La asistencia sanitaria pública en Yecla (Murcia): 1850-1930

This work picks up the available data on the organization of the public sanitary attendance in Yecla from the second helf of the XIX century until the first decades of the XX century. This amount of information allows to analyze the evolution of the public hygiene, the work of the regular doctors and the performances of the Council of Sanity during a period characaterized for the decrease of the rate of mortality.En el presente trabajo se recogen los datos disponibles sobre la organización de la asistencia sanitaria pública en la ciudad de Yecla (Murcia) en el período comprendido por la segunda mitad del siglo XIX y las tres primeras décadas del siglo XX. Partiendo del estudio de las Actas Capitulares y de las Juntas de Sanidad fundamentalmente y basándonos en las disposiciones legales de la época, la Ley General de Sanidad de 1855 y la Instrucción General de Sanidad de 1904, se analiza la evolución de la higiene pública, el trabajo de los médicos titulares y las actuaciones de 1a Junta de Sanidad en un período caracterizado por el inicio de la caída de las tasas de mortalidad y que ha venido en denominarse de «transición sanitaria» o «transición epidemiológica&raquo

La transición demográfica en Yecla (1860-1930)

It does a demographic analysis of a period named ademographic transitionp in the local boundary of Yecla (Murcia). After describing the methodical characteristic, in special the ones refering to the population stimate object of this survey, birth rates, mortality rates and intercensal rise are compared with the published ones from the Country of Murcia and Spain. The survey basically describes the development of the vital rates without comming into any consideration about causal explanations.Se efectua un análisis demogrfifico del período denominado «transición demográfica» en el ámbito local de Yecla (Murcia). Tras describir las peculiaridades metodológicas, en especial las referentes al cálculo de la población objeto de estudio, se comparan las tasas de natalidad, mortalidad y crecimiento intercensal con los publicados sobre la Región de Murcia y España. El estudio es esencialmente descriptivo de la evolución de las tasas vitales sin entrar en consideraciones sobre explicaciones causales

Psychoeducative groups help control type 2 diabetes in a primary care setting

Introduction: The purpose of this study is to measure the impact of a psychoeducational group intervention in diabetes using glycosylated haemoglobin (HbA1c), the body mass index (BMI) and cardiovascular risk factors (CVRF) compared with conventional educational measures provided individually. Methods: A quasi-experimental study (pre/post-intervention) with a non-equivalent control group was conducted, including 72 type 2 individuals with diabetes (mean data: age 63.08 years, HbA1C 6.98%, BMI 30.48 kg/m²). The beneficial effect of psychoeducational group therapy in the study group (PGT) was compared with conventional diabetes education in the control group (CG). Results: The PGT had a higher mean HbA1c reduction (-0.51 ± 1.7 vs. -0.06 ± 0.53%, p 0.003), met the objectives of optimal control of HbA1c to a higher degree (80% vs. 48%, p 0.005) and greater mean weight reduction (-1.93 ± 3.57 vs. 0.52 ± 1.73 kg, p 0002) than the CG.A significant improvement in total cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure was achieved in PGT (all p < 0.05). Conclusions: PGT patients achieved a significant improvement in HbA1C, BMI and CVRF, and outperformed the conventional diabetes education group in achieving the optimal diabetes control objectives. Structural changes in the assistance programs should be considered to introduce these more efficient therapies for diabetes education in primary care

Pneumonia treated in the internal medicine department: Focus on healthcare-associated pneumonia

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p<0.001), had poorer functional status (Barthel 100, 30 and 65; p<0.001) and had more risk factors for aspiration pneumonia (18, 50 and 34%; p<0.001). The frequency of testing to establish an aetiological diagnosis was lower among HCAP patients (87, 72 and 79; p<0.001), as was adherence to the therapeutic recommendations of guidelines (70, 23 and 56%; p<0.001). In-hospital mortality increased progressively between CAP, HCAP and HAP (8, 19 and 27%; p<0.001). Streptococcus pneumoniae was the main pathogen in CAP and HCAP. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) caused 17 and 12.3% of HCAP. In patients with a confirmed aetiological diagnosis, the independent risk factors for pneumonia due do difficult-to-treat microorganisms (Enterobacteriaceae, P. aeruginosa or MRSA) were HCAP, chronic obstructive pulmonary diseases and higher Port Severity Index. Our data confirm the importance of maintaining high awareness of HCAP among patients treated in IMDs, because of the different aetiologies, therapy requirements and prognosis of this population. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases