A necessary evolution in time: From the Society of Medicine and Surgery of Albacete to the Royal Academy of Medicine of Castilla la Mancha.(1968-2018)

In 1968, the health professionals of Albacete needed coordination between their scientific and teaching activities, and the Sociedad de Medicina y Cirugia de Albacete emerged. Currently, fifty years later, with the entire campus of Health Sciences of the University of Castilla la Mancha and the existing extra-university teaching and research centers, an entity is needed to coordinate all these activities so that evolution is necessary from the Society of Medicine and Surgery of Albacete to the Royal Academy of Biomedical Sciences of Castilla la Manch

Cross-cultural adaptation, reliability, and validation of the Spanish perceived physical literacy instrument for adolescents (S-PPLI)

Objective: The aim of this study was to examine the reliability and validity of the Spanish Perceived Physical Literacy Instrument (S-PPLI) questionnaire in Spanish adolescents. Method: The participants of this study were 360 Spanish adolescents (aged 12-17 years) from three secondary schools in the Region of Murcia (Spain). A cultural adaptation process of the original version of the PPLI questionnaire was developed. Confirmatory factor analysis was applied to test the three-factor structure of physical literacy. Intraclass correlation coefficients were computed to estimate the test-retest concordance. Results: Using a confirmatory factor analysis, the factor loading of all items above the standard of 0.40 ranged from 0.53 to 0.77, suggesting that the observed variables sufficiently represented the latent variables. Analyses for convergent validity showed average variance extracted values that ranged from 0.40 to 0.52 and composite reliability values higher than 0.60. All the correlations were below the recommended cutoff point of 0.85, which indicated that the three physical literacy factors achieved adequate discriminant validity. Intraclass correlation coefficients ranged from 0.62 to 0.79 (p < 0.001 for all items), which indicated moderate/good reliability. Conclusions: Our results suggest that the S-PPLI is a valid and reliable measure of physical literacy among Spanish adolescents

Exploring the link between perceived physical literacy and academic performance outcomes: insights from the EHDLA study

ObjectiveThe aim of this study was to verify the relationship between perceived physical literacy (PPL) and academic performance outcomes among Spanish adolescents aged 12–17 years.MethodsThis cross-sectional study is a secondary examination utilizing data derived from the Eating Healthy and Daily Life Activities (EHDLA) project. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) was used to evaluate the PPL of the participants. To determine academic performance, the numerical grades for each subject were added together and then divided by the total number of subjects.ResultsOverall, a positive trend in the association between S-PPLI scores and academic performance was observed. We identified two significant ranges within the S-PPLI scores. First, there was a significant range between 9 and 33 points on the S-PPLI, indicating an inverse association with academic performance. Second, another significant range was observed at scores of 34 points or higher on the S-PPLI, suggesting a positive association with academic performance. Participants with low PPL had the lowest academic performance (mean = 6.4; bias-corrected and accelerated (BCa) bootstrapped 95% confidence interval (CI): 6.2–6.6). Conversely, those adolescents with high PPL had the highest academic performance (mean = 6.9; BCa bootstrapped 95% CI: 6.6–7.1). Significant differences were found between low PPL and medium PPL (p-adjusted = 0.031) and between low PPL and high PPL (p-adjusted = 0.031).ConclusionsIncreased physical literacy could be a relevant factor for achieving greater academic performance in adolescents. This study has potential implications for physical education instructors, school leaders, and healthcare practitioners

Evolución de la dieta y la actividad física de los estudiantes universitarios tras la pandemia de COVID-19

Objetivo: valorar la evolución de la adherencia a la dieta mediterránea y el nivel de actividad física de los estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha durante la pandemia de COVID-19 y un año después de la misma. Método: estudio observacional transversal mediante cuestionarios sobre la adherencia a la dieta mediterránea y el nivel de actividad física. Participaron 893 alumnos matriculados en grados de Ciencias de la Salud de la Universidad de Castilla-La Mancha, 575 en la primera encuesta (durante la pandemia) y 318 en la segunda (un año después). Por sexos, 672 mujeres y 221 hombres (en la primera encuesta, el 77,7 % eran mujeres y el 22,3 % hombres, mientras que en la segunda lo eran el 70,8 % y 29,2 %, respectivamente). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario de Prevención con Dieta Mediterránea (PREDIMED), modificado. El nivel de actividad física se valoró con el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: tras un año desde el confinamiento por la COVID-19, el consumo de aceite de oliva casi se ha triplicado. Se ha duplicado también el consumo de frutas diario. De igual modo, se ha duplicado el consumo de vino y bebidas alcohólicas. Por el contrario, se encontró una reducción del consumo de mantequilla y margarina, al igual que de bebidas carbonatadas y azucaradas. Asimismo, aumentó significativamente el porcentaje de estudiantes universitarios con adherencia alta a la dieta mediterránea (del 26 % al 34,3 %). En cuanto al nivel de actividad física, ha aumentado significativamente el porcentaje de estudiantes universitarios que realizan actividad fisica ligera, moderada e incluso intensa de forma irregular. Este aumento no se ha encontrado en el caso de las actividades de fuerza muscular y flexibilidad. Conclusión: los resultados del estudio nos indican que, aunque los niveles de adherencia a la dieta mediterránea y de actividad física han mejorado tras el confinamiento por la COVID-19, la adherencia a la dieta mediterránea y el nivel de actividad física de la población universitaria analizada siguen siendo bajos. Es necesario aplicar estrategias para la consecución o mantenimiento de un estilo de vida saludable en dicha población.Objective: to assess the evolution of adherence to Mediterranean diet and level of physical activity of university students of Health Sciences in Castilla-La Mancha during the COVID-19 lockdown and one year afterwards. Methods: a cross-sectional observational study using questionnaires on adherence to the Mediterranean diet and level of physical activity. A total of 893 students enrolled in Health Sciences degrees at the University of Castilla la Mancha participated, 575 in the first survey (during the lockdown) and 318 in the second (one year later). By sex, 672 women and 221 men (in the first survey 77.7 % were women and 22.3 % men while in the second survey these were 70.8 % and 29.2 %, respectively). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The level of physical activity was assessed with the Rapid Assessment of Physical Activity Scale (RAPA). Results: one year after the COVID-19 confinement, consumption of olive oil has almost tripled. Daily fruit consumption has also doubled. Similarly, the consumption of wine and alcoholic beverages has doubled. Conversely, there was a reduction in the consumption of butter and margarine, as well as of carbonated drinks and sweetened beverages. Likewise, the percentage of university students with high adherence to the Mediterranean diet increased significantly (from 26 % to 34.3 %). Regarding physical activity level, there was a significant increase in the percentage of university students who engaged in light, moderate and even intense physical activity on an irregular basis. This increase was not found in the case of muscular strength and flexibility training activities. Conclusion: the results of the study indicate that, although the levels of adherence to the Mediterranean diet and physical activity have improved after the COVID-19 confinement, adherence to Mediterranean diet and physical activity level among the university population analyzed is still low. It is necessary to implement strategies for the achievement or maintenance of a healthy lifestyle in this population

Active interventions in hypercholeteroloemia patiens with high cardiovascular risk in primary care

Introduction: Hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially. Objective: To determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C &lt;100 mg &lt;dL in high-risk patients attended in Primary Care (PC) in our country. Methodology: epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL. Results: The study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64% had a previous EVC, acute myocardial infarction (20.33%), angina (16.07%), stroke /TIA (9.19%), arthropathy (5.25%), diabetes (70 , 87%), hypertension (71.01%), and abdominal obesity (69.62%). The 43.57% (95% CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50% (95% CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56% (95% CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg /dL at baseline, 107.4 mg /dL in the 2nd visit, 97.3 mg /dL in the 3rd visit, up to 90.7 mg /dL at the final visit (p &lt;0.0001) The increase in HDL-C from baseline (50.9 mg /dL) and final (53.6 mg /dL) was also significant (p = 0.013). Conclusions: The reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.Introducción: La hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y en prevención secundaria especialmente. Objetivo: Comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: Estudio epidemiológico, prospectivo, multicentrico, realizado en Centros de AP de diferentes CC.AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: Los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32% eran varones. El 41,64% presentaba un EVC previo, infarto agudo de miocardio (20,33%), angina (16,07%), ictus/AIT (9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión (71,01%), y obesidad abdominal (69,62%). El 43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron la 2a visita (241) consiguieron el OT. El 62,50% (IC95%: 55,68; 68,98) de los que realizaron la 3a (216) consiguieron el OT. Finalmente, el 77,56% (IC95%: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/ dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/ dL en la 3a visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001) El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las guías, permite alcanzar el OT en más de las tres cuartas partes de los previamente no controlados en el plazo de medio año. Estos resultados nos deben estimular a superar la inercia terapéutica en el control de la ECV mediante una actuación precoz y enérgica ante la hipercolesterolemi

Nonalcoholic steatohepatitis and cardiovascular risk factors in primary care

Varias circunstancias motivan el creciente interés por la esteatosis hepática no alcohólica (EHNA): la elevada prevalencia de la enfermedad en el mundo occidental, su capacidad de progresión a formas histológicas más agresivas y su asociación con enfermedades que incrementan el riesgo cardiovascular. Objetivo: analizar la relación de la esteatosis hepática no alcohólica con los factores de riesgo cardiovascular en pacientes con criterios de síndrome metabólico. Método: fue realizado un estudio descriptivo transversal con una muestra de 100 pacientes, con 2 o más factores de riesgo cardiovascular, con nula o baja ingesta de alcohol, que acudían a consulta de atención primaria. A los seleccionados se les solicitó analítica completa e interconsulta para ecografía de abdomen completo. Se evaluó si tenían esteatosis hepática; en caso de ser afirmativo, se estratificaba en 3 grados. Se recogieron las siguientes variables tanto cualitativas (sexo, antecedentes personales y familiares de diabetes, hipertensión arterial, dislipidemia, entre otros) y cuantitativas (edad, peso, talla, índice de masa corporal, tratamiento farmacológico, cifras de distintos parámetros analíticos, cifras de tensión arterial y perímetro abdominal). Resultados: participaron 100 pacientes, 56% de los cuales eran mujeres, con una edad media de 61,84 DE ± 9,5 años. Del total de sujetos del estudio, el 23 % no tenía esteatosis hepática no alcohólica; un 29% tenía esteatosis hepática leve; otro 29%, esteatosis hepática moderada; y el 19% restante, esteatosis hepática severa. En los hombres, el 82% presentó esteatosis hepática. De las mujeres, el 28,57% no presentó hígado graso. Un 22% tenía sobrepeso y un 38% de los pacientes eran obesos. Solo un 22% y un 18% tenían alteradas las cifras tensionales sistólica y diastólica, respectivamente. El 60% tenía una glucemia basal alterada. En cuanto a los parámetros lipídicos, el 36% tenía hipertrigliceridemia; el 41%, hipercolesterolemia, con un 65% de colesterol LDL alto y un 16% de colesterol HDL bajo. El 83% de los pacientes tenía 2 o más criterios de síndrome metabólico. Conclusiones: hay una estrecha relación entre la aparición de esteatosis hepática no alcohólica y los factores de riesgo cardiovascular en pacientes con síndrome metabólico, por lo que se recomienda que, ante la aparición de estos, se analice el hígadoSeveral factors motivate the growing interest in this disease. They include the high prevalence of the disease in the Western world, its ability to progress to more aggressive histological forms, and its association with diseases that increase cardiovascular risk. Objective: The objective of this study was to analyze the relationship of nonalcoholic steatohepatitis (NASH) with cardiovascular risk factors in patients with criteria for metabolic syndrome. Method: This is a descriptive cross-sectional study of 100 patients who had two or more cardiovascular risk factors, who did not consume alcohol or consumed only small amounts of alcohol, and who came to the primary care clinic. The patients selected underwent complete analyses including abdominal ultrasound. They were evaluated for hepatic steatosis, and, if they tested positive, it was stratified into three degrees. Among the qualitative variables used were sex, personal and family history of diabetes, hypertension, dyslipidemia, and the quantitative variables included age, weight, height, body mass index, pharmacological treatment, numbers of different analytical parameters, blood pressure and abdominal perimeter. Results: There were 100 patients, 56% of whom were women. Patients’ mean age was 61.84 SD ± 9.5 years. Of the total number of subjects in the study, 23% did not have NASH, 29% had mild hepatic steatosis, 29% had moderate hepatic steatosis and 19% had severe hepatic steatosis. Of the men in the study, 82% had hepatic steatosis. Of the women, 28.57% did not have fatty livers. 22% were overweight and 38% obese. Only 22% had altered the systolic blood pressure and and 18% had altered diastolic blood pressure. 60% had altered basal glycemia. 36% had hypertriglyceremia, 41% had hypercholesterolemia including 65% with high LDL cholesterol and 16% with low HDL cholesterol. 83% of the patients had two or more criteria for metabolic syndrome.Conclusions: There is a close relationship between the occurrence of NASH and cardiovascular risk factors in patients with metabolic syndrome, and it is advisable that the liver be analyzedEstudio financiado en parte por la Comisión de Investigación de la Gerencia Integrada de Albacet

Effects of the Mediterranean diet on the cardiovascular risk factors

Background: Eating habits have been modified, which together with a more sedentary lifestyle has contributed to a significant increase in cardiovascular risk factors and consequently in cardiovascular disease. It is believed that this epidemic could be reduced with a change to a healthier lifestyle and diet, such as the Mediterranean diet. Objetive: To demonstrate the benefit of the Mediterranean diet as a valid dietary pattern for the primary prevention of cardiovascular disease Methods: study of the articles found in bibliographic review of different databases through systematic technique Results: In interventions with Mediterranean diet, a global beneficial effect on blood pressure has been observed with significant reductions in systolic, diastolic or both depending on the study. There is also a positive effect on glucose levels, HbA1c and incidence of type 2 diabetes mellitus with a significant level of significance. Regarding the lipid profile, the results are more variable, although generally it is considered that there is a reduction of total cholesterol, triglycerides, concentration and oxidation of LDL and ApoB and an increase of HDL. Inflammatory markers such as CRP, IL6, IL8, TNF alpha, ICAM, P-selectin, are also reduced in several of the studies analyzed. Likewise, the Mediterranean diet has proven to be an useful tool in the reversal of the metabolic syndrome. Conclusions: After a few decades in which prevention and treatment of cardiovascular diseases focused on the use of low-fat diets, the Mediterranean diet is currently emerging as a healthier alternative since it has shown a greater reduction in blood pressure, glycaemia, lipid profile, markers of inflammation and endothelial damage

Sexual Health: The great forgotten of the educational scope

Introduction: Sexual education is a priority in the psychosocial development of people and there is a significant deficit both in the school and the Institutes and Universities, in the informative-preventive field, as in sexual counseling and in the intervention of Clinical Sexology and / or Sexual Medicine that are taught, already as indispensable subjects in the Faculties of Medicine of Europe, USA, Canada and Latin America. In Spain we have more than a decade with a Master of Sexology that is taught at universities (Almeria, Health Sciences (UAL, Seville, Extremadura) Other University as Camilo José Cela, (at the INCISEX, the Institute of Sexological Sciences ) has been teaching sexology for more than 4 decades, and today sex education occupies spaces in many schools and in many families.The physical and emotional need to touch us, to give us pleasure and intimacy, accompanies us from birth to We die, to all people, sexuality is reworked throughout a life. Objective: To value sexual education in our area. Method: Analysis of rights and duties in education applied to the sexual field in our country. The OMS. defines Sexual Health in 1975. The W.A.S. in the XIII World Congress of Sexology, (29.06.1997 establishes the Universal Declaration of Sexual Rights or Declaration of Valencia) and updates them in 2014. Results: There has been an increase in Spanish legislation in the field of sex education, however, an important deficit is still detected that logically limits the formation and development of people. For a National Sexual Health Plan, and implementation of the March 2010 Law. Organic Law 2/2010, of arch 3, on sexual and reproductive health and the voluntary interruption of pregnancy. https://www.boe.es/buscar/pdf/2010/BOE-A-2010-3514- consolidado.pdf Conclusions: Sexual education should be increased in schools, institutes and universities that facilitate the personal development of all people, from infancy to old age

Abordaje no farmacológico del dolor en pediatría desde la perspectiva de enfermería: Aplicación de materiales audiovisuales y buzzy®

Objetivo. Evaluacion del abordaje multidisciplinario del dolor pediátrico. Metodo. Revisión sistemática de la bibliografía más actualizada acerca del tema en los buscadores médicos Pubmed, Cuiden, Scielo, Cochrane Library y Cinahl. Aplicando en los motores de búsqueda los términos: “Pain Assessment”, “Pain Measurement” “Pain Management” “Nonpharmacologic treatment”, realizando  una acotación a aquellos artículos escritos en castellano e inglés y con fecha de publicación posterior a enero de 2015. Resultados y Discusión. Se ha tratado la identificación de la intensidad del dolor que requiere de un abordaje complejo y no existe un método de evaluación que se muestre superior a otro. Parece por tanto adecuado la aplicación de la combinación del autoregistro por parte del paciente siempre que sea posible, la familia y la aplicación de escalas de aplicación sistematizada por parte de personal cualificado para ello. Para la aplicación de las escalas parece conveniente la utilización según la validación de estas en determinados grupos de pacientes y lo familiarizado que este el personal encargado de registrarlas. El tratamiento farmacológico está siendo desarrollado amplia y eficazmente como medida complementaria a las formas habituales de tratamiento del dolor. Estas medidas en su mayoría de las veces por su fácil aplicación, escaso coste y casi nulo riesgo de iatrogenia se están implementando en la mayoría de las unidades de atención pediátrica. Esta aplicación de medidas exige de la creatividad y capacitación continua del personal que las lleve a cabo y de una correcta evaluación del dolor en cada momento de la asistencia. Conclusión. El control del dolor y la ansiedad que asocia son un desafío de abordaje multidisciplinar en el que la enfermería cumple un gran papel, desde su posición tanto de realizadora de la gran mayoría de procedimientos que pueden desencadenarlo como desde la aplicación de las medidas no farmacológicas