Person:
Guillén Grima, Francisco

person.page.identifierURI

https://academica-e.unavarra.es/handle/2454/49219

Last Name

Guillén Grima

First Name

Francisco

person.page.departamento

Ciencias de la Salud

ORCID

0000-0001-9749-8076

person.page.upna

352

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Now showing 1 - 10 of 65

Open Access
The urgent surgery elderly mortality risk score: a simple mortality score
(Arán Ediciones, 2019) Eguaras Córdoba, Inés; Herrera Cabezón, Javier; Sánchez Acedo, Pablo; Galbete Jiménez, Arkaitz; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Introduction: an increasing number of elderly patients undergo urgent abdominal surgery and this population has a higher risk of mortality.The main objective of the study was to identify mortality-associated factors in elderly patients undergoing abdominal surgery and to design a mortality scoring tool, the Urgent Surgery Elderly Mortality risk score (the USEM score). Patients and methods: this was a retrospective study using a prospective database. Patients > 65 years old that underwent urgent abdominal surgery were included. Risk factors for 30-day mortality were identified using multivariate regression analysis and weights assigned using the odds ratios (OR). A mortality score was derived from the aggregate of weighted scores. Model calibration and discrimination were judged using the receiver operating characteristics curves and the Hosmer-Lemeshow test. Results: in the present study, 4,255 patients were included with an 8.5% mortality rate. The risk factors significantly associated with mortality were American Society of Anesthesiologists (ASA) score, age, preoperative diagnosis (OR: 37.82 for intestinal ischemia, OR: 5.01 for colorectal perforation, OR: 6.73 for intestinal obstruction), surgical wound classification and open or laparoscopic surgery. A risk score was devised from these data for the estimation of the probability of survival in each patient. The area under the ROC curve (AUROC) for this score was 0.84 (95% CI: 0.82-0.86) and the AUROC correct was 0.83 (0.81-0.85). Conclusions: a simple score that uses five clinical variables predicts 30-day mortality. This model can assist surgeons in the initial evaluation of an elderly patient undergoing urgent abdominal surgery.
Open Access
Identificación de problemas y propuestas para mejorar la atención de las urgencias extrahospitalarias en Navarra: un estudio Delphi
(Gobierno de Navarra, 2011) Pérez Ciordia, Ignacio; Brugos Larumbe, Antonio; Guillén Grima, Francisco; Fernández Martínez, C.; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
Fundamento. Las urgencias extrahospitalarias de Navarra sufrieron modificaciones en la organización hace dos años, destacando la creación del servicio de urgencias rural (SUR) que coexiste geográficamente con el servicio normal de urgencias. El objetivo del estudio es conocer la opinión de expertos sobre los problemas y las recomendaciones de mejora que afectan a las urgencias extrahospitalarias. Metodología. Se realizó un estudio Delphi con la participación de 37 expertos (médicos y enfermeras). Por medio del correo electrónico se realizan 3 rondas de cuestionarios sucesivos. El último cuestionario identifica el grado de acuerdo con las ideas del grupo y se identifican los 15 problemas y recomendaciones más relevantes, seleccionando aquellas ideas que alcancen, al menos, el 50 % de acuerdo y una prioridad superior al percentil 25. Agrupamos las ideas mediante análisis de clúster jerárquico. Resultados. Se identifican 4 clúster de problemas, destacando entre ellos que «la población utiliza las urgencias para patología banal, como una consulta más» con una puntuación de 297 puntos. De las recomendaciones, con 3 clúster identificados, destaca la «necesidad de diseñar un plan estratégico de atención a las urgencias con unos recursos acorde a las necesidades» (310 puntos de prioridad) y «enviar mensajes claros a la población sobre uso correcto de urgencias» (192 puntos de prioridad). Conclusión. El método Delphi identifica problemas y áreas de mejora a través del consenso.
Open Access
Clinical impact of rapid bacterial microbiological identification with the MALDI-TOF MS
(MDPI, 2023) Uzuriaga, Miriam; Leiva, José; Guillén Grima, Francisco; Rua, Marta; Yuste, José R.; Ciencias de la Salud; Osasun Zientziak
Rapid microbiological reports to clinicians are related to improved clinical outcomes. We conducted a 3-year quasi-experimental design, specifically a pretest–posttest single group design in a university medical center, to evaluate the clinical impact of rapid microbiological identification information using MALDI-TOF MS on optimizing antibiotic prescription. A total of 363 consecutive hospitalized patients with bacterial infections were evaluated comparing a historical control group (CG) (n = 183), in which the microbiological information (bacterial identification and antibiotic susceptibility) was reported jointly to the clinician between 18:00 h and 22:00 h of the same day and a prospective intervention group (IG) (n = 180); the bacterial identification information was informed to the clinician as soon as it was available between 12:00 h and 14:00 h and the antibiotic susceptibility between 18:00 h and 22:00 h). We observed, in favor of IG, a statistically significant decrease in the information time (11.44 h CG vs. 4.48 h IG (p < 0.01)) from the detection of bacterial growth in the culture medium to the communication of identification. Consequently, the therapeutic optimization was improved by introducing new antibiotics in the 10–24 h time window (p = 0.05) and conversion to oral route (p = 0.01). Additionally, we observed a non-statistically significant decrease in inpatient mortality (global, p = 0.15; infection-related, p = 0.21) without impact on hospital length of stay. In conclusion, the rapid communication of microbiological identification to clinicians reduced reporting time and was associated with early optimization of antibiotic prescribing without worsening clinical outcomes.
Open Access
Análisis de la calidad de la información proporcionada a los pacientes por parte de unidades clínicas especializadas ambulatorias mediante análisis por modelos multinivel
(Gobierno de Navarra, 2009) Rodrigo Rincón, Isabel; Viñes Rueda, José Javier; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Fundamento. La influencia de la información recibida por los pacientes en su satisfacción es de gran importancia ya que, entre otros aspectos, puede mejorar la adherencia del paciente al tratamiento y contribuir a mejorar su estado de salud. El objetivo del estudio es conocer, a partir de los cuestionarios de satisfacción, qué porcentaje de la variabilidad de la percepción del paciente sobre la información recibida acerca del régimen de vida y los medicamentos se atribuye a los siguientes niveles: paciente, unidad clínica y especialidad; así como identificar las variables que han influido en los resultados. Material y métodos. Se realizaron entrevistas telefónicas a 6.922 pacientes atendidos en consultas externas en el Servicio Navarro de Salud en el año 2005 (tasa de respuesta 92,4%). Se ha evaluado si los pacientes habían recibido prescripción farmacológica e información sobre el régimen de vida y, en caso afirmativo, su valoración de la calidad de la mencionada información. Se han analizado 94 unidades clínicas en régimen ambulatorio y 34 especialidades médicas. Se ha realizado un análisis estadístico jerárquico con 3 niveles. Resultados. En los ítems estudiados, el porcentaje de la variabilidad explicada por la unidad clínica y la especialidad médica osciló entre 0 y el 12,6% y el explicado por el paciente, entre el 87,4% y el 99,3%. Conclusiones. Se ha detectado variabilidad en el comportamiento de las distintas unidades clínicas en relación con la prescripción farmacológica y con la información proporcionada sobre el régimen de vida. No obstante, la mayor parte de la variabilidad se ha localizado en el nivel "paciente".
Open Access
A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students
(BioMed Central, 2012) Pischke, Claudia R.; Zeeb, Hajo; Hal, Guido van; Vriesacker, Bart; McAlaney, John; Bewick, Bridgette M.; Akvardar, Yildiz; Guillén Grima, Francisco; Orosova, Olga; Salonna, Ferdinand; Kalina, Ondrej; Stock, Christiane; Helmer, Stefanie M.; Mikolajczyk, Rafael T.; Ciencias de la Salud; Osasun Zientziak
Background: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. Methods/Design: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. Discussion: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. Final trial registration number DRKS00004375 on the ‘German Clinical Trials Register’.
Open Access
Prevalencia e incidencia de la enfermedad de Alzheimer en Europa: metaanálisis
(Elsevier España, 2017) Niu, Hao; Álvarez Álvarez, Ismael; Guillén Grima, Francisco; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
Introducción: La enfermedad de Alzheimer es el principal tipo de demencia, y una enfermedad de etiología desconocida. Con el aumento de la población anciana mundial, el número de pacientes con enfermedad de Alzheimer muestra una tendencia de crecimiento rápido. El objetivo de este metaanálisis es evaluar la prevalencia e incidencia de la enfermedad de Alzheimer en Europa. Metodología: La búsqueda de artículos se realizó en las bases de datos Medline, Scopus y CINAHL Complete utilizando las palabras claves “Alzheimer”, “Alzheimer’s disease” y “AD”; combinadas con “prevalence”, “incidence” y “epidemiology”. Se utilizó el modelo Bayesiano de efectos aleatorios, mostrando intervalos de credibilidad al 95%. Para estimar la heterogeneidad se usó el estadístico I2. Resultados: La prevalencia de enfermedad de Alzheimer en Europa fue 5,05% (IC 95% 4,73-5,39). La prevalencia por sexo en los hombres y las mujeres fue 3,31% (IC 95% 2,85-3,80) y 7,13% (IC 95% 6,56-7,72), respectivamente, y se encontró una tendencia creciente por grupos de edad. La incidencia de enfermedad de Alzheimer en Europa fue 11,08 por 1000 personas-año (IC 95% 10,30-11,89), siendo en los hombres y las mujeres de 7,02 por 1000 personas-año (IC 95% 6,06-8,05) y 13,25 por 1000 personas-año (IC 95% 12,05-14,51), respectivamente, con igual tendencia creciente con el aumento de la edad. Conclusiones: Los resultados del metaanálisis permiten una mejor comprensión de la enfermedad y su impacto en Europa.
Open Access
Individual- and community-level determinants of maternal health service utilization in southern Ethiopia: a multilevel analysis
(SAGE, 2023) Yoseph, Amanuel; Teklesilasie, Wondwosen; Guillén Grima, Francisco; Astatkie, Ayalew; Ciencias de la Salud; Osasun Zientziak
Background: Maternal health service utilization decreases maternal morbidity and mortality. However, the existing evidence is inadequate to design effective intervention strategies in Ethiopia. Objectives: This study aimed to examine the utilization of maternal health service and identify its determinants among women of reproductive age in southern Ethiopia. Design: A community-based cross-sectional study was conducted from October 21 to November 11, 2022 on a sample of 1140 women selected randomly from the Northern Zone of the Sidama region. Methods: Data were collected using the Open Data Kit mobile application and exported to Stata version 15 for analysis. We used a multilevel mixed-effects modified Poisson regression with robust standard error to identify determinants of maternal health service utilization. Results: Utilization of antenatal care, health facility delivery, and postnatal care was 52.0% (95% confidence interval: 49.0%, 55.0%), 48.5% (95% confidence interval: 45.6%, 51.4%), and 26.0% (95% confidence interval: 23.0%, 29.0%), respectively. Antenatal care use was associated with receiving model family training (adjusted prevalence ratio: 1.19; 95% confidence interval: 1.06, 1.35), knowledge of antenatal care (adjusted prevalence ratio: 1.54; 95% confidence interval: 1.31, 1.81), perceived quality of antenatal care (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), and having birth preparedness plan (adjusted prevalence ratio: 1.13; 95% confidence interval: 1.02, 1.25). The identified determinants of health facility delivery use were middle wealth rank (adjusted prevalence ratio: 1.35; 95% confidence interval: 1.03, 1.77), perceived quality of health facility delivery (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), antenatal care (adjusted prevalence ratio: 1.76; 95% confidence interval: 1.36, 2.26), and high community-level women literacy (adjusted prevalence ratio: 1.55; 95% confidence interval: 1.10, 2.19). Postnatal care use was associated with facing health problems during postpartum period (adjusted prevalence ratio: 1.79; 95% confidence interval: 1.18, 2.72), urban residence (adjusted prevalence ratio: 3.52; 95% confidence interval: 2.15, 5.78), knowledge of postnatal care (adjusted prevalence ratio: 1.11; 95% confidence interval: 1.04, 1.19), and low community-level poverty (adjusted prevalence ratio: 0.43; 95% confidence interval: 0.25, 0.73). Conclusion: Maternal health service use was low in the study area and was influenced by individual- and community-level determinants. Any intervention strategies must consider multi-sectorial collaboration to address determinants at different levels. The programs should focus on the provision of model family training, the needs of women who have a poor perception, and knowledge of maternal health service at the individual level.
Open Access
Evaluation of the degradation of materials by exposure to germicide UV-C light through colorimetry, tensile strength and surface microstructure analyses
(Elsevier, 2022) Mitxelena Iribarren, Oihane; Mondragón, Beñat; Pérez Lorenzo, Eva; Smerdou, Cristian; Guillén Grima, Francisco; Sierra-García, J. Enrique; Rodríguez Merino, Fernando; Arana, Sergio; Ciencias de la Salud; Osasun Zientziak
Due to the COVID19 pandemic, solutions to automate disinfection using UV-C combined with mobile robots are beginning to be explored. It has been proved that the use of these systems highly reduces the risk of contagion. However, its use in real applications is not being as rapid as it needs to be. One of the main market input barriers is the fear of degrading facilities. For this reason, it is crucial to perform a detailed study on the degradation effect of UV-C light on inert materials. This experimental study proves that, considering exposition times equivalent to several work years in hospital rooms, only the appearance of the material is affected, but not their mechanical functionalities. This relevant result could contribute to accelerate the deployment of these beneficial disinfection technologies. For that purpose, a colorimetry test, tensile strength test, and analysis of the surface microstructure were carried out. The results showed that polymers tend to turn yellow, while fabrics lose intensity depending on the color. Red is hardly affected by UV-C, but blue and green are. Thus, this study contributes to the identification of the best materials and colors to be used in rooms subjected to disinfection processes. In addition, it is shown how the surface microstructure of the materials is altered in most of the materials, but not the tensile strength of the fabrics.
Open Access
Influence of type of uniform and days of usage in microbiological contamination of nurses uniform in a university hospital
(BioMed Central, 2011) Guillén Grima, Francisco; Aguinaga Pérez, A.; Núñez Córdoba, J.; Sara, C.; Ciencias de la Salud; Osasun Zientziak
Nurse uniforms can act as a reservoir of infections, with the areas around the pockets, cuffs and aprons the most contaminated. The aim of this study is compare the contamination of Standard nurse’s uniform consisted of a dress, pinafore apron with the “scrub dress” type of uniform, as well as to measure the influence of the number of shifts as uniform was used in its contamination.
Open Access
Estudio transversal de los factores que influyen en la adhesión a la dieta mediterránea en el embarazo
(Arán Ediciones, 2015) Álvarez Álvarez, Ismael; Aguinaga Ontoso, Inés; Marín Fernández, Blanca; Guillén Grima, Francisco; Niu, Hao; Ciencias de la Salud; Osasun Zientziak
Introducción: La dieta mediterránea es un estilo de vida con efectos beneficiosos contrastados en el embarazo, tanto para la madre como para su descendencia. Sin embargo, se desconocen los factores que influyen en la adhesión a esta dieta. Objetivo: Investigar los factores (nivel educativo, ocupación, lugar de nacimiento, número de hijos previo y edad) que influyen en la adhesión a la dieta mediterránea en mujeres embarazadas de la comarca de Pamplona. Material y métodos: Utilizando los datos del Estudio Internacional de Sibilancias en Lactantes (EISL) en la comarca de Pamplona, se analizaron las asociaciones entre los alimentos y los factores. Se estableció una puntuación de dieta mediterránea y se estudiaron las puntuaciones de acuerdo a los factores. Resultados: Se encontraron diferencias significativas en la puntuación de dieta mediterránea según el nivel de estudios (p=<0,001), la ocupación (p=0,015) y la edad (p=<0,001). Conclusión: Mujeres con mejor nivel educativo, mejor ocupación y mayor edad muestran una mayor afinidad a la dieta mediterránea durante el embarazo.