Diagnosis and home follow-up of patients affected by COVID-19 is being approached by primary health care professionals through telephone consultations. This modality of teleconsultation allows one to follow the evolution of patients and attend early to possible complications of the disease. The purpose of the study was to analyze the evolution of a cohort of patients with suspected SARS-CoV-2 disease followed by primary care professionals and to determine the factors that are associated with hospital admission. A prospective cohort study was carried out on 166 patients selected by consecutive sampling that showed symptoms compatible with COVID-19. The follow-up was approached via telephone for 14 days analyzing hospitalization and comorbidities of the patients. There were 75% of the hospitalized patients that were male (p = 0.002), and 70.8% presented comorbidities (p < 0.001). In patients with diabetes, the risk of hospitalization was 4.6-times larger, in hypertension patients it was 3.3-times, those suffering from renal insufficiency 3.8-times, and immunosuppressed patients 4.8-times (IC 95%: 1.9–11.7). In 86.7% of the cases, clinical deterioration was diagnosed in the first seven days of the infection, and 72% of healing was reached from day seven to fourteen. Monitoring from primary care of patients with COVID-19 allows early diagnosis of clinical deterioration and detection of comorbidities associated with the risk of poor evolution and hospital admission.

The Hospital Care Unit for individuals with intellectual disabilities and behavioral disorders provides comprehensive care in a controlled and video-surveyed facility that minimizes access to potentially manipulative materials during aggression or pica episodes. The patient was admitted to the unit due to issues including ingestion of non-edible fluids, aggression toward staff and other patients, and self-injury. All patients participated in occupational activities led by an occupational therapist from Monday to Friday from 10 a.m. to 11:30 a.m. In addition, creative workshops such as cinema forums and cooking workshops were held on some afternoons. During the analyzed period from January to June 2022, the patient experienced three episodes of pica, 14 assaults toward staff, and eight toward peers. All of these incidents occurred after dinner and were triggered either by the inability to eat dessert or by refusal to brush teeth afterward. In our case study, the implementation of creative workshops such as cooking had a positive effect on decreasing instances of pica and aggression. These workshops slightly improved participation in other occupational therapy activities and stabilized the patient’s behavior, increasing the likelihood of her being able to return to her habitual residence.

Mortality rates among pluripathological patients are significantly higher in the hospital setting, with advanced age and dependence on certain vital functions the main clinical aspects. Other features involved in the care, such as the loss of autonomy and social problems, have important ethical implications. The aim of this article is to analyze the health problems and the functional and social situation of chronic patients after hospital admission in order to determine their care needs and the ethical implications these might have. For this, a cross-sectional descriptive study is being carried out with a sample of 111 chronic pluripathological patients admitted to the internal medicine service and discharged later. Overall, 96.6% of the patients in the sample were dependent, 91.7% had social problems or were at social risk and 36.9% had cognitive impairment. Among dependent patients, 59.4% had social problems (p = 0.029), 19.2% lived alone (p = 0.13), and in 73.3% of cases the housing was inadequate (p = 0.47). Among those with cognitive impairment, 79.5% of patients had social problems (p = 0.001), and 10.3% lived alone (p = 0.038). The results of the study confirm the presence of dependence and social problems at hospital discharge in a high proportion of chronic patients. Planning their care can lead to ethical conflicts related to the use of information technologies, which are destined to promote the patients’ autonomy, and to the social problems associated with the illness.

ObjectivesTo assess the expected learning outcomes of medical humanities subjects in medical studies curricula. To connect those expected learning outcomes with the types of knowledge to be acquired in medical education.MethodsMeta-review of systematic and narrative reviews. Cochrane Library, MEDLINE (Pubmed), Embase, CINAHL, and ERIC were searched. In addition, references from all the included studies were revised, and the ISI Web of Science and DARE were searched.ResultsA total of 364 articles were identified, of which six were finally included in the review. Learning outcomes describe the acquisition of knowledge and skills to improve the relationship with patients, as well as the incorporation of tools to reduce burnout and promote professionalism. Programs that focus on teaching humanities promote diagnostic observation skills, the ability to cope with uncertainty in clinical practice, and the development of empathetic behaviors.ConclusionThe results of this review show heterogeneity in the teaching of medical humanities, both in terms of content and at the formal level. Humanities learning outcomes are part of the necessary knowledge for good clinical practice. Consequently, the epistemological approach provides a valid argument for including the humanities in medical curricula.

Aim: to analyze the efficacy of an educational online intervention focused on lifestyle changes in reducing body weight from baseline to 6 months in the pre-diabetic population of 18–45 years old in Extremadura (Spain). Methods: a single-blind, multicenter randomized parallel-comparison trial with two intervention groups in a 1:1 ratio will be carried out. Participants will be randomly assigned to intervention A or B with 37 cases in each group according to inclusion criteria of being enrolled or working at Extremadura University, scoring >7 points on the Findrisc test and not having diagnosed diabetes mellitus or physical disabilities. Intervention-A group will have access to online information about healthy diet and exercise. Intervention-B group will have access to a six-session educational program regarding behavioral changes in diet and exercise habits. They will complete follow-up activities and have a personal trainer and motivation. The primary outcome will be identifying changes in body weight from baseline to 1 and 6 months and between groups. The secondary outcomes will be accomplishing regular physical activity (>30 min/day or >4 h/week), decreasing sugary food intake or avoiding it altogether, increasing vegetable/fruit intake and lowering HbA1c levels to non-diabetic status when necessary.

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Diabetic foot is a severe complication of diabetes, with serious consequences such as amputations and high mortality rates as well as elevated economic costs. To evaluate whether or not nursing staff follow the recommendations of national and international organizations regarding diabetic foot prevention, a cross-sectional and observational descriptive study was carried out using an ad hoc self-administered questionnaire validated by seven experts, with a Cronbach’s alpha of 0.731. Of the total 164 participants, 157 met the inclusion criteria. Findings showed that 96.58% asked their patients to remove their footwear, 78.34% performed thorough examinations, and 80.25% assessed the risk of developing diabetic foot. Participants educated their patients in self-care and evaluated skills related to diabetic foot control either frequently (84.07%) or very frequently (62.42%), and only 19.11% of them carried out group activity workshops. Significant statistical differences were found in the performance of activities in the groups by participant age intervals, whether working in primary health care or a hospital, having specific training, and the participant’s DM patient ratio. We obtained high percentages of compliance in the assessed activities in comparison to other studies. Nevertheless, we believe it is necessary to encourage screening in specialized care, skills testing, and the implementation of educational group activities and workshops.

Onychomycosis is one of the most common foot conditions. Mixed onychomycosis and onychomycosis caused by non-dermatophyte moulds are increasing in incidence, especially in vulnerable populations, hence the importance of this study, which presents the prevalence of onychomycosis in a population of homeless people, comparing the findings with a sample of a well-resourced population. The total sample consisted of 70 participants, divided into two separate groups, a homeless population and a second group in which we included people attending a private clinic. The average age of the sample is [49.19 ± 28.81] with an age range of 18 to 78 years). In the homeless group, the most prevalent infectious agents were non-dermatophyte fungi, with a total of 48%, compared to 28% in the group housed. The most common site of infection in both groups was the nail of the first finger. We, therefore, conclude that there is a difference in the infecting agent in the homeless population and the population with homes.