Papers by Antonio Segura Fragoso
Healthcare
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Medicina de Familia. SEMERGEN
Resumen La pandemia por el SARS-CoV-2 persiste con toda su virulencia a pesar de haberse administ... more Resumen La pandemia por el SARS-CoV-2 persiste con toda su virulencia a pesar de haberse administrado 650.382.819 dosis de vacuna anti-COVID a nivel mundial. La prueba de referencia para la identificación de la infección es la reacción en cadena de la polimerasa con transcriptasa inversa (RT-qPCR). La utilidad de esta prueba puede disminuir al simplificar su resultado como positivo o negativo. Determinar el número de ciclos (Ct) en las pruebas RT-qPCR positivas puede ayudar en la toma de decisiones cuando se interpretan en el contexto clínico de los pacientes.
Medicina de Familia. SEMERGEN, 2022
Introducción: En España, los sistemas sanitarios están transferidos a las Comunidades Autónomas (... more Introducción: En España, los sistemas sanitarios están transferidos a las Comunidades Autónomas (CC.AA.), constituyendo 19 sistemas sanitarios con gestión y recursos diferenciados. Durante la primera onda epidémica del COVID-19 se objetivaron diferencias en los sistemas de declaración y en las tasas de letalidad (TL) entre las CC.AA. El objetivo de este estudio fue analizar las TL por CC.AA. durante la segunda onda epidémica (del 20 de julio al 25 de diciembre de 2020) y su relación con la prevalencia de la infección. Material y métodos: Se realizó un estudio observacional descriptivo con la información disponible sobre el número de fallecidos por COVID-19 registrados en el Ministerio de Sanidad, Consejerías de Salud y los Departamentos de Salud Pública de las CC.AA. y según el exceso de mortalidad informado por el Sistema de Monitorización de Mortalidad Diaria (MoMo). La prevalencia de la infección se estimó a partir de las diferencias entre la segunda y cuarta ronda del estudio ENE-COVID y sus intervalos de confianza del 95%. Se calcularon las TL (fallecidos por cada mil infectados) globales, por sexo, grupos de edad (< 65 y ≥ 65 años) y CC.AA. Se calculó la Razón Estandarizada de Letalidad por edad (REL) de las CC.AA. utilizando las TL de España para cada grupo de etario. Estas estimaciones se realizaron con las defunciones declaradas oficialmente (TLo) y el exceso de defunciones estimadas por MoMo (TLMo). Se estimaron las correlaciones entre las prevalencias de infección y las TLo y TLMo, ponderando por población. Resultados: Para el conjunto de España, la TLo durante la segunda onda epidémica fue del 7,6‰, oscilando entre 3,8‰ de Baleares y 16,4‰ de Asturias, y la TLMo fue de 10,1‰, oscilando entre el 4,8‰ de Madrid y el 21,7‰ en Asturias. Se observaron diferencias significativas entre la TLo y la TLMo en Canarias, Castilla la Mancha, Extremadura, Comunidad Valenciana, Andalucía y las Ciudades Autónomas de Ceuta y Melilla. La TLo fue significativamente mayor en hombres (8,2‰) que en mujeres (7,1‰). Las TLo y TLMo fueron significativamente mayores en el grupo de edad ≥65 años (55,4‰ y 72,2‰ respectivamente) que en el grupo <65 años (0,5‰ y 1,4‰ respectivamente). País Vasco, Aragón, Andalucía y Castilla la Mancha presentaron una REL significativamente superiores a uno. Las correlaciones entre la prevalencia de infección y las TLo fueron inversas. Conclusiones: La letalidad por COVID-19 durante la segunda onda epidémica en España mejoró respecto a la primera. Los datos disponibles sugieren que la letalidad de la segunda onda en las CC.AA. estaría influida por la elevada letalidad observada en la primera onda en personas con comorbilidades, así como por las limitaciones de los sistemas de detección y notificación de SARS-CoV-2. Las tasas de letalidad fueron mayores en hombres y personas mayores, y variaban significativamente entre CC.AA. Es necesario profundizar en el análisis de las causas de estas diferencias. Introduction: In Spain, health systems are transferred to the Autonomous Communities (AC), constituting 19 health systems with differentiated management and resources. During the first epidemic wave of COVID-19, differences were observed in reporting systems and in case-fatality rates (FR) between the AC. The objective of this study was to analyze the FR according to AC. during the 2nd epidemic wave (from July 20 to December 25, 2020), and its relationship with the prevalence of infection. Material and methods: A descriptive observational study was carried out, extracting the information available on the number of deaths from COVID-19 registered in the Ministry of Health, the Health Councils and the Public Health Departments of the AC, and according to the excess mortality reported by the System Monitoring of Daily Mortality (MoMo). The prevalence of infection was estimated from the differences between the second and fourth rounds of the ENE-COVID study and their 95% confidence intervals. The global FR (deaths per thousand infected) were calculated according to sex, age groups (<65 and ≥ 65 years) and AC. The age-Standardized Fatality Rates (SFR) of the AC. were calculated using the FR of Spain for each age group. These estimates were made with officially declared deaths (FRo) and excess deaths estimated by MoMo (FRMo). The correlations between the prevalences of infection and the FRo and FRMo were estimated, weighting by population. Results: For the whole of Spain, the FRo during the second epidemic wave was 7.6 ‰, oscillating between 3.8 ‰ in the Balearic Islands and 16.4 ‰ in Asturias, and the TLMo was 10.1 ‰, oscillating between 4,8 ‰ from Madrid and 21.7 ‰ in Asturias. Significant differences were observed between the FRo and the FRMo in the Canary Islands, Castilla la Mancha, Extremadura, the Valencian Community, Andalusia and the Autonomous Cities of Ceuta and Melilla. The FRo was significantly higher in men (8.2 ‰) than in women (7.1 ‰). The FRo and FRMo were…
Metabolic Syndrome and Related Disorders, 2017
Objective: The main objective of this study is to know the prevalence and the clinical and epidem... more Objective: The main objective of this study is to know the prevalence and the clinical and epidemiological characteristics of patients with metabolic syndrome (MetS) and premorbid metabolic syndrome (pre-MetS) included in the Identification of the Spanish Population at Cardiovascular and Renal Risk (IBERICAN) study. Materials and Methods: The IBERICAN study is an epidemiological, multicentric observational study carried out in Primary Healthcare Centers from all over Spain, in which an open cohort of subjects with/ without cardiovascular risk factors (CVRF) is constituted. The MetS was defined according to the international criterion based on the presence of at least three of the five criteria of the harmonized definition. Results: A total of 4304 patients were selected; 38.5% patients (95% confidence interval 37.0-40.0) met the MetS criteria. In both groups (MetS and pre-MetS), patients were older (62.3-12.1 vs. 54.4-15.2, P < 0.001). The CVRF analyzed were more frequent in patients with MetS: hypertension (HT) (71.1% vs. 33.0%, P < 0.001), dyslipidemia (65.8% vs. 40.2%, P < 0.001), diabetes mellitus (DM) (38.2% vs. 6.4%, P < 0.001), and obesity (54.8% vs. 21.7%, P < 0.001), and all the cardiovascular diseases (CVDs) analyzed were more prevalent in these patients: stroke (5.1% vs. 3.6%, P = 0.013), heart failure (5.1% vs. 1.6%, P < 0.001), ischemic heart disease (9.8% vs. 5.8%, P < 0.001), and peripheral arterial disease (6.8% vs. 3.7%, P < 0.001). We observed that patients with DM were 6.36 times more likely to present MetS; patients with obesity, 3.81 times; and patients with HT, 2.66 times. Conclusion: Patients with MetS and with pre-MetS presented higher CVRF and increased associated renal and CVD. The prognostic value of these findings must be analyzed in the longitudinal follow-up of the IBERICAN cohort.
Cuestionario diseñado para evaluar las funciones de procesamiento sensorial y funcionamiento ejec... more Cuestionario diseñado para evaluar las funciones de procesamiento sensorial y funcionamiento ejecutivo en niños entre 3 y 11 años. Este cuestionario es potencialmente útil en contextos clínicos para la detección de alteraciones en el neurodesarrollo, en las cuales podría presentarse un déficit en las funciones ejecutivas y en el procesamiento sensorial
Background: e accessibility, versatility and motivation provided by virtual reality technology (V... more Background: e accessibility, versatility and motivation provided by virtual reality technology (VRT) have fostered its rapid expansion as a rehabilitation technique to improve functional mobility. e aim of this study was to investigate the effectiveness of rehabilitation programmes using VRT, specific virtual reality technology (VRT-S) and non-specific virtual reality technology (VRT-NS), to improve functional mobility in individuals aged >60 years versus conventional treatment (CT) or no intervention. Methods: Nine databases (Cochrane Library, Scopus, PEDro, Medline, CSIC, Web of Science, OT Seeker, NGCH and CINAHL) were searched to identify randomised trials up to December 2019. Results of clinical trials that used VRT-S and VRT-NS in rehabilitation were combined, using a random effects model with inverse variance weighting of the studies. GRADE was used to assess the quality of evidence. e protocol was registered in PROSPERO: CRD42019131630. Overall, there was moderate quality...
Emergencias, 2015
espanolObjetivo. Determinar el efecto en los problemas relacionados con la medicacion (PRM) de la... more espanolObjetivo. Determinar el efecto en los problemas relacionados con la medicacion (PRM) de la intervencion de un farmaceutico centrada en la conciliacion de medicacion (CM) en los pacientes 65 anos ingresados en una unidad de corta estancia (UCE) vinculada a un servicio de urgencias hospitalario (SUH). Metodo. Ensayo clinico controlado y aleatorizado de 17 meses de duracion (febrero 2013-junio 2014) realizado en la UCE de un SUH. Se incluyeron pacientes 65 anos con alto riesgo de sufrir PRM. Ciento treinta pacientes fueron asignados aleatoriamente a un grupo control (n = 65) o a un grupo de intervencion (n = 65). El tipo de intervencion realizada fue la CM mediante un farmaceutico especialista. La variable de resultado principal fue la frecuencia de PRM resueltos en ambos grupos. Resultados. Se revisaron un total de 3.081 medicamentos en 130 pacientes con una edad media de 79 (DE 7,6) anos, de los cuales 66 (50,8%) fueron hombres. Se registraron discrepancias en 1.901 (61,7%...
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias, 2015
OBJECTIVES To determine the effect on medication-related problems (MRPs) of a process of medicati... more OBJECTIVES To determine the effect on medication-related problems (MRPs) of a process of medication reconciliation carried out by a specialized pharmacist for patients aged 65 years or older admitted to an emergency department short-stay unit (SSU). MATERIAL AND METHODS Randomized clinical trial of 17 months (February 2013-June 2014) in the SSU of a hospital emergency department. Patients were aged 65 years or older at high risk of MRPs. A total of 130 patients were randomized to a control group (n = 65) or the intervention group (n = 65). The reconciliation process (intervention) was carried out by a specialized pharmacist. The main outcome was the number of MRPs resolved in each group. RESULTS A total of 3081 medications for 130 patients were reviewed. The patients' mean (SD) age was 79 (7.6) years and 66 (50.8%) were men. Discrepancies affecting 1901 medications (61.7%) were detected. The distributions of age, sex, and number of medication discrepancies were similar in the co...
Revista de Salud Ambiental, 2013
Recomendaciones para elaborar el resumen de una comunicación (investigación o experiencia) a un c... more Recomendaciones para elaborar el resumen de una comunicación (investigación o experiencia) a un congreso Recommendations for preparing the abstract of a communication (research or experience) to a conference Recomendações para elaborar um resumo de uma comunicação (pesquisa ou experiência) para um congresso
Journal of Personalized Medicine, 2021
Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EB... more Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EBF for the minimum recommended time of 6 months is challenging. Aims: This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. Method: This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. Results: The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experi...
espanolEl presente trabajo describe la calidad de vida de la poblacion penitenciaria espanola en ... more espanolEl presente trabajo describe la calidad de vida de la poblacion penitenciaria espanola en relacion con la percepcion de su estado de salud. Se evaluo a 882 internos que cumplian pena de prision en centros de las comunidades autonomas de Cataluna, Aragon, Madrid y Castilla la Mancha. Los resultados reflejan una peor percepcion de su calidad de vida y de su salud entre los internos que presentan un menor nivel de estudios, los que han cometido delitos violentos, los reincidentes y con antecedentes familiares de enfermedad mental, los que presentan patologias cardiacas y enfermedad mental. Este trabajo puede aportar datos relevantes sobre la dimension de la calidad de vida en las prisiones, dimension no muy estudiada y pone a su vez de manifiesto la necesidad de seguir investigando las variables inherentes a la situacion de encarcelamiento y su repercusion sobre la calidad de vida y la salud de las personas privadas de libertad. EnglishThis paper describes the quality of life of...
Frontiers in Psychology, 2021
Introduction: Resilience is a multidimensional and dynamic construct associated with positive gro... more Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture.Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first time to practice placement education.Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga (UMA) and Castilla-La Mancha (UCLM) (Spain). Two weeks prior to the beginning of the practice education period, the participants complete...
Children, 2021
This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based i... more This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. ...
International Journal of Environmental Research and Public Health, 2020
The objective of this study was to assess the potential levels of burnout syndrome in occupationa... more The objective of this study was to assess the potential levels of burnout syndrome in occupational therapists in Spain, as well as the risk factors involved in its prevalence. The data were obtained through an online survey. The tool utilised for this purpose was the Maslach Burnout Inventory General Survey (MBI-GS) that takes into consideration the following dimensions: emotional fatigue, depersonalisation and reduction of personal satisfaction. A sociodemographic questionnaire was also utilised. The sample of the study included 758 occupational therapists, 90.8% of whom were women and 9.2% of whom were men. For identifying the variables associated to the presence of burnout, the prevalence was compared through the chi-squared test, and the odds ratios by age were calculated through the binary logistic regression model. We found that 69.4% of the occupational therapists presented burnout syndrome and especially emotional fatigue (63.5%). Likewise, relevant and significant differenc...
Medicina de Familia. SEMERGEN, 2021
OBJECTIVES To know the degree of simultaneous optimal control of diabetes (DM), high blood pressu... more OBJECTIVES To know the degree of simultaneous optimal control of diabetes (DM), high blood pressure (BP) and hypercholesterolemia and determine the associated factors. MATERIAL AND METHOD Cross-sectional descriptive study in diabetic patients 18 years aged or older selected consecutively in primary care centers (PC). Patient data were obtained through access to electronical clinical history. Clinical and analytical variables of interest were registered. Good metabolic control was considered as HbA1c < 7%, good blood pressure control (PA) as values < 140/80 mmHg and good LDL cholesterol control (c-LDL) as values < 100 mg/dL. Bivariate analysis was performed and odds ratio were calculated in a logistic regression model. The study was approved by the San Carlos Clinical Hospital's Clinical Research Ethics Committee (CREC), in Madrid. RESULTS 1420 patients (55.8% male), with an average (SD) age of 70.6 (10.8) years were included. 75.9% were hypertensive patients, and 69.1% dyslipemic. HbA1c values were 6.9 (1.2) %, sistolic BP 135.0 (16.8) mmHg, diastolic BP 75.9 (10.6) mmHg and LDL-cholesterol 93.7 (32.8) mg/dL. Good metabolic control of DM was achieved at 63.0% (95% CI: 60.4-65.5), good control of HTA at 42.6% (95% CI: 40.0-45.2) and good LDL cholesterol control in 61.1% (95% IC: 58.4-63.7) of patients. Good simultaneous control of the three cardiovascular risk factors (CVRF) was reached at 16.1% (95% CI: 14.2-18.1). A positive and independent association (p<0.05) was observed between good simultaneous control of CVRF with age (OR: 1.017) and with personal history of cardiovascular disease (OR: 1.596). CONCLUSIONS The results of our study indicate that a small proportion, less than two out of 10 patients, meet the good control goals recommended by clinical practice guidelines. We found important differences between patients with and without cardiovascular disease.
International Journal of Environmental Research and Public Health, 2020
Increased migration has led to increased prejudice towards immigrant populations. This study aims... more Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student nurses (n = 624), using the Attitude towards Immigration in Nursing scale. Results: Nursing students showed some positive attitudes towards immigration, such as that immigrants should have the right to maintain their customs or that immigrants should have free access to healthcare and education, in contrast to some negative attitudes, such as that crime rates have increased due to immigration or that immigrants receive more social welfare assistance than natives. Significant differences in attitudes were revealed between students from the three universities. Discussion: Training in transcultural nursing is necessary for all nursing students in order to reduce negative attitudes towa...
Children, 2020
The commencement and maintenance of exclusive breastfeeding (EB) are dependent on several mother–... more The commencement and maintenance of exclusive breastfeeding (EB) are dependent on several mother–infant factors. To analyse the prevalence of EB during four different periods and to analyse the factors that can affect its maintenance, we performed a prospective, observational, longitudinal study of 236 mothers and their child between 37 and 42 weeks of gestation and weighing more than 2.5 kg. Four interviews were conducted (T1: on discharge, T2: at 15 days, T3: at one month, T4: at three months). The results showed that EB decreased considerably at three months (69.5% vs. 47.46%). The factors that reduced the risk of abandonment were as following: having decided before giving birth that one wants to offer breastfeeding (T2: odds ratio (OR): 0.02, p = 0.001), T3 (OR: 0.04, p = 0.001) and T4 (OR: 0.07, p = 0.01)) and having previous experience with EB (T2 (OR: 0.36, p = 0.01), T3 (OR: 0.42 p = 0.02) and T4 (OR: 0.51, p = 0.03)). The factors that increased the risk of EB abandonment we...
International Journal of Environmental Research and Public Health, 2020
(1) This review aims to evaluate the effectiveness of treatments with virtual reality systems (VR... more (1) This review aims to evaluate the effectiveness of treatments with virtual reality systems (VRSs) on the functional autonomy of older adults versus conventional treatment. (3) Methods: Systematic review and meta-analysis. An electronic data search was carried out, following the PRISMA statement, up to February 2020. We combined results from clinical trials using VRSs for the improvement of basic and instrumental activities of daily living. The guidelines of the Cochrane Handbook for Systematic Reviews of Interventions were followed for calculations and risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. (4) Results: The final analysis included 23 studies with a population of 1595 participants. A moderate, but clinically significant, effect was found for basic activities of daily living (BADLs), (Standard Medium Deviation, SMD 0.61; 95% CI: −0.15-1.37; P < 0.001). A small effect was found for instrumental ADLs (Instrumental Activities of daily living, IADLs) (SMD −0.34; 95% CI: −0.82-0.15; P < 0.001). Functional ambulation was the BADL which improved the most (SMD −0.63; 95% CI: −0.86, −0.40; P < 0.001). (5) Conclusion: The use of VRSs is an innovative and feasible technique to support and improve the functional autonomy of community-dwelling older adults. Due to the very low quality of the evidence for our main outcomes, the effects of a VRS on the BADLs and IADLs are uncertain. Clinical trials of a higher methodological quality are necessary to increase the level of knowledge of its actual effectiveness.
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Papers by Antonio Segura Fragoso