Aurelio Luna Maldonado

Actitudes de los médicos de familia hacia los derechos de los pacientes

Objetivo Conocer las actitudes de los medicos de familia hacia los derechos del paciente y las variables socioprofesionales que pueden influir en ellas. Diseno Descriptivo, transversal, basado en la aplicacion de un cuestionario. Emplazamiento Atencion primaria de Murcia. Participantes En total, 227 medicos de familia. Intervenciones El cuestionario se envio por correo e incluia variables socioprofesionales, asi como una valoracion de la satisfaccion profesional y de la importancia de los derechos del paciente (mediante escalas tipo Likert). Mediciones principales y resultados Los profesionales conceden la mayor valoracion al derecho a una asistencia adecuada en el plano humano (4,86; intervalo de confianza [IC] del 95%, 4,81-4,91), mientras que el acceso a la historia clinica es el derecho menos valorado (3,91; IC del 95%, 3,76-4,05). La media de la satisfaccion total es de 2,79 (IC del 95%, 2,71-2,87). Se observan diferencias estadisticamente significativas en la valoracion de los derechos de los pacientes segun las distintas caracteristicas sociolaborales y la satisfaccion profesional. Hay una correlacion significativa entre la valoracion total de los derechos y la satisfaccion profesional global (p = 0,039). Conclusiones La valoracion global de la importancia que conceden los medicos de familia a los derechos de los pacientes es muy alta. Los medicos de mas edad, que trabajan en el ambito urbano, con menos tarjetas sanitarias asignadas, en centros docentes y con una mayor satisfaccion profesional, conceden una mayor importancia a los derechos de los pacientes.

Asociación entre victimización por bullying y consumo de sustancias entre la población universitaria de España

The purpose of this study is to analyze the prevalence and association between victimization and substance use among the university population in the southeast of Spain in a sample of 543 randomly selected college students (405 females and 138 males with an average age of 22.6 years). As a cross-sectional study, data was collected through an anonymous survey to assess victimization and drug use over the last 12 months. Results indicated that 62.2% of college students reported bullying victimization and 82.9% consumed some type of psychoactive substance, and found a statistically significant association between both variables measured. Additionally, logistic regression analysis confirmed the association between psychoactive substance use and different types of victimization. Our findings confirm the need for prevention to prevent this relation between victimization and substance use.

Epidemiology, Evolution, and Long‐Term Survival of Alcoholic Cirrhosis Patients Submitted to Liver Transplantation in Southeastern Spain

BACKGROUND Alcoholic cirrhosis (AC) is a common cause of death among individuals abusing alcohol. In the last resort, liver transplantation (LT) is considered the only solution to save the patients life, generating socioeconomic and public health problems. Clinical and sociodemographic characteristics, rejection frequency, and short- and long-term graft survival are not well known in end-term AC patients undergoing LT. The aim was to determine the sociodemographic and clinical characteristics, their incidence in LT, main pre- and posttransplant complications, and short- and long-term post-transplant graft survival in AC patients in southeastern Spain. METHODS The medical records of 1,026 patients who underwent LT over the last 23 years were retrospectively reviewed, and demographic data and posttransplant survivals were analyzed and compared. Biochemical characteristics, major pre- and posttransplant complications and short- and long-term survivals were analyzed in a total of 398 male patients with AC undergoing LT. RESULTS AC and viral cirrhosis are the main indications for LT in our study. Mostly represented in our study are AC men without associated viral infections with a mean age of 53.06 years. Main pretransplant complications in AC patients are ascites (78.3%) and encephalopathy (43.5%), while acute graft rejection is the most common liver posttransplant complication (26.6%), nevertheless with low graft loss frequency (1.1%). AC and autoimmune cirrhosis show the best posttransplant survival in both the short and long term. Patients with AC included on the waiting list for LT were Child-Pugh class B (52.1%) and Model for End-Stage Liver Disease score of 10 to 19 (71.2%). The highest percentage of AC patient survival was observed at 1 year posttransplant (81.2%) and progressively decreased over time up to 10 years posttransplant (69.6%). Pretransplant complications such as ascites and encephalopathy did not have an influence on the percentage of posttransplant survivals, although better survival rates were observed in nonviral AC patients. CONCLUSIONS AC without viral infections is the main indication for LT in southeastern Spain although its frequency has decreased in last decade. AC is a good indication for LT for its high survival rate and few posttransplant complications. Despite having a high percentage of pretransplant complications (ascites and encephalopathy) but does not appear to influence survivals being observed posttransplant survival rates above those expected. Conversely, viral infections in the patient with AC decrease patient survivals. The main future goals are design new strategies to detect, treat, and reduce AC frequency in our population and know alcoholic recidivism rate posttransplant in our population.

Determinación de un eje hipotético en registros incompletos. Su utilidad para la individualización de las marcas de mordeduras humanas

Resumen El objetivo del presente trabajo es analizar la posibilidad de identificar las marcas de dientes humanos a partir de un analisis metrico basado en los angulos que forman los incisivos con respecto a un eje intercanino hipotetico. El analisis de la validez de este metodo utiliza el trazado anteriormente citado teniendo en cuenta diferentes zonas anatomicas y diferentes proyecciones fotograficas. Para el estudio, se registro con cera la mordida normal de 50 estudiantes voluntarios; dicha impresion se utilizo para el montaje de los moldes de yeso en un articulador. Con este articulador se infligieron tres mordeduras a un muneco cubierto de plastilina en tres zonas diferentes (hombro, antebrazo y mano) y se tomaron fotografias en diferentes angulos. Los resultados fueron analizados estadisticamente con el fin de establecer una correlacion con los valores reales de las mediciones de cada modelo de yeso (control). La aplicacion de lo que denominamos “el metodo del borde incisal” para el estudio de las distintas proyecciones fotograficas de marcas de dientes hechas en diferentes zonas anatomicas nos muestran unos resultados con una variacion minima entre los valores de control y el problema (nivel de confianza del 95%). Se aprecian diferencias significativas solo en el caso de los incisivos laterales (42 y 22).