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Perez Morales D.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Naval Pulido E.,Sociedad Espanola de Medicos de Atencion Primaria SEMERGEN | Martin J.A.,Sociedad Espanola de Medicos Generales y de Familia SEMG | Castineiras Fernandez J.,Hospital Universitario Virgen Macarena | Cozar Olmo J.M.,Hospital Universitario Virgen Of Las Nieves
Atencion Primaria | Year: 2010

Benign prostatic hyperplasia (BPH) is a high prevalence condition in men over 50 years that requires continued assistance between primary care and urology. Therefore, consensus around common referral criteria was needed to guide and support both levels. Medical history, symptom assessment with International Prostate Symptom Score (IPSS) questionnaire, digital rectal examination and prostate-specific antigen (PSA) measurement are diagnostic tests available for general practitioners that allow setting a correct BPH diagnose. Patients with an IPSS<8 should be monitored by evaluating them annually. Treatment with α-blockers and an evaluation at the first and third month is recommended in patients with an IPSS 8-20 and if the prostate is small, if the prostate size is large treatment with α-blockers or 5α-reductase inhibitors and evaluation at the third and six month is recommended, and in patients with a large prostate and a PSA >1.5 ng/ml combined treatment and evaluation at the first and sixth month is recommended. Some clear criteria for referral to urology are established in this document, which help in the management of these patients. Those patients with BPH who do not show any improvement at the third month of treatment with α-blockers, or the sixth month with 5α-reductase inhibitors, will be referred to urology. Patients will also be referred to urology if they have lower urinary tract symptoms, a pathological finding during rectal examination, IPSS>20, PSA>10 ng/ml or PSA>4 ng/ml and free PSA<20% or if they are <50 years with suspected BHP, or if they have any urological complication. © 2009 Elsevier España, S.L. All rights reserved. Source


Agusti C.,Institute Catala dOncologia | Agusti C.,CIBER ISCIII | Fernandez-Lopez L.,Institute Catala dOncologia | Fernandez-Lopez L.,CIBER ISCIII | And 13 more authors.
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV | Year: 2013

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. © 2013 Copyright Taylor and Francis Group, LLC. Source


Orozco D.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Basora J.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Garcia L.,Novo Nordisk AS | Paz S.,Outcomes10 | Lizan L.,Outcomes10
Atencion Primaria | Year: 2013

Aims: To assess the current situation of the inspection validation of prescriptions (IVP) in Spain since the introduction of the electronic procedure (EP) from the healthcare professionals' perspective. Design: Observational, cross sectional study, in two phases; combining qualitative and quantitative techniques. Setting: Primary Care (PC), Secondary Care (SC) and the health care management sector. Participants: Primary care physicians (PCPs), endocrinologists, medical inspectors, pharmacists and health Authorities of Autonomous Communities (AACC). Method: Semi-structured surveys and Computer Assisted Telephone Interviewing. Results: The IVP presents three modalities in Spain: manual, electronics and electronics linked to electronic prescription. The participants of the same level of management perceive in a similar way the purpose of the IVP, and there exist differences between the different levels of interviewed managers. Differences exist in the situation of EP between AACC. It is more implemented in primary care (PC) than in specialized (63% vs 37%), with similar degree in urban and rural areas. Six of 17 AACC presented a public access to the corresponding legislation. Conclusion: The IVP is perceived as a tool for the economic control in expenditure on drugs and as additional administrative load in PC. The rhythm of implementation of EP differs between AACC as well as the access to the regulation. © 2012 Elsevier España, S.L. All rights reserved. Source


Tranche S.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Brotons C.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Pascual de la Pisa B.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | Macias R.,Sociedad Espanola de Medicina de Familia y Comunitaria semFYC | And 3 more authors.
Gynecological Endocrinology | Year: 2016

Objectives: The objective of this study is to evaluate the effects of a soy drink with a high concentration of isoflavones (ViveSoy®) on climacteric symptoms. Methods: An open-label, controlled, crossover clinical trial was conducted in 147 peri- and postmenopausal women. Eligible women were recruited from 13 Spanish health centers and randomly assigned to one of the two sequence groups (control or ViveSoy®, 500 mL per day, 15 g of protein and 50 mg of isoflavones). Each intervention phase lasted for 12 weeks with a 6-week washout period. Changes on the Menopause Rating Scale and quality of life questionnaires, as well as lipid profile, cardiovascular risk and carbohydrate and bone metabolism were assessed. Statistical analysis was performed using a mixed-effects model. Results: A sample of 147 female volunteers was recruited of which 90 were evaluable. In both sequence groups, adherence to the intervention was high. Regular consumption of ViveSoy® reduced climacteric symptoms by 20.4% (p = 0.001) and symptoms in the urogenital domain by 21.3% (p < 0.05). It also improved health-related quality life by 18.1%, as per the MRS questionnaire (p <0.05). Conclusion: Regular consumption of ViveSoy® improves both the somatic and urogenital domain symptoms of menopause, as well as health-related quality of life in peri- and postmenopausal women. © 2016 Taylor & Francis. Source

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