136 research outputs found
Follow-up of health-related quality of life and pain in a cohort of patients with rheumatoid arthritis before and after COVID-19
Background
The foot is one of the anatomical structures of the body most affected in rheumatoid arthritis (RA), associated with the disability of patients, even more during COVID-19. The aim of this study was to analyse whether the period of physical inactivity during COVID-19 is an influential factor on health-related quality of life and foot pain in patients with RA.
Methods
162 patients with foot pain and RA, recruited from the Hospital Virgen de las Nieves, Granada (Spain) were included. Data was collected during two different periods: January - December 2018 in person and June - September 2021 by phone. Patients were asked to complete the Spanish adapted version of the 12-Item Short Form Survey (SF-12) and the Visual Analogue Scale (VAS).
Results
The results from the SF-12 questionnaires were divided between its two subscales (i.e., mental, and physical component). The physical component shows an improvement between 2018 and 2021, from 32.05 in 2018–35.18 in 2021 (p < 0.05). The opposite happened with the mental component, showing a deterioration, from 39.69 in 2018–34.48 in 2021 (p < 0.05). Regarding pain, VAS shows higher levels of pain with statistically significant differences, both in general pain (from 6 in 2018–7 in 2012) and in foot pain (from 5 to 7), (p < 0.05).
Conclusion
Mental quality of life and pain, both general and foot pain, are influenced by the period of physical inactivity during COVID-19
Insomnia Symptoms, Sleep Hygiene, Mental Health, and Academic Performance in Spanish University Students: A Cross-Sectional Study
Background: Insomnia has been associated with decreased academic performance and
unhealthy behaviors in university students. Although many studies have analyzed sleep phenomenology
among this population, only few have focused on insomnia and its related variables. In addition,
such studies do not always include a clinical interview or a specific and validated instrument for
measuring insomnia. This study aimed to explore the prevalence of insomnia symptoms and the
relationship between insomnia and health habits, mental health, and academic performance in a large
university student sample. Methods: Five hundred and eighty-two students were recruited from
the University of Granada, Spain. Data were collected through an online survey with questions on
sociodemographic and academic data and health habits as well as the Pittsburgh Sleep Quality Index,
Insomnia Severity Index, Sleep Hygiene Index, and Sleepiness, Depression, Anxiety, and Stress Scales.
A multiple regression analysis explored the relationship between academic performance, health
habits, mood state, and insomnia symptoms. Results: The prevalence of students with symptoms of
insomnia was high (39.7%). A multiple logistic regression analysis revealed that depression, sleep
hygiene, stress and anxiety were significant predictors of insomnia symptoms. Multivariate analyses
revealed that subjective insomnia symptoms, sleep efficiency, and depression were significantly
correlated with academic performance in a dependent way. Conclusions: In university students,
anxiety, stress, and poor sleep hygiene are risk factors for insomnia, which plays an important role in
academic performance. Promoting sleep and mental health could be a potentially effective way to
improve their academic performance
Antibiotic Resistance Changes in Gram-Positive Bacteria from Urine Cultures: Development Analysis in a Health Area of South-East Spain
This study analyzed the epidemiology and antibiotic susceptibility profile of significant
bacteriuria and assessed the impact of adopting EUCAST criteria on antibiotic resistances. A systematic
review was performed on publications in English or Spanish between 1 January 2010 and
30 June 2021 on the susceptibility of Gram-positive bacteria isolated in urinary samples in Europe.
A retrospective descriptive study was also conducted on the results of 21,838 urine cultures with
presumptive urinary tract infection (UTI) obtained during the past five years by the Department
of Microbiology of the Virgen de las Nieves University Hospital (Granada, Spain). The activity
of various antibiotics was determined, differentiated among various populations, and interpretations
compared according to the application of EUCAST or CLSI criteria. Among 21,838 cases
of significant bacteriuria, 27.69% were by Gram-positive bacteria, which were Enterococcus faecalis
in 19.04% and Enterococcus faecium in 3.92%. The susceptibility profile remained stable for most
antibiotics except for levofloxacin for E. faecalis and Staphylococcus aureus and nitrofurantoin for
E. faecium. The resistance of Enterococcus spp. and Staphylococcus spp. to glycopeptides was exceptionally
low in our setting. No significant difference in the prevalence ofmethicillin-resistant Staphylococcus
aureus was observed between hospital (26.67%) and community (28.85%) samples. Resistances in our
local setting remain stable and appear to be lower than reported in other studies. The adoption of
EUCAST vs. CLSI criteria did not produce a general change in resistance rates. Findings suggest
the need to revise certain empirical criteria, such as aminoglycoside synergy for Enterococcus and for
community-origin S. aureus
Emerging Presence of Culturable Microorganisms in Clinical Samples of the Genitourinary System: Systematic Review and Experience in Specialized Care of a Regional Hospital
The detection of emerging pathogens responsible for genitourinary infections has increased
with technological advances. We conducted a systematic review of publications on the involvement of
these microorganisms in genitourinary samples, and we also investigated their presence and antibiotic
susceptibility in samples from patients at our regional hospital (Granada, Spain). The MEDLINE
database was searched up to 31 December 2020, and a cross-sectional descriptive study was performed
of results obtained in urine samples and genital exudates from January 2016 through December
2019. The review highlighted the frequent involvement of Neisseria meningitidis in genital infections,
while the data on other microorganisms were consistent with findings in our patient series. The
emerging microorganisms most often responsible for urinary tract infections were Streptococcus bovis
(58.5%) and Gardnerella vaginalis (23.6%) in females, and S. bovis (32.3%), Aerococcus urinae (18.6%),
and Corynebacterium spp. (16.9%) in males; those most frequently reported in genital infections were
S. viridans (36.4%) in females and C. glucuronolyticum (32.2%) and G. vaginalis (35.6%) in males. In
general, emerging pathogens are resistant to conventional antibiotics such as penicillin. However,
there has also been an increase in beta-lactam resistance by the S. bovis group and Corynebacterium
spp. The systematic review showed that emerging microorganisms are responsible for only a small
percentage of genitourinary infections but are of major clinical interest, with a predominance of
the S. bovis group, G. vaginalis, Lactobacillus spp., Aerococcus spp., and Corynebacterium spp. in urine
samples and of G. vaginalis and C. glucuronolyticum in genital samples. Given the increasing resistance
to antibiotics empirically prescribed in patients with genitourinary infections, it is recommended to
create an antibiogram in all cases
Antibiotic Resistances of Enterobacteriaceae with Chromosomal Ampc in Urine Cultures: Review and Experience of a Spanish Hospital
The Enterobacteriaceae Citrobacter freundii, Enterobacter cloacae, Klebsiella aerogenes, Morganella
morganii, Providencia stuartii, and Serratia marcescens (CESPM group) produce numerous
urinary tract infections (UTIs) which are difficult to treat due to their high multiresistance rate. The
objectives of this study were to carry out a systematic review of antibiotic resistances by UTIs and
to determine changes over time in urine cultures from a reference hospital in southern Spain. The
literature was searched for European data on the resistance rates of each microorganism, and a
retrospective cross-sectional descriptive study was performed in samples with suspicion of UTI
from patients in Virgen de las Nieves University Hospital (Granada, Spain) between 2016 and the
first half of 2021. Among 21,838 positive urine cultures, 1.85% were caused by E. cloacae, 0.77%
by M. Morganii, 0.65% by K. aerogenes, 0.46% by C. freundii, 0.29% by P stuartii, and 0.25% by
S. marcescens. The lowest resistance rates by microorganism were: E. cloacae to amikacin (3.47%) and
imipenem (5.28%); M. morganii to piperacillin–tazobactam (1.79%), cefepime (4.76%), and tobramycin
(7.74%); K. aerogenes to tobramycin (3.55%), gentamicin (4.25%), trimethoprim–sulfamethoxazole
(4.96%), imipenem (5.75%), and cefepime (6.43%); C. freundii to imipenem (no resistance), nitrofurantoin
(1.96%), fosfomycin (2.80%), and ertapenem (6.12%); P. stuartii to cefepime (3.28%) and
ceftazidime (3.28%); and S. marcescens to gentamicin (1.8%), ciprofloxacin (3.64%), cefepime (3.70%),
piperacillin–tazobactam (3.70%), and trimethoprim–sulfamethoxazole (5.45%). In our setting, CESMP
Enterobacteriaceae showed the lowest resistance to piperacillin–tazobactam, cefepime, imipenem,
gentamicin, and colistin, which can therefore be recommended for the empirical treatment of UTIs.
The COVID-19 pandemic may have had a clinical impact in relation to the increased resistance of E.
cloacae and M. morgani to some antibiotics
Antibiotic resistances of Pseudomonas aeruginosa and Acinetobacter baumannii in urine cultures: experience in a hospital of Southeast Spain
The objectives of this study were to perform a systematic review of publications between 2010 and 2021 on the antibiotic resistance of Pseudomonas aeruginosa and Acinetobacter baumannii from urinary tract infections and to analyze changes over time in hospital urine cultures from 2016 through 2021. The literature was searched, and a retrospective cross-sectional descriptive study was performed in the hospital. Out of 21 838 positive urine cultures, 3.86% were due to P. aeruginosa and 0.44% were due to A. baumannii. For P. aeruginosa, lower resistance rates were observed to virtually all tested antibiotics than were obtained in the systematic review, and the present series of hospital samples showed an in vitro resistance rate <10% to ceftazidime, cefepime, meropenem, piperacillin-tazobactam, amikacin, tobramycin, and colistin. For A. baumannii, the resistance rates to almost all antibiotics were higher in the present series than in the systematic review, being lowest to colistin (10%). Both microorganisms show reduced in vitro susceptibility to some antibiotics during the years of the COVID-19 pandemic in comparison to previous years. In our setting, both piperacillin-tazobactam and meropenem can be recommended for the empirical treatment of UTIs by P. aeruginosa, whereas only colistin can be recommended for UTIs by A. baumannii.Universidad de Granada/CBU
Presence and Relevance of Emerging Microorganisms in Clinical Genitourinary Samples
The following supporting information can be downloaded at:
https://www.mdpi.com/article/10.3390/microorganisms11040915/s1Abstract: Microorganisms responsible for genitourinary infections increasingly include species other
than conventional etiological agents that are of clinical and pathogenic relevance and therapeutic
interest. This cross-sectional descriptive study selected samples from clinical genitourinary episodes
between January 2016 and December 2019 in which emerging microbiological agents were detected.
The patients’ epidemiological characteristics, clinical presentation, antibiotic treatment, and outcome
were studied to identify their pathogenic role. The emerging microorganisms most frequently
detected in urinary tract infections were Streptococcus bovis (58.5%) and Gardnerella spp. (23.6%) in
females and S. bovis (32.3%), Aerococcus urinae (18.6%), and Corynebacterium spp. (16.9%) in males,
while the most frequently detected in genital infections were S. viridans (36.4%) in females and
C. glucuronolyticum (32.2%) and Gardnerella spp. (35.6%) in males. All cases in female children were
produced by S. bovis. Symptomatic episodes were more frequent with Aerococcus spp. and S. bovis and
the presence of leukocytosis more frequent with Aerococcus spp. Quinolones and doxycycline were
most often prescribed antibiotics for genital infections and quinolones and amoxicillin-clavulanic
acid for urinary infections. Urinary infection by Aerococcus spp. was more frequent in males of
advanced age, Corynebacterium spp. was more frequent in permanent vesical catheter carriers, and
episodes of asymptomatic bacteriuria by Gardnerella spp. were more frequent in patients with kidney
transplant and chronic consumers of corticosteroid therapy. Lactobacillus spp. should be considered in
urinary infections of patients of advanced age and with a previous antibiotic load. Genital infection
by Gardnerella spp. was significantly associated with a history of risky sexual relations
Differences in Dietary Habits, Physical Exercise, and Quality of Life between Patients with Obesity and Overweight
Background: Overweight and obesity differ in their repercussions on the health and health-related quality of life (HRQoL) of patients. The objective of this study was to compare physical activity levels and dietary habits before admission and HRQoL at discharge between patients with obesity and overweight. Methods: A cross-sectional study was undertaken among participants in a clinical trial on education for healthy eating and physical activity, enrolling non-diabetic patients admitted to Internal Medicine Departments. These were classified by body mass index (BMI) as having overweight (25-29.9 Kg/m2) or obesity (≥30 kg/m2). Data were gathered on sociodemographic characteristics, clinical variables (medication for anxiety/depression, Charlson Comorbidity Index, length of hospital stay), physical exercise and diet (International Physical Activity and Pardo Questionnaires), and HRQoL (EQ-5D-5L). The study included 98 patients with overweight (58.2% males) and 177 with obesity (52% males). Results: In comparison to patients with obesity, those with overweight obtained better results for regular physical exercise (p = 0.007), healthy diet (p = 0.004), and "emotional eating" (p = 0.017). No between-group difference was found in HqoL scores. Conclusion: Patients with overweight and obesity differ in healthy dietary and physical exercise behaviors. Greater efforts are warranted to prevent an increase in the BMI of patients, paying special attention to their state of mind.This research was funded by Carlos III Health Institute and The European Regional Development Fund (ERDF), grant nº PI17/00419.S
Hospital Intervention to Reduce Overweight with Educational Reinforcement after Discharge: A Multicenter Randomized Clinical Trial
Introduction: Obesity and overweight affect more than one-third of the world’s population
and pose a major public health problem. Objective: To evaluate the impact of an educational
intervention on dietary habits and physical exercise in patients with overweight admitted to departments
of internal medicine, comprising a pre-discharge educational session with follow-up and
reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight,
systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital
readmissions, emergency department visits, and death. Method: A randomized experimental study
with a control group was performed in hospitalized non-diabetic adults aged 18 years with body
mass index (BMI) 25 kg/m2. Results and conclusions: The final sample included 273 patients. At
three months post-discharge, the intervention group had lower SBP and DPB and improved dietary
habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the
control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences
in hospital readmissions, emergency department visits, or mortality at any time point. Both groups
evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary
habits but a worsening of EQ-5D-5L-value-assessed HRQOL. Discussion: The intervention group
showed greater improvements over the short term, but between-group differences disappeared at
6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over
the follow-up period. Further research is warranted to determine whether a minimum intervention
with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy
habits, as in the present control group, may be an equally effective strategy without specific individual
educational input.Instituto de Salud Carlos IIIEuropean Commission PI17/0041
Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors
Background: Integrative oncology has proven to be a useful approach to control cancer symptoms and improve the
quality of life (QoL) and overall health of patients, delivering integrated patient care at both physical and emotional levels.
The objective of this randomized trial was to evaluate the effects of a triple intervention program on the QoL and lifestyle
of women with breast cancer. Methods: Seventy-five survivors of stage IIA-IIB breast cancer were randomized into 2
groups. The intervention group (IG) received a 6-month dietary, exercise, and mindfulness program that was not offered
to the control group (CG). Data were gathered at baseline and at 6 months postintervention on QoL and adherence
to Mediterranean diet using clinical markers and validated questionnaires. Between-group differences at baseline and 3
months postintervention were analyzed using Student’s t test for related samples and the Wilcoxon and Mann-Whitney U
tests. Results: At 6 months postintervention, the IG showed significant improvements versus CG in physical functioning
(p = .027), role functioning (p = .028), and Mediterranean diet adherence (p = .02) and a significant reduction in body
mass index (p = .04) and weight (p = .05), with a mean weight loss of 0.7 kg versus a gain of 0.55 kg by the CG (p = .05).
Dyspnea symptoms were also increased in the CG versus IG (p = .066). Conclusions: These results demonstrate that an
integrative dietary, physical activity, and mindfulness program enhances the QoL and healthy lifestyle of stage IIA-IIB breast
cancer survivors. Cancer symptoms may be better managed by the implementation of multimodal rather than isolated
interventions.Background: Integrative oncology has proven to be a useful approach to control cancer symptoms and improve the
quality of life (QoL) and overall health of patients, delivering integrated patient care at both physical and emotional levels.
The objective of this randomized trial was to evaluate the effects of a triple intervention program on the QoL and lifestyle
of women with breast cancer. Methods: Seventy-five survivors of stage IIA-IIB breast cancer were randomized into 2
groups. The intervention group (IG) received a 6-month dietary, exercise, and mindfulness program that was not offered
to the control group (CG). Data were gathered at baseline and at 6 months postintervention on QoL and adherence
to Mediterranean diet using clinical markers and validated questionnaires. Between-group differences at baseline and 3
months postintervention were analyzed using Student’s t test for related samples and the Wilcoxon and Mann-Whitney U
tests. Results: At 6 months postintervention, the IG showed significant improvements versus CG in physical functioning
(p = .027), role functioning (p = .028), and Mediterranean diet adherence (p = .02) and a significant reduction in body
mass index (p = .04) and weight (p = .05), with a mean weight loss of 0.7 kg versus a gain of 0.55 kg by the CG (p = .05).
Dyspnea symptoms were also increased in the CG versus IG (p = .066). Conclusions: These results demonstrate that an
integrative dietary, physical activity, and mindfulness program enhances the QoL and healthy lifestyle of stage IIA-IIB breast
cancer survivors. Cancer symptoms may be better managed by the implementation of multimodal rather than isolated
interventions
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