are often difficult, requiring extensive workup and multiple surgical procedures. We present our experience with esophageal atresia associating gastrointestinal congenital anomalies in the last 10 years. Clinical and surgical perspectives were pointed willing to make relevant observations in matters of diagnosis and treatment strategy in these patients. Therefore, 7 cases resembling this pattern were identified – duodenal atresia and anorectal malformation being the most common coexistent malformations. All the cases exhibited technical and procedural staging difficulties that we shaped according to the patient’s general picture in the absence of a standardized approach. Careful preoperative follow-up, multidisciplinary communication, watchful waiting and an individually patient-shaped approach are elementary requirements for good outcomes in complex cases of EA

Pain management in the right iliac fossa during the Covid-19 pandemic

Abdominal pain in the right iliac fossa in women may be caused by a complicated ovarian cyst, adnexitis, and appendicitis. The paper analyses the characteristics of patients with right iliac fossa pain admitted during the Covid-19 pandemic. A retrospective analysis on 25 cases with abdominal pain in the right iliac fossa admitted to “St. Apostol Andrei” Emergency County Clinical Hospital Constanta, Romania between March 2020 and March 2021 was performed. In 52% of the cases, the symptomatology remitted with antispasmodics, 4 (16%) patients had cystic torsion and right adnexectomy (group A, without adnexa), 6 (24%) patients had ruptured cysts and right cystectomy, and 2 (8%) had immediate cystectomy together with appendectomy due to signs of peritoneal irritation (group B, adnexa retained). The age, the signs and the symptoms, as well as the inpatient diagnosis in group A were lower compared to patients in group B. The ovarian cyst can become a major surgical emergency if twisted or ruptured and it reaches an important vascular source, especially if it is associated with acute appendicitis, which often poses problems of differential diagnosis. The collaboration between gynecologists and surgeons is essential in the optimal therapeutic solution of these cases

The management of tubo-ovarian abscesses associated with appendicitis

A relatively uncommon medical complication, the tubo-ovarian abscess (TOA) can result from ascending pelvic infection in the female genital tract. The paper aims at exploring the characteristics of patients with TOA and at comparing the outcomes of the surgical management with postoperative recovery. A retrospective analysis of 25 cases diagnosed with bilateral, right or left TOA at “St. Apostol Andrei” Emergency Clinical County Hospital Constanta, Romania between January 2019 and December 2020 was performed. The patients’ clinical characteristics, age, environment of origin, socio-economic background, educational level, the means of contraception used, surgical procedures, and postoperative recovery were analyzed. Out of the 25 cases, 40% presented bilateral TOA, 32% right TOA and 28% left TOA and left adnexectomy. In 3 patients (37.5%) with right TOA, appendicectomy was also performed. In 72% of the cases, a median pubic-umbilical incision was performed. The remaining 7 patients (28%) with left TOA underwent Pfannenstiel incision. All cases had a favorable postoperative evolution, the patients being discharged 5-9 days after surgery, benefiting from antibiotic therapy 10 days after their discharge. The co-existence of appendicitis and adnexal pathology should raise awareness for adopting a surgical strategy in order to prevent postoperative complications

LANDSCAPE DYNAMICS IN THE SOMEȘ CORRIDOR. CASE STUDY: GURUSLĂU DEPRESSION (ROMANIA)

Changes in land use patterns induced by different agricultural practices are reflected territorially through transformations at the level of elementary landscape units, with an impact on territorial identity and cohesion. The aim of this study is to highlight the dynamics of the territorial structures in the post-communist period (1990-2018), diachronically reflected in the transformations of the landscape of the Guruslău Depression, using the landscape metrics. The main direction of the scientific research was based on the analysis of land use changes and the identification of the spatial elements of structural-landscape distinction with impact on land degradation process. The evaluation of the landscape dynamics in the current context uses several effective metrics and tools, which increasingly require the identification of interdisciplinary methods of analysis, with a decisive impact on territorial development. Besides, the present approach is also motivated by the increasing environmental impact of climate change. The methodology used in the present paper is based both on the geoprocessing of vector data using GIS tools and correlated spatial analysis, and on the identification of landscape types using a new process of reclassifying land use categories, according to a set of landscape definition variables. The results of the research highlighted both the particularities of landscape transformations that occurred in the reference interval, as well as the favourable conditions for addressing biocultural diversity, by identifying traditional agricultural practices and the resilience of geographical landscapes given the adaptation to changing development strategies. Meanwhile, by detecting the landscape structures affected by change, in correlation with the impact induced on the biodiversity of the territory, the present study has a wide applicability in the most appropriate implementation of local development policies, as well as in identifying the forms of sustainable valorisation of the landscape in the study area

Klebsiella pneumoniae cryptogenic liver abscess and endophthalmitis – a case report and review of literature

Klebsiella pneumoniae has emerged as the predominant pathogenic agent of liver abscess in Asia, and the incidence is increasing worldwide. Hypervirulent strains are associated with septic metastatic dissemination in the eyes, lungs, and central nervous system, causing severe morbidity. We present the case of a 54year old man, with no previous comorbidities, admitted in emergency for the blind red painful eye. Further investigation documented septic endophthalmitis with transscleral extension and orbital cellulitis. Thoraco-abdominal computed tomography evidenced a hepatic abscess as the locus of the primary infection. Intravenous antibiotherapy with cefuroxime, followed by meropenem and vancomycin were efficient for managing the hepatic abscess. However, as the eyeball was perforated at the admission, evisceration was performed. The vitreous sample revealed Klebsiella pneumoniae, with a positive string test as the etiologic agent. The diagnostic and therapeutic management required a permanent collaboration between an ophthalmologist, infectious diseases specialist, surgeon, and radiologist

CONSERVATING THE TRADITIONAL CELLARS OF SALACEA, BIHOR COUNTY, ROMANIA

This paper argues for the enhanced utilization of the built heritage in the case of the unique cellars of Salacea, Bihor Country which is called „the village of 1000 cellars„. The research analysis of the cellars includes field investigations, study of existing bibliography, air-photo interpretation. For examining the architectureal plans, facades and volumes use was made of software such as: Archicad 22 R1 INT version 22.0.0.3006, Artlantis (2017) 6.5 version 6.5.2.14, Adobe Illustrator CC (2017) version 21.1.0 and Adobe Photoshop CC (2015) version 16.1, and for processing the photos Adobe Lightroom version 6.12. Cartographic materials have been processed in 3D Studio Max, Corel Draw and Corel Photopaint. The use of spatial data allowed identification and analysis of important aspect for understanding the territorial reality. The study identifies two authentic models of cellars that could be exploited for their heritage potential for tourism development and a source of income for the local area

Prostate Imaging Reporting and Data System score (PI-RADS) and Glutathione S-transferase P1 methylation status (GST-P1) in the diagnosis of prostate cancer patients with borderline PSA values

Objectives. The objective of this study was to evaluate the potential use of Prostate Imaging – Reporting and Data System version 2 (PI-RADS) in combination with Glutathione S-transferase P1 (GST-P1) expression for an improved diagnosis of prostate cancer, in patients with inconclusive values of prostate-specific antigen (PSA). Materials and Methods. The study was conducted on 80 patients for whom PSA values were evaluated and were found to be inconclusive (4-10 ng/ml). These patients underwent imagistic evaluation (PI-RADS), followed by transurethral prostate biopsy, with the evaluation of GST-P1 expression and histopathological examination (for diagnosis confirmation). Results. By combining the results of PI-RADS and GST-P1 the capacity of the tests to correctly identify healthy subjects, with an area under curve of 0,832 (95% CI 0.732–0.907), with a sensitivity of 73,25% and a specificity of 77,78%. Conclusions. PI-RADS lesions and GST-P1 methylation testing when PSA levels are in a “grey zone”, provide a better specificity and sensitivity by comparison through single testing. Testing patients with inconclusive PSA levels allows for a more accurate diagnosis and less over-diagnosis by non-invasive procedures, such as repeated biopsies