Explicaciones de las prácticas sexuales de riesgo en hombres que tienen sexo con hombres

ObjectiveTo explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men.MethodsWe performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis.ResultsRisky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues.ConclusionsThe concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective.     

Conductas sexuales de riesgo y actividades preventivas frente al cáncer de cuello uterino en mujeres universitarias vacunadas frente al VPH

Aim

To estimate the association between the human papillomavirus (HPV) vaccine and sexual risk behaviour, as well as the participation in the Cervical Cancer Screening Program (CCSP).

Cáncer de próstata,terapia antiandrogénica y riesgo cardiovascular

AimTo assess if cardiovascular risk (CVR) charts are able to identify the increased risk caused by androgen deprivation therapy (ADT) in patients with prostate cancer (PCa).DesignRetrospective cohort study.LocationUrban and rural health centres in the province of Ourense.ParticipantsPatients diagnosed with PCa who had been prescribed treatment for ADT between 2007 and 2008.Main measuresAge, residence (rural/urban), staging (Gleason), diagnostic procedure and, at the beginning and end of follow-up, lipid profile, blood pressure, diagnosis of diabetes mellitus, smoking, use of antihypertensive and lipid-lowering drugs, and Framingham calibrated and ATP III indexes, were determined. Cardiovascular events were recorded during the follow-up. Each patient was his own control. Increasing age was not used in the calculation of the scores at the end of the follow up period. The scores were compared using the t-test for paired samples (SPSS 15.0).ResultsA total of 209 cases were included. The mean (SD) age was 73.8 (8.0) years, with 64.6% of urban cases. The scores at baseline and at 12 months of follow-up were: Framingham 9.0 (4.6) and 9.2 (4.8) (P = 0.5), ATP III 14.2 (1.7) and 14.2 (1.7) (P = 0.9).ConclusionCVR charts do not assess the increased risk associated with androgen deprivation therapy in prostate cancer.     

Consumo de tabaco y alcohol según la jornada laboral en España

ObjectiveTo examine the association between smoking and alcohol consumption and the type of working day in the Spanish populationMethodsCross-sectional study among employees residing in Spain aged >18 years (N = 8,736). We took data from the National Health Survey (2011-2012). Information was collected on the type of working day (morning, afternoon, evening, part-time, reduced hours, and shift-work) and smoking and drinking habits. Demographic characteristics and health- and work-related factors were also taken into account. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated through log-binomial regressions.ResultsAmong respondents, 32.1% smoked regularly, especially those working the night shift (43.5%). Moderate alcohol consumption was found in 54.8% of workers and excessive consumption in 1.5%. Most of the moderate and heavy drinkers worked part-time, with 57.6% and 1.8% respectively. The aOR of being a smoker was higher among night workers (OR = 1.58; 95% CI: 1.01-2.46). None of the work shifts were significantly associated with alcohol consumption.ConclusionsNight shift work was associated with regular smoking. This collective of workers should be monitored closely by occupational health services and regularly undergo programs to control tobacco consumption and smoking-related diseases. Additional research to elucidate the reasons for this association could help to achieve preventive and therapeutic success.     

La inteligencia artificial y sus aplicaciones en medicina II: importancia actual y aplicaciones prácticas

Technology and medicine follow a parallel path during the last decades. Technological advances are changing the concept of health and health needs are influencing the development of technology.Artificial intelligence (AI) is made up of a series of sufficiently trained logical algorithms from which machines are capable of making decisions for specific cases based on general rules.This technology has applications in the diagnosis and follow-up of patients with an individualized prognostic evaluation of them.Furthermore, if we combine this technology with robotics, we can create intelligent machines that make more efficient diagnostic proposals in their work.Therefore, AI is going to be a technology present in our daily work through machines or computer programs, which in a more or less transparent way for the user, will become a daily reality in health processes. Health professionals have to know this technology, its advantages and disadvantages, because it will be an integral part of our work.In these two articles we intend to give a basic vision of this technology adapted to doctors with a review of its history and evolution, its real applications at the present time and a vision of a future in which AI and Big Data will shape the personalized medicine that will characterize the 21st century.     

Prevalencia de consumo de alcohol y factores de riesgo cardiovascular en un área sanitaria de Extremadura. Estudio Hermex

ObjectivesAlcohol has been associated with a lower risk of developing cardiovascular disease. It has been our objective to determine the prevalence of use of alcohol and its association with the presence of cardiovascular risk factors (CRF).DesignCross-sectional study.SettingDon Benito-Villanueva de la Serena health area (Badajoz).ParticipantsWe selected a random sample of 25 to 79 year olds, representative of the population.MethodsWe collected a survey about the history of cardiovascular risk factors and alcohol consumption in the previous seven days. We measured blood pressure and a fasting blood sample was obtained. The association of alcohol consumption with the different CRF was studied by multivariate analysis, adjusting for different variables.ResultsA total of 2833 subjects participated, with a mean age 51.2 (SD 14.7) years and 46.5% males. We detected 36.1% (95% CI 34.4 to 37.9) of alcohol consumers. The overall prevalence and consumption medium or high risk was 63.2% and 15.2% in men, and 12.6% and 1.5% in women, respectively. In men, consumption of medium-high risk was associated with hypercholesterolemia, hypertension and smoking. In women, low-risk consumption was associated with a lower prevalence of obesity and hypertension and higher smoking.ConclusionsWe found a lower prevalence of alcohol use, especially in women, compared to the Spanish national average. The consumption of medium-high risk mainly affects men and is associated with increased cardiovascular risk. In women at low risk consumption is associated with a lower prevalence of certain CRF and increased smoking.     

Guía de buenas prácticas de seguridad informática en el tratamiento de datos de salud para el personal sanitario en atención primaria

The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients’ personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities.     

Adaptación y validación de un cuestionario para evaluar las prácticas de autocuidado en población infantil sana residente en España

ObjectiveTo adapt and validate the Child and Adolescent Self-Care Performance Questionnaire (CASPQ) to the context of healthy children aged 8 to 12 years residing in Spain and evaluate their metric properties.DesignValidation study based on Classical Test Theory.LocationFour schools participating in the Salut i Escola programme of a Primary Care Centre of Barcelona (Spain).ParticipantsFour hundred and ninety-eight elementary school students participated in the study during the first six months of 2016.Main measurementsCultural adaptation of the questionnaire was carried out. Response process and factorial structure were evaluated and the relationships of the adapted questionnaire scores with those of the KIDSCREEN-27 questionnaire were analysed. Likewise, internal consistency and reproducibility of the scores were evaluated.ResultsFour hundred and eighty-nine questionnaires were obtained. The confirmatory factor analysis of its theoretical structure showed a sufficient adjustment. A positive association was observed between the questionnaire scores and those of KIDSCREEN-27. The overall internal consistency was satisfactory; nevertheless, that of each factor was marginal or moderate. The reproducibility of the scores was optimal.ConclusionsThe CASPQ adapted to the healthy child population of 8 to 12 years old shows appropriate metric properties and similar to those of the original questionnaire. Therefore, it is a useful tool to assess self-care practices and plan interventions aimed at its promotion.     

Recomendaciones prácticas sobre ejercicio físico durante el embarazo basadas en las principales guías de práctica clínica

The main guidelines for physical activity/exercise during pregnancy recommend that all pregnant women without medical or obstetric contraindications remain physically active during pregnancy, in order to achieve health benefits and, at the same time, reduce the possibility of complications during pregnancy.The objective of this article was to extract the practical recommendations on physical exercise during pregnancy, of interest to the primary care physician, from the clinical practice guidelines of three international societies of Obstetrics and Gynecology of recognized prestige and great international influence on this subject, two of them pioneers in the elaboration of this type of recommendations: the American College of Obstetrics and Gynecology and the Society of Obstetricians and Gynaecologists of Canada; and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, together with the one published by the Spanish Society of Gynecology and Obstetrics.     

El impacto de la crisis en la relación entre vivienda y salud. Políticas de buenas prácticas para reducir las desigualdades en salud asociadas con las condiciones de vivienda

Housing conditions can impact on physical and mental health through 4 interrelated dimensions: 1) the home (the emotional housing conditions), 2) the physical housing conditions, and 3) the physical environment, and 4) the social (community) environment of the neighborhood where the house is located. In Spain, the use of the construction market as an engine for economic growth and the promotion of private property as the main type of housing tenure has led to the use of housing as a speculative good instead of its being considered a first-necessity good. While Spain is the Organisation for Economic Co-operation and Development (OECD) country with the largest housing stock per inhabitant, this stock is highly underutilized, thus excluding the most deprived sector of the population from access to housing. The impact of the current economic crisis on housing has mainly been due to a reduction in household income, which has increased the number of families or persons struggling to cover their housing costs or being evicted. Evidence indicates that this type of problem has a negative impact on health, especially on mental health, but financial problems also make it difficult to meet other basic needs such as eating. There are several instruments to reduce the impact of the economic crisis, such as debt financing or deed of assignment in payment. In the long-term, the creation of a social housing stock should be promoted, as well as rental assistance mechanisms.