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Agustí C, Mascort J, Casabona J. [The STI puzzle: Multiple causes, profound impact]. Aten Primaria 2024; 56:102883. [PMID: 38335814 PMCID: PMC10864843 DOI: 10.1016/j.aprim.2024.102883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Affiliation(s)
- Cristina Agustí
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT), Department of Health. Government of Catalonia, Badalona, Barcelona, España; Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, España; Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Barcelona, España.
| | - Juanjo Mascort
- EAP Florida Sud, ICS, L'Hospitalet de Llobregat, Barcelona, España; Catalan Society of Family and Community Medicine (CAMFiC), Barcelona, España; Spanish Society of Family and Community Medicine (semFYC), Barcelona, España; Department of Clinical Sciences, Facultat de Medicina, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - Jordi Casabona
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT), Department of Health. Government of Catalonia, Badalona, Barcelona, España; Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, España; Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Barcelona, España; Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Martínez-Sanz J, Losa-García JE, Orozco N, Alastrué I, Mascort J, Pérez-Elías MJ. Executive summary of the consensus document on the shared care of patients with HIV infection between primary and hospital care. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:102-107. [PMID: 37919199 DOI: 10.1016/j.eimce.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 11/04/2023]
Abstract
The current reality of the diagnosis and treatment of HIV infection justifies a multidisciplinary and coordinated approach between Primary Care and Hospital Care, contemplating bidirectionality and communication between the two care settings. The consensus document, coordinated by the AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC-GeSIDA) and the Spanish Society of Family and Community Medicine (semFYC), was born out of this need. Here, the recommendations of the four sections that comprise it are summarized: the first deals with aspects of prevention and diagnosis of HIV infection; the second contemplates the clinical care of people living with HIV; the third deals with social factors, including legal and confidentiality issues, quality of life, and the role of NGOs; finally, the fourth block addresses bidirectional and shared training/teaching and research.
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Affiliation(s)
- Javier Martínez-Sanz
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain.
| | - Juan E Losa-García
- Unidad de Enfermedades Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | - Ignacio Alastrué
- Centro de Información y Prevención del Sida y otras ITS, Valencia, Spain
| | - Juanjo Mascort
- Centro de Salud La Florida Sud, ICS, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María Jesús Pérez-Elías
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain
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Machlab S, Francia E, Mascort J, García-Iglesias P, Mendive JM, Riba F, Guarner-Argente C, Solanes M, Ortiz J, Calvet X. Risks, indications and technical aspects of colonoscopy in elderly or frail patients. Position paper of the Societat Catalana de Digestologia, the Societat Catalana de Geriatria i Gerontologia and the Societat Catalana de Medicina de Familia i Comunitaria. Gastroenterol Hepatol 2024; 47:107-117. [PMID: 37209916 DOI: 10.1016/j.gastrohep.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/22/2023]
Abstract
Colonoscopy (CS) is an invasive diagnostic and therapeutic technique, allowing the study of the colon. It is a safe and well tolerated procedure. However, CS is associated with an increased risk of adverse events, insufficient preparation and incomplete examinations in the elderly or frail patient (PEA/F). The objective of this position paper was to develop a set of recommendations on risk assessment, indications and special care required for CS in the PEA/F. It was drafted by a group of experts appointed by the SCD, SCGiG and CAMFiC that agreed on eight statements and recommendations, between them to recommend against performing CS in patients with advanced frailty, to indicate CS only if the benefits clearly outweigh the risks in moderate frailty and to avoid repeating CS in patients with a previous normal procedure. We also recommended against performing screening CS in patients with moderate or advanced frailty.
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Affiliation(s)
- Salvador Machlab
- Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Esther Francia
- Servei de Medicina Interna, Unitat de Geriatria, Hospital de Sant Pau, Barcelona, España
| | - Juanjo Mascort
- CAP Florida Sud, Institut Català de La Salut, Hospitalet de Llobregat, España; Departament de Ciències Clíniques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España
| | - Pilar García-Iglesias
- Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España
| | | | - Francesc Riba
- Servei de Geriatria i Cures Pal·liatives, Hospital de la Santa Creu Jesús, Tortosa, España
| | - Carles Guarner-Argente
- Servei Aparell Digestiu, Hospital de Sant Pau, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España
| | - Mònica Solanes
- CAP Onze de Setembre, Institut Català de la Salut, Lleida, España
| | - Jordi Ortiz
- Servei d'Aparell Digestiu, Consorci Sanitari de Terrassa, Terrassa, España
| | - Xavier Calvet
- Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España.
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Agustí C, Cunillera O, Almeda J, Mascort J, Carrillo R, Olmos C, Montoliu A, Alberny M, Molina I, Cayuelas L, Casabona J. Efficacy of an electronic reminder for HIV screening in primary healthcare based on indicator conditions in Catalonia (Spain). HIV Med 2022; 23:868-879. [DOI: 10.1111/hiv.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Agustí
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
| | - Oriol Cunillera
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
| | - Jesús Almeda
- Institut Universitari d'Investigació en Atenció Primària (IDIAP Jordi Gol) Barcelona Spain
- Research Support Unit Primary Health General Directorate of Costa de Ponent Catalan Institute of Health (ICS) Cornellà de Llobregat Spain
| | - Juanjo Mascort
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
- Department of Clinical Sciences Faculty of Medicine University of Barcelona (UB) Barcelona Spain
| | - Ricard Carrillo
- Catalan Society of Family and Community Medicine (CAMFiC) Barcelona Spain
- Spanish Society of Family and Community Medicine (semFYC) Barcelona Spain
| | - Carmen Olmos
- Health Department Catalan Government Barcelona Spain
| | - Alexandra Montoliu
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Unit of Infections and Cancer ‐ Information and Interventions (UNIC ‐ I&I) Cancer Epidemiology Research Program (CERP) Hospitalet de Llobregat Barcelona Spain
| | - Mireia Alberny
- Medical Management of Primary Care Servicies STI/HIV Area Catalan Institute of Health (ICS) Barcelona Spain
| | - Izarbe Molina
- Association of Family and Community Nursing of Catalonia (AIFiCC) Barcelona Spain
| | - Laia Cayuelas
- Centro de Atención Primaria Casanova Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE) Barcelona Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies on Sexually Transmitted Infections and AIDS of Catalunya (CEEISCAT) Department of Health Generalitat of Catalunya Badalona Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) Instituto de Salud Carlos III Madrid Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine Universitat Autónoma de Barcelona Badalona Spain
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Mascort J, Carrillo R, Alastrue I, Zarco J, Aguado C, Rodríguez B, Fransi L, Ramon JL. [Pre-exposure prophylaxis for HIV infection and Primary Care (PA)]. Aten Primaria 2021; 52:137-139. [PMID: 32156335 PMCID: PMC7063139 DOI: 10.1016/j.aprim.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J Mascort
- Grupo deTrabajo sobreVIH-Sida de la semFYC.
| | - R Carrillo
- Grupo deTrabajo sobreVIH-Sida de la semFYC
| | - I Alastrue
- Grupo deTrabajo sobreVIH-Sida de la semFYC
| | - J Zarco
- Grupo deTrabajo sobreVIH-Sida de la semFYC
| | - C Aguado
- Grupo deTrabajo sobreVIH-Sida de la semFYC
| | | | - L Fransi
- Grupo deTrabajo sobreVIH-Sida de la semFYC
| | - J L Ramon
- Grupo deTrabajo sobreVIH-Sida de la semFYC
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Mascort J, Aguado C, Alastrue I, Carrillo R, Fransi L, Zarco J. [HIV and primary care. Think back to AIDS]. Aten Primaria 2017; 49:65-66. [PMID: 28209235 PMCID: PMC6875960 DOI: 10.1016/j.aprim.2017.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 01/17/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- J Mascort
- Grupo de Trabajo sobre VIH-sida de la semFYC.
| | - C Aguado
- Grupo de Trabajo sobre VIH-sida de la semFYC
| | - I Alastrue
- Grupo de Trabajo sobre VIH-sida de la semFYC
| | - R Carrillo
- Grupo de Trabajo sobre VIH-sida de la semFYC
| | - L Fransi
- Grupo de Trabajo sobre VIH-sida de la semFYC
| | - J Zarco
- Grupo de Trabajo sobre VIH-sida de la semFYC
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Agustí C, Montoliu A, Mascort J, Carrillo R, Almeda J, Elorza JM, Aragón M, Casabona J. Missed opportunities for HIV testing of patients diagnosed with an indicator condition in primary care in Catalonia, Spain. Sex Transm Infect 2016; 92:387-92. [PMID: 26888659 DOI: 10.1136/sextrans-2015-052328] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/23/2016] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of HIV testing among patients diagnosed with an indicator condition (IC) for HIV, seen in primary care (PC) in Catalonia, and to estimate the prevalence of HIV infection among those patients. DESIGN Cross-sectional and population-based study in patients aged between 16 and 65 diagnosed with an IC within PC in Catalonia. METHODS Data used in this study were extracted from a large population-based public health database in Spain, the Information System for the Development of Research in Primary Care (SIDIAP). All participants registered in SIDIAP from 1 January 2010 to 31 August 2012 and with a diagnosis of an IC were screened to identify those with an HIV test within the following 4 months. RESULTS 99 426 patients were diagnosed with an IC during the study period. In these patients, there were 102 647 episodes in which at least one IC was diagnosed. An HIV test was performed within 4 months in only 18 515 of the episodes in which an IC was diagnosed (18.5%). The prevalence of HIV infection was 1.46%. Women (OR 1.35, 95% CI 1.30 to 1.39), people aged 50 or over (OR 2.85, 95% CI 2.69 to 3.00) and patients having a single IC (OR 3.59. 95% CI 3.20 to 4.03) had the greatest odds of not having an HIV test. CONCLUSIONS The study highlights the persistence of missed opportunities for HIV testing within PC in Catalonia. Urgent engagement with PC professionals is required in order to increase HIV testing and prevent late HIV diagnoses.
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Affiliation(s)
- Cristina Agustí
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT)-Public Health Agency of Catalonia (ASPC), Badalona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Alexandra Montoliu
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT)-Public Health Agency of Catalonia (ASPC), Badalona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Juanjo Mascort
- Catalan Society of Family and Community Medicine (CAMFiC), Barcelona, Spain Sociedad Española de Medicina Familiar y Comunitaria (semFYC), Barcelona, Spain Departament de Ciències Clíniques, Facultat de Medicina, Universitat de Barcelona (UB), Barcelona, Spain
| | - Ricard Carrillo
- Catalan Society of Family and Community Medicine (CAMFiC), Barcelona, Spain
| | - Jesús Almeda
- Research Support Unit, Primary Care Directorate of Costa de Ponent, Catalan Health Institute, Cornellà de Llobregat, Spain IDIAP Jordi Gol, Barcelona, Spain
| | | | | | - Jordi Casabona
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT)-Public Health Agency of Catalonia (ASPC), Badalona, Spain CIBER Epidemiología y Salud Pública, Barcelona, Spain Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Agustí C, Fernàndez-López L, Mascort J, Carrillo R, Aguado C, Montoliu A, Puigdangolas X, De la Poza M, Rifà B, Casabona J. Attitudes to rapid HIV testing among Spanish General Practitioners. HIV Med 2014; 14 Suppl 3:53-6. [PMID: 24033906 DOI: 10.1111/hiv.12055] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objectives of this study were to investigate the acceptability of rapid HIV testing among general practitioners in Spain and to identify perceived barriers and needs in order to implement rapid testing in primary care settings. METHODS An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15th June and 31st October 2010. RESULTS Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were General Practitioners (GP). Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the results obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). CONCLUSIONS This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
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Affiliation(s)
- C Agustí
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT-ICO), Badalona; CIBER Epidemiología y Salud Pública, Barcelona
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Font C, Mascort J, Márquez M, Esteban C, Sánchez D, Durall N, Pumarola M, Luján A. Paraparesis as initial manifestation of a Prototheca zopfii infection in a dog. J Small Anim Pract 2014; 55:283-6. [PMID: 24502403 DOI: 10.1111/jsap.12188] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A case of protothecosis causing non-ambulatory paraparesis in a dog without clinical evidence of disseminated infection is described. A five-year-old female Labrador retriever was referred with a 10-day history of progressive non-ambulatory paraparesis and lumbar pain as the only physical and neurological abnormalities. Lumbar myelography revealed severe extradural spinal cord compression extending from L4 to L7 vertebrae, and a right hemilaminectomy was performed. Surgical findings included an adherent whitish hard ill-defined mass. Cytology and biopsy results disclosed the presence of algae enclosed in a matrix of chronic inflammatory infiltrate. Culture confirmed the presence of Prototheca species. Neurological improvement occurred within a month, and the dog received antifungal treatment without evidence of clinical disseminated disease for 6 months, but died after a generalised tonic-clonic seizure. Post-mortem examination revealed multiple foci of inflammatory granulomatous infiltrate and algae-like structures in the brain, lumbar intumescence and cauda equina. Prototheca zopfii was identified using molecular biology methods.
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Affiliation(s)
- C Font
- Hospital ARS Veterinaria, Cardedeu 3, 08023, Barcelona, Spain
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Agustí C, Fernández L, Mascort J, Carrillo R, Casabona J. Barreras para el diagnóstico de las infecciones de transmisión sexual y virus de la inmunodeficiencia humana en Atención Primaria en España. Enferm Infecc Microbiol Clin 2013; 31:451-4. [DOI: 10.1016/j.eimc.2012.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 11/23/2012] [Accepted: 12/17/2012] [Indexed: 11/29/2022]
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Agustí C, Fernàndez-López L, Mascort J, Carrillo R, Aguado C, Montoliu A, Puigdengolas X, De La Poza M, Rifà B, Casabona J. Acceptability of rapid HIV diagnosis technology among primary healthcare practitioners in Spain. AIDS Care 2012; 25:544-9. [PMID: 23061873 DOI: 10.1080/09540121.2012.726339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study investigated the acceptability of rapid HIV testing among general practitioners (GP) and aimed to identify perceived barriers and needs in order to implement rapid testing in primary care settings. An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15 June 2012 and 31 October 2010. Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were GP. Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the result obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
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Affiliation(s)
- C Agustí
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Institut català d'Oncologia, Agència Salut Pública de Catalunya, Generalitat de Catalunya, Badalona, Spain.
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Puente D, Cantero FX, Llagostera M, Piñeiro P, Nieto R, Saladich R, Mascort J, Marzo M, Almeda J, Segarra M. A cross-sectional study of the appropriateness of colonoscopy requests in the Spanish region of Catalonia. BMJ Open 2012; 2:e002207. [PMID: 23204141 PMCID: PMC3533100 DOI: 10.1136/bmjopen-2012-002207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Colonoscopies are being requested with increasing frequency in the last few years, as they are used both as a diagnostic and therapeutic procedure in several gastrointestinal diseases. Our purpose is to describe the appropriateness of colonoscopy requests issued both from primary care centres and from hospitals, according to the EPAGE II guidelines (European Panel on the Appropriateness of Gastrointestinal Endoscopy). METHODS AND ANALYSIS Cross-sectional study. Colonoscopy requests issued since January 2011 and received at the endoscopy units of all six reference hospitals serving the primary care centres of the South Metropolitan and Central Catalonia districts will be collected (total=1500 requests). Variables to be collected include gender, date of birth, origin of the request and reference hospital, priority of the procedure, type of clinician requesting the procedure, date and indication of request, abdominal examination performed, anal inspection examination performed, date of last colonoscopy if applicable, diagnosis and date of diagnosis. Using the available information and the EPAGE II website, colonoscopy requests will be assigned as an appropriateness score. The association between the variables collected and the EPAGE II scores will be assessed using a Student's t test and a χ(2) test. A multilevel logistic model will be generated on the factors associated with the appropriateness of the requests. ETHICS AND DISSEMINATION Colonoscopy is a costly procedure and not free from complications. In order to increase cost effectiveness, reduce waiting lists and optimise resources, it is necessary to use tools such as the EPAGE II guidelines, which establish criteria to assess the appropriateness of colonoscopies. The purpose of this study is to describe the current situation and to discuss whether current clinical practice is appropriate. The results of the study will be published in the next few years. In consideration of the ethical principles and methods of the research study, approval was granted for the project.
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Affiliation(s)
- Diana Puente
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | | | - Maria Llagostera
- Gerència Territorial Metropolitana Sud, Institut Català de la Salut, L'Hospitalet del Llobregat, Spain
| | - Pilar Piñeiro
- Servei d'Atenció Primària (SAP) Penedès-Garraf-Llobregat Nord, ABS Penedès Rural, Institut Català de la Salut, Alt Penedès, Spain
| | - Raquel Nieto
- Servei d'Atenció Primària (SAP) Penedès-Garraf-Llobregat Nord, ABS Penedès Rural, Institut Català de la Salut, Alt Penedès, Spain
| | - Rosa Saladich
- EAP Sant Boi de Llobregat-4 (Vinyets), Institut Català de la Salut, Sant Boi de Llobregat, Spain
| | - Juanjo Mascort
- EAP L'Hospitalet de Llobregat-8 (Florida Sud), Institut Català de la Salut, L'Hospitalet de Llobregat, Spain
- Campus Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Spain
| | - Mercè Marzo
- Unitat de Suport a la Recerca Costa de Ponent, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Cornellà, Spain
| | - Jesús Almeda
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Unitat de Suport a la Recerca Costa de Ponent, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Cornellà, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Manel Segarra
- EAP Hospitalet de Llobregat-1 (Centre), Institut Català de la Salut, L'Hospitalet de Llobregat, Spain
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Millán Y, Mascort J, Blanco A, Costa C, Masian D, Guil-Luna S, Pumarola M, Martin de las Mulas J. Hypomyelination in three Weimaraner dogs. J Small Anim Pract 2010; 51:594-8. [DOI: 10.1111/j.1748-5827.2010.00997.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Andreu García M, Marzo M, Mascort J, Quintero E, García-Alfonso P, López-Ibor C, Castells A, Segura PP. [Prevention of colorectal cancer]. Aten Primaria 2009; 41:127-8. [PMID: 19304348 DOI: 10.1016/j.aprim.2008.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Accepted: 12/22/2008] [Indexed: 12/24/2022] Open
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Bolíbar B, Pareja C, Astier-Peña MP, Morán J, Rodríguez-Blanco T, Rosell-Murphy M, Iglesias M, Juncosa S, Mascort J, Violan C, Magallón R, Apezteguia J. Variability in the performance of preventive services and in the degree of control of identified health problems: a primary care study protocol. BMC Public Health 2008; 8:281. [PMID: 18691407 PMCID: PMC2533323 DOI: 10.1186/1471-2458-8-281] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Accepted: 08/08/2008] [Indexed: 11/18/2022] Open
Abstract
Background Preventive activities carried out in primary care have important variability that makes necessary to know which factors have an impact in order to establish future strategies for improvement. The present study has three objectives: 1) To describe the variability in the implementation of 7 preventive services (screening for smoking status, alcohol abuse, hypertension, hypercholesterolemia, obesity, influenza and tetanus immunization) and to determine their related factors; 2) To describe the degree of control of 5 identified health problems (smoking, alcohol abuse, hypertension, hypercholesterolemia and obesity); 3) To calculate intraclass correlation coefficients. Design Multi-centered cross-sectional study of a randomised sample of primary health care teams from 3 regions of Spain designed to analyse variability and related factors of 7 selected preventive services in years 2006 and 2007. At the end of 2008, we will perform a cross-sectional study of a cohort of patients attended in 2006 or 2007 to asses the degree of control of 5 identified health problems. All subjects older than16 years assigned to a randomised sample of 22 computerized primary health care teams and attended during the study period are included in each region providing a sample with more than 850.000 subjects. The main outcome measures will be implementation of 7 preventive services and control of 5 identified health problems. Furthermore, there will be 3 levels of data collection: 1) Patient level (age, gender, morbidity, preventive services, attendance); 2) Health-care professional level (professional characteristics, years working at the team, workload); 3) Team level (characteristics, electronic clinical record system). Data will be transferred from electronic clinical records to a central database with prior encryption and dissociation of subject, professional and team identity. Global and regional analysis will be performed including standard analysis for primary health care teams and health-care professional level. Linear and logistic regression multilevel analysis adjusted for individual and cluster variables will also be performed. Variability in the number of preventive services implemented will be calculated with Poisson multilevel models. Team and health-care professional will be considered random effects. Intraclass correlation coefficients, standard error and variance components for the different outcome measures will be calculated.
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Affiliation(s)
- Bonaventura Bolíbar
- Institut d'Investigació en Atenció Primària Jordi Gol, C/Gran Via de Corts Catalanes 587 àtic, 08007 Barcelona, Spain.
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Pugliese M, Carrasco JL, Geloso MC, Mascort J, Michetti F, Mahy N. Gamma-aminobutyric acidergic interneuron vulnerability to aging in canine prefrontal cortex. J Neurosci Res 2004; 77:913-20. [PMID: 15334609 DOI: 10.1002/jnr.20223] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aged dog is considered a promising model for examining molecular and cellular processes involved in a variety of human neurological disorders. By using the canine counterpart of senile dementia of the Alzheimer's type (ccSDAT), we investigated the specific vulnerability of the gamma-aminobutyric acid (GABA) cortical subset of interneurons, characterized by their calcium-binding protein content, to neuronal death. Dogs representing a large variety of breeds were classified into three groups: young control, aged control, and ccSDAT. In all dogs, the general distribution and cell typology of parvalbumin-, calretinin-, and calbindin-positive neurons were found to be similar to those in the human. As in Alzheimer's disease patients, neurons displaying parvalbumin or calretinin immunoreactivity were resistant and the calbindin-positive ones depleted. Together with aging, amyloid deposition in its early phase (stage II) participates in this specific neuronal death, but with a lower potency. In conclusion, our data provide evidence that preservation of GABAergic cortical interneurons has to be focused on the early stage of beta-amyloid deposition. We also demonstrate the usefulness of dogs of all breeds for investigating the early phases of human brain aging and Alzheimer's disease.
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Affiliation(s)
- M Pugliese
- Unitat de Bioquímica, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
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Abstract
A 14-month-old female crossbreed dog with leishmaniasis, receiving allopurinol, was presented with acute paraplegia. A diagnosis of renal failure with pelvic limb lower motor neuron signs was made and the dog was euthanased. Histopathological examination demonstrated leukocytoclastic vasculitis in multiple organs. Malacia and haemorrhage affecting the spinal cord was associated with multiple foci of vasculitis within the nervous tissue. Rupture and thrombosis of inflamed vessels caused haemorrhage in the spinal cord and subsequent paralysis.
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Affiliation(s)
- A Font
- Hospital Ars Veterinaria, Carrer Cardedeu 3, 08023 Barcelona, Spain
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20
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Abstract
A six-year-old male crossbred dog was presented with clinical signs of right-sided heart failure. Echocardiography demonstrated a pericardial effusion with cardiac tamponade, while pericardiocentesis and cytology did not reveal any evidence of malignancy. Pericardial drainage was performed twice over a period of three months to resolve haemodynamic impairment before a subtotal pericardiectomy was performed. Biopsy of parietal and visceral pericardium confirmed the diagnosis of pericardial mesothelioma. Intrathoracic cisplatin combined with intravenous doxorubicin were administered, although neutropenia, mild azotaemia and alopecia were noted as adverse reactions to these drugs. Intravenous cisplatin was repeated 45 days later after the signs of nephrotoxicity had resolved. The dog was still free of disease after 27 months. Intrathoracic chemotherapy after pericardiectomy and early diagnosis are recommended to improve prognosis, having achieved long-term survival in the present case.
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Affiliation(s)
- J M Closa
- Hospital Ars Veterinaria, Barcelona, Spain
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21
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Puigdengolas X, Alberny M, Carrillo R, Mendive JM, Mascort J. [HIV: preventive load and primary care intervention]. Aten Primaria 1998; 22:3-4. [PMID: 9741154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Abstract
Four dogs infected with Leishmania had proliferative lesions on the mucosae of the penis, tongue, oral cavity, prepuce, or nose. These mucosal, nodular lesions produced by parasites of the genus Leishmania have not been described previously in the dog. Leishmaniasis should be considered in the differential diagnosis of tumor-like lesions of mucous membranes.
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Affiliation(s)
- A Font
- Hospital Ars Veterinaria, Barcelona, Spain
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Ruberte J, Añor S, Carretero A, Vilafranca M, Navarro M, Mascort J, Pumarola M. Malformations of the vertebral bodies and the ribs associated to spinal dysraphism without spina bifida in a Pekingese dog. Zentralbl Veterinarmed A 1995; 42:307-13. [PMID: 8578905 DOI: 10.1111/j.1439-0442.1995.tb00382.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A Pekingese dog with hemivertebrae, rib malformations and spinal cord dysraphism without spina bifida was presented. Two types of hemivertebrae were seen: bilateral and unilateral. Thoracic hemivertebrae were associated with fused ribs and rudimentary ribs. Spinal dysraphism consisted of polycavitary syringomyelia in the dorsal and lateral funiculi, hydromyelia and anomalies of the dorsal median septum and median fissure, associated to lumbar and sacral hemivertebrae. Cauda equina agenesia was also present. To conclude, the dog showed two malformations from different embryonic origins. Vertebral and rib malformations are of mesodermic origin and spinal dysraphism is of ectodermic origin. A possible common mechanism responsible for both anomalies is discussed.
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Affiliation(s)
- J Ruberte
- Department of Pathology and Animal Production, Veterinary School, Autonomous University of Barcelona, Hospital Ars Veterinaria, Spain
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Puig J, Vilafranca M, Font A, Closa J, Pumarola M, Mascort J. Acute intrinsic renal failure and blood coagulation disorders after a snakebite in a dog. J Small Anim Pract 1995; 36:333-6. [PMID: 7474966 DOI: 10.1111/j.1748-5827.1995.tb02942.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Acute intrinsic renal failure was diagnosed in a two-year-old, male, German shepherd dog following a Vipera aspis bite. Clinical signs included depression, hypersalivation, vomiting, tachypnoea, abdominal pain, splenomegaly, oliguria with haematuria and haemolysed serum. Leucocytosis with a shift to the left, thrombocytopenia, prolonged coagulation times (activated partial thromboplastin time, prothrombin time and thrombin time), hypofibrinogenaemia, azotaemia and hyposthenuria were the most prominent laboratory abnormalities. Histopathological evaluation of the kidneys showed a discrete glomerular hypercellularity, mesangial lysis and renal tubules filled with many hyaline casts and some necrotic cells.
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Affiliation(s)
- J Puig
- Hospital Ars Veterinaria, Barcelona, Spain
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Abstract
A posterior mediastinal paraganglioma is described in a five-year-old female collie showing paralysis of the hindlimbs. The mass was observed radiographically and a myelogram confirmed a spinal cord compression at the thoracic level. Histological examination of the mass diagnoses a paraganglioma which was confirmed by histochemical and immunohistochemical studies. This is compared with paraganglioma found in man.
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Affiliation(s)
- J Mascort
- Hospital Ars Veterinaria, Barcelona, Spain
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Affiliation(s)
- J Closa
- Hospital Ars Veterinaria, Barcelona, Spain
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Abstract
One dog with visceral leishmaniasis associated with monoclonal gammopathy is described. Most dogs with visceral leishmaniasis present with hyperproteinemia due to a polyclonal gammopathy, but the possibility of monoclonal gammopathy must be considered. Because dogs accompany their owners when they travel, the diagnosis of leishmaniasis should be considered if an animal with monoclonal gammopathy has visited an area where the disease is endemic. The observation of Leishmania in the macrophages of a bone marrow, lymph node smear, or skin biopsy specimen is diagnostic.
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Affiliation(s)
- A Font
- Hospital ARS VETERINARIA, Barcelona, Spain
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Font A, Gines C, Closa JM, Mascort J. Visceral leishmaniasis and disseminated intravascular coagulation in a dog. J Am Vet Med Assoc 1994; 204:1043-4. [PMID: 8045804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A dog being treated with meglumine antimonate for leishmaniasis was examined because of anorexia, vomiting, diarrhea, weakness, and signs of abdominal discomfort. The history, physical examination findings, clinicopathologic abnormalities, and results of coagulation testing were compatible with a diagnosis of renal failure and disseminated intravascular coagulation. The signs of abdominal pain were most likely a result of microcirculatory obstruction. The cause of disseminated intravascular coagulation in this dog was not determined; however, visceral leishmaniasis could have been associated.
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Affiliation(s)
- A Font
- Hospital Ars Veterinaria, Barcelona, Spain
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Affiliation(s)
- A Font
- Ars Veterinaria Hospital, Barcelona, Spain
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Affiliation(s)
- L Ferrer
- Department of Histology and Pathology, Veterinary School, Universidad Autóonoma, Barcelona, Spain
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