Efectos adversos de la vacunación contra el virus del papiloma humano

ResumenObjetivoDescribir las reacciones adversas más frecuentes producidas por la vacunación contra el virus del papiloma humano (VPH).DiseñoEstudio descriptivo transversal mediante encuesta telefónica.EmplazamientoSistema Sanitario Público de Andalucía.ParticipantesMujeres vacunadas frente al VPH en Andalucía, seleccionadas por muestreo aleatorio simple con representatividad provincial.MedicionesSe realizaron 3.135 llamadas telefónicas por el servicio público “Salud Responde” dependiente de teleoperadores con supervisión de personal sanitario.Resultados principalesDe las 2.880 llamadas que cumplían criterio de inclusión, se consiguió encuestar a 1.207 personas (41,9% de respuesta). De las 2.124 encuestas realizadas tuvieron algún tipo de reacción adversa (fiebre, inflamación, dolor o enrojecimiento) en 467 dosis (22%): el 6,6% fue fiebre, el 49,5% inflamación, el 72,4% dolor, y el 6% enrojecimiento.ConclusionesSe puede decir que es una vacuna segura, lo que concuerda con lo recogido en su ficha técnica y en la literatura.AbstractObjectiveTo describe the most frequent adverse reactions produced by the human papillomavirus (HPV) vaccine.DesignCross-sectional descriptive study using a telephone survey.SettingA province in the Andalusian Public Health System.ParticipantsFemales vaccinated against HPV in Andalusia, selected by simple random sampling representative of the province.Main measurementsA total of 3,135 telephone calls were made by the public service “Health Answers” using telephone operators supervised by health personnel.ResultsOf the 2,880 calls that fulfilled the inclusion criteria, 1,207 people (41.9% response) took part in the survey. Of the 2,124 surveys made there was some type of adverse reaction (fever, inflammation, pain or rash) in 467 doses (22%): 6.6% was fever, 49.5% inflammation, 72.4% pain, and 6% a rash.ConclusionsIt can be said that HPV vaccine is safe, which is in agreement with that published in the summary of the product characteristics and in the literature

Relationship between Diet, Menstrual Pain and other Menstrual Characteristics among Spanish Students.

This study sought to describe and compare adherence to the Mediterranean diet and consumption of local foods from the Huelva region among Spanish university women in relation to menstrual pain and other menstrual characteristics. This cross-sectional study included 311 health science students. The study variables were sociodemographic and gynecologic characteristics, adherence to the Mediterranean diet using the KIDMED questionnaire, alcohol consumption (SDU) and consumption of local food. A descriptive bivariate analysis and multiple binary regression were performed for menstrual pain. Up to 55.3% of participants had moderate adherence to the Mediterranean diet and only 29.6% had high adherence. Women with low adherence had longer menstrual cycles (p < 0.01). Eating less than two pieces of fruit per day (OR = 3.574; 95%CI = 1.474– 8.665; p < 0.05) and eating pulses more than one day a week (OR = 2.320; 95%CI = 1.006–5.348) raised the probability of suffering menstrual pain. A positive correlation between SDU and cycle length was identified (r = 0.119, p = 0.038), and menstrual bleeding was lower in women who consumed olive oil daily (p = 0.044). In conclusion, the Mediterranean diet, alcohol consumption and consuming typical foods from southern Spain appear to influence cycle length, menstrual flow and menstrual pain. Further research is necessary to confirm and expand these findings.post-print315 K

Desenho e validação de um questionário de satisfação do operador económico sujeito a controlo pelo Sistema de Saúde Público Andaluz

Purpose and justification: To design and validate a questionnaire on the satisfaction with the environmental and food factor surveillance and control carried out by health authorities of the economic operators subjected to such control.Method and materials: Designing a descriptive, cross-sectional study for the validation of a questionnaire on the economic operator’s satisfaction with the official control agent’s performance.Location: The study was conducted in the Aljarafe-Sevilla Norte Primary Care Health District, which encompasses populations in Seville and Huelva. The inspection activity is carried out by 58 official control agents, who conduct inspections at 9,689 food companies in the Autonomous Community of Andalusia.Participants: Telephone surveys were given to a random sample of 675 economic operators which were subjected to sanitary control during the month of July 2019.Method: The questionnaire, which was designed by a group of experts, consisted of 12 closed-ended questions on a numerical scale and 1 open-ended question. Its construct validity, discriminating capacity and internal consistency were ascertained.Results: Two factors—“technical quality” and “organizational quality”—were identified, which explain 52.45 % of the variance. The questionnaire has internal consistency (Cronbach ́s alpha: 0.808).Conclusions: The questionnaire has sufficient psychometric properties to be considered a useful and reliable tool for measuring the satisfaction of economic operators with the sanitary control carried out by official control agents.Justificación y objetivo: Diseñar y validar un cuestionario de satisfacción de la actividad de vigilancia y control de factores ambientales y alimentarios ejercida por las autoridades sanitarias y percibida por los operadores económicos sometidos a ella.Material y método: Diseño del estudio descriptivo transversal de validación de un cuestionario de satisfacción del operador económico respecto a la actuación del agente de control oficial.Emplazamiento: El ámbito de estudio fue el Distrito Sanitario de Atención Primaria Aljarafe-Sevilla Norte, que comprende poblaciones de Sevilla y Huelva. La actividad la prestan 58 agentes de control oficial que realizan controles en 9 689 empresas alimentarias comunitarias.Participantes: Se realizaron encuestas telefónicas a una muestra aleatoria de 675 operadores económicos sometidos a control sanitario durante el mes de julio de 2019.Método: El cuestionario fue diseñado por un grupo de expertos, constando de 12 preguntas cerradas con escala numérica y una pregunta abierta. Se analizó la validez de constructo, capacidad discriminante y consistencia interna.Resultados: Se identificaron dos factores, “calidad técnica” y “calidad organizativa”, que explican el 52,45 % de la varianza, con consistencia interna (alfa de Cronbach 0,808).Conclusiones: El cuestionario reúne suficientes propiedades psicométricas como para que pueda ser considerado una herramienta útil y fiable para medir la satisfacción de los operadores económicos en relación a las actuaciones del agente de control oficial en el control sanitario.Justificação e objetivo: Elaborar e validar um questionário de satisfação para a vigilância e controle dos fatores ambientais e alimentares realizado pelas autoridades sanitárias à perceção dos operadores económicos a ele sujeitos.Material e método: Desenho de estudo descritivo transversal, para validação de questionário de satisfação do operador económico, quanto ao desempenho do agente oficial de controlo.Âmbito: A área em estudo foi o Distrito Sanitário de Cuidados de Saúde Primários de Aljarafe-Sevilla Norte, que inclui as cidades de Sevilha e Huelva. A atividade é realizada por 58 agentes oficiais de controlo, que realizam controlos em 9.689 empresas comunitárias de alimentos.Participantes: Foram realizadas contactos telefónicos a uma amostra aleatória de 675 operadores económicos submetidos ao controle sanitário durante o mês de julho de 2019.Método: O questionário foi elaborado por um grupo de especialistas, composto por 12 questões fechadas com escala numérica e uma questão aberta. Foram analisadas a validade do constructo, capacidade discriminante e consistência interna.Resultados: Foram identificados dois fatores, “qualidade técnica” e “qualidade organizacional” que explicam 52,45 % da variância, com consistência interna (alfa de Cronbach 0,808).Conclusões: O questionário possui propriedades psicométricas suficientes para ser considerado uma ferramenta útil e confiável para medir a satisfação dos operadores económicos, em relação às ações do agente de controlo oficial pelo controlo sanitário

Prevalencia de la Lactancia Materna en Huelva, duración y factores relacionados

Objective: To know the prevalence and duration of the breastfeeding, as well as the relation with the sociodemographic, obstetric and child and maternal education factors. Design: descriptive observational study. Site: seven health centers of Huelva city. Participants: 268 mothers of 1-2 y.o. children. The selection was made straight, in order of arrival. Main measurements: prevalence and duration of the breastfeeding, sociodemographic characteristics, perinatal characteristics and complementary feeding. Results: The 52,9 % (CI:46,99-58,91) of the sample initiated the exclusive breastfeeding. Six months later remained the 19,7 % (CI:15,33-24,87). The 63,4% (CI:57,54-69,04) initiated the total breastfeeding, 47,7% (CI:41,82-53,75) continue with it 3 months later and the 26,1% (CI:21,12-31,63) 6 months later. The breastfeeding is related with: the academic education of the mother, the number of children, to attend the workshops childbirth preparation, number of sessions, level of satisfaction with maternal and child education, to have requested assistance on breastfeeding, to know the breastfeeding support group and to have atended to it.Conclusions: The prevalence of the breastfeeding is less concerning than expected by the national data, the length of it is far from the recommendations of the WHO and the educational level of the mother, favors the prevalence and duration of breastfeeding. Health professionals must continue with their promotion and support.Objetivos: Conocer la prevalencia y duración de la Lactancia Materna (LM), así como la relación con las variables sociodemográficas, obstétricas y de educación materno infantil. Diseño: Estudio observacional descriptivo. Emplazamiento: siete centros de salud de Huelva capital. Participantes: 268 mujeres con niños de 1 a 2 años. La selección se hizo consecutiva, por orden de llegada. Mediciones principales: prevalencia y duración de LM, características sociodemográficas, características perinatales y alimentación complementaria. Resultados: Iniciaron la LM exclusiva un 52,9 % (IC:46,99-58,91). A los seis meses permanecen un 19,7% (IC:15,33-24,87). Un 63,4% (IC:57,54-69,04) comienzan lactancia materna total (exclusiva o mixta), un 47,7% (IC:41,82-53,75) continúa con ella a los 3 meses y un 26,1% (IC:21,12-31,63) a los 6 meses. La LM está relacionada con: la formación académica de la madre, el número de hijos, asistir a los talleres de preparación al parto, número de sesiones, nivel de satisfacción con respecto a la educación materno infantil, haber solicitado ayuda sobre LM, conocer el grupo de apoyo a la lactancia y haber asistido al mismo. Conclusiones: La prevalencia de LM es baja con respecto a lo esperado por los datos nacionales, la duración de la misma se aparta de las recomendaciones de la OMS y el nivel educativo de la madre favorece la prevalencia y duración de la LM. Los profesionales de la salud debemos continuar con su promoción y apoyo

Differences between institutionalized patients and those included in a home care program in Seville

Objetivo: Conocer las características y las diferencias clínicas entre pacientes institucionalizados y los de programas de atención domiciliaria. Dise˜no: Estudio observacional descriptivo transversal multicéntrico. Emplazamiento Sevilla, 2016. Participantes: Un total de 1.857 pacientes ancianos (1.441 institucionalizados y 416 en domicilio). Mediciones: Las variables estudiadas fueron: sexo, edad, estado civil, apoyo familiar, patologías, criterios de pluripatología y fármacos. Se valoraron el estado funcional y el cognitivo mediante las escalas de Barthel, Lawton-Brody y Pfeiffer. Resultados: Un 71,40% fueron mujeres. Estadísticamente el hecho de estar institucionalizados o vivir en el domicilio se relaciona con las siguientes patologías y categorías: esquizofrenia (p < 0,001), HTA (p = 0,012), DM (p = 0,001), FA (p< 0,001) y neoplasias (p = 0, 012), A1 (p = 0,012), A2 (p < 0,001), B1 (p < 0,001), B2 (p = 0,002), C (p < 0,001), E1 (p < 0,001), E3 (p = 0,01), F2 (p < 0,01), G2 (p = 0,024) y H (p = 0,005). El promedio del índice de Barthel de la muestra fue de 49,1 ± 34,45 (IC 95%: 47,49-50,7), el de Lawton-Brody en domicilio fue de 2,33 ± 2,49 y en institucionalizados, de 1,59 ± 2,12. La media de la escala de Pfeiffer fue de 4,93 ± 3,53. Conclusiones: Se asocia con la institucionalización el deterioro cognitivo, consecuencia de posi-bles patologías neurológicas (categoría E3) y psiquiátricas. Por el contrario, no se asocia con lacomorbilidad del paciente, puesto que es muy elevada en pacientes en situación de atencióndomiciliaria con mejores estados de independencia funcional y cognitivo.Objectives: To describe the characteristics and clinical differences between institutionalisedpatients and those included in a home care program.Design: A descriptive, observational, cross-sectional, and multicentre study.Site Seville, 2016.Study subjects: A total 1857 elderly patients of similar characteristics (1441 institutionalisedand 416 at home) in Seville in 2016.Measurements: The variables studied included gender, age, civil status, family support, pat-hologies, multiple pathology criteria, and medication prescriptions. Functional and cognitivestatus was evaluated using the Barthel index, and the Lawton-Brody and Pfeiffer scales.Results: The majority of patients (71.40%) were women. The fact of being institutionalisedor being included in a home care program were statistically related to the following patholo-gies and categories: schizophrenia (p < .001), arterial hypertension (p = .012), diabetes mellitus(p = .001), atrial fibrillation (p < .001), and neoplasia (p = .012), A1 (p = .012), A2 (p < .001), B1(p < .001), B2 (p = .002), C (p < .001), E1 (p < .001), E3 (p = .01), F2 (p < .01), G2 (p = .024), andH (p = .005). The mean Barthel index of the sample was 49.1 ± 34.45 (95% confidence interval:47.49-50.7). The mean Lawton-Brody scale in the case of patients included the home care pro-gram was 2.33 ± 2.49 and in those institutionalised 1.59 ± 2.12. The mean Pfeiffer scale was4.93 ± 3.53.Conclusions: Cognitive impairment was related to institutionalisation, being a result of possibleneurological (E3 category) and psychiatric diseases. On the other hand, patient comorbidity wasnot related to it, because it is very high in patients included in a home care program, in whomfunctional and cognitive independency status is better

Mortality and use of healthcare resources in elderly patients in Seville: Differences between institutionalised patients and those included in a home care program

Objetivos La sociedad está envejeciendo y como consecuencia está aumentando la población con gran fragilidad y comorbilidad. El objetivo es analizar la mortalidad y sus posibles factores y el uso de recursos sanitarios en ancianos y estudiar si existen diferencias entre pacientes institucionalizados y en atención domiciliaria. Materiales y métodos Estudio observacional analítico de cohortes, longitudinal prospectivo realizado en la provincia de Sevilla durante el año 2016. Constituido por 1.314 pacientes ancianos (1.061 institucionalizados y 253 en atención domiciliaria). Las variables estudiadas fueron la mortalidad, sus factores potenciales y el uso de recursos sanitarios. Resultados No se encontraron diferencias en la mortalidad entre pacientes en residencia y domicilio (RR = 1,044; intervalo de confianza del 95%, 0,74-1,46; p = 0,799). La principal causa de mortalidad fueron las enfermedades del sistema circulatorio seguidas de las respiratorias. Entre los factores asociados a la mortalidad cabe destacar: edad, dependencia y presencia de ingresos en observación, planta y urgencias. La independencia funcional del paciente está asociada a una mayor supervivencia. Se encuentran diferencias en los avisos solicitados por los pacientes a su médico de Atención Primaria) (p < 0,001), las consultas a Dispositivos de Cuidados Críticos y Urgencias (p = 0,022) y los ingresos en observación (p < 0,001), siendo mayor en pacientes en domicilio las 2 primeras y en institucionalizados la última. Conclusiones No existen diferencias entre ambos grupos en relación con la mortalidad ni la causa de muerte. La edad, el grado de dependencia funcional y la presencia de ingresos son factores asociados a la mortalidad. El uso de recursos sanitarios es mayor en pacientes en domicilio.Objectives Society is ageing, and as a consequence, the population with increased frailty and comorbidity is growing. The aim is to analyse the mortality and its potential factors, as well as the use of healthcare resources in elderly patients, and to study the differences between institutionalised patients and those included in a home care program. Materials and methods An observational, longitudinal and prospective cohort study was conducted in Seville during 2016. The study subjects consisted of 1314 elderly patients (1061 institutionalised and 253 at home). The variables studied included mortality and its potential factors, and the use of healthcare resources. Results No differences were found in mortality between institutionalised and home care program patients (RR = 1.044; 95% CI; 0.74-1.46; P=.799). The leading cause of death was circulatory diseases followed by respiratory diseases. Among the factors explaining the mortality, it is important to highlight: age, dependency and admissions in the hospital or the emergency department. The patient's functional independence is associated with a higher survival rate. Differences were found between both groups in the number of calls to the Critical Care and Emergency Services (P=.022) or the primary care doctor (P<.001) and in the hospital admissions (P<.001), the first 2 differences being higher in home care program patients, and the latter in institutionalised patients. Conclusions There are no differences between groups either in the mortality or in the cause of death. Age, functional dependency and admissions in the hospital are factors which explain the mortality. The use of healthcare resources is higher in patients at home