Uterine microbiota may be involved in reproductive health and disease. This study aims to describe and compare the vaginal and endometrial microbiome patterns between women who became pregnant and women who did not after in vitro fertilization. We also compared the vaginal and endometrial microbiome patterns between women with and without a history of repeated implantation failures (RIF). This pilot prospective cohort study included 48 women presenting to the fertility clinic for IVF from May 2017 to May 2019. Women who achieved clinical pregnancy presented a greater relative abundance of Lactobacillus spp. in their vaginal samples than those who did not (97.69% versus 94.63%; p = 0.027. The alpha and beta diversity of vaginal and endometrial samples were not statistically different between pregnant and non-pregnant women. The Faith alpha diversity index in vaginal samples was lower in women with RIF than those without RIF (p = 0.027). The alpha diversity of the endometrial microbiome was significantly higher in women without RIF (p = 0.021). There were no significant differences in the vaginal and endometrial microbiomes between pregnant and non-pregnant women. The relative abundance of the genera in women with RIF was different from those without RIF. Statistically significant differences in the endometrial microbiome were found between women with and without RIF.

La salud mental de estudiantes universitarios es un motivo de investigación a nivel internacional. El objetivo de este estudio fue estimar la prevalencia de ansiedad, depresión y estado de salud autopercibida de los estudiantes de medicina de la Universidad Miguel Hernández y analizar su asociación con diferentes variables sociodemográficas y del estilo de vida. Para ello, se realizó un estudio descriptivo transversal de estudiantes de medicina de 1º a 6º curso de la Universidad Miguel Hernández de Elche durante el curso 2019-20. Se utilizaron la Escala Visual Analógica (EVA) del European Quality of Life-5 Dimensions (EQ-5D), la Escala de Ansiedad y Depresión de Goldberg (EADG), el estudio Prevención con Dieta Mediterránea (PREDIMED), el Alcohol Use Disorders Identification Test (AUDIT-C) y el Test de Fagerström. Todos los cuestionarios están validados en España. Para el análisis se ajustaron modelos logísticos multivariantes. Fueron encuestados 474 estudiantes. La tasa de respuesta global fue del 55.26%. Un 68.1% de la muestra eran mujeres. Se estimó una prevalencia de probable ansiedad del 54.9%, probable depresión del 60.9% y probable ansiedad o depresión del 73.3%. La salud autopercibida regular-mala-muy mala fue del 8.9%. Se detectó una asociación estadísticamente significativa con el sexo, la edad, el curso académico, el municipio de residencia, el tipo de alimentación, la actividad física y el consumo de tóxicos. Como conclusión, los estudiantes de medicina de la Universidad Miguel Hernández presentaron una prevalencia alta de probable ansiedad y depresión. Se observaron diferencias en función del sexo, curso académico, tipo de alimentación y consumo de tóxicos. The mental health of university students is a reason for international research. The objective of this study was to estimate the prevalence of anxiety, depression and self-perceived health status of medical students from the Miguel Hernandez University and analyze their association with different sociodemographic and lifestyle variables. We did a cross-sectional descriptive study of medical students from 1st to 6th year of the Miguel Hernandez University during the 2019-20 academic year. They were used the Visual Analogue Scale (VAS) of the European Quality of Life-5 Dimensions (EQ-5D), the Goldberg Anxiety and Depression Scale (GADS), the Mediterranean Diet Prevention study (PREDIMED), the Alcohol Use Disorders Identification Test (AUDIT-C) and the Fagerström Test were used. All the questionnaires are validated in Spain. For the analysis, multivariate logistic models were adjusted. They were surveyed 474 students. The overall response rate was 55.26%. 68.1% of the sample were women. A prevalence of probable anxiety of 54.9%; probable depression of 60.9% and probable anxiety or depression of 73.3% was estimated. Regular-bad-very bad self-perceived health was only 8.9%. A statistically significant association was detected between the aforementioned variables and sex, age, academic year, municipality of residence, type of diet, physical activity and consumption of toxics. The medical students of the Miguel Hernandez University presented a high prevalence of probable anxiety and depression. Differences were observed based on sex, academic year, type of diet and consumption of toxic drugs.

Adherence to statin therapy is crucial for reducing the recurrence of cardiovascular events. Numerous methods exist to measure medication adherence, including those based on prescription data, patient self-report, medication counting, and direct methods. It is important to determine which of these methods are appropriate for use in clinical practice. This systematic review aimed to identify the methods used to measure adherence and persistence to statins in patients undergoing cardiovascular secondary prevention and to evaluate the validity indicators of these methods. This systematic review included studies reporting methods to measure adherence and/or persistence to statins in cardiovascular secondary prevention. Medline, Embase, and Scopus databases were searched from inception to February 2025. Rayyan was used for the study selection and extraction data processes. Validity indicators of the adherence/persistence methods were collected; it was reported. Risk of bias of studies reporting the method validity was evaluated using the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool. A total of 77 studies were included. Regarding adherence measurement, the most frequently used method was prescription refill records (n = 55) and self-report methods (n = 20). Electronic monitoring methods (n = 2), self-perceived adherence by physician (n = 1), and pill counting (n = 1) were less frequently used methods. Direct methods, using HPLC–MS/MS, were used in combination with other indirect methods (n = 5). For measuring persistence, prescription refill records were the predominant method (n = 9), while self-report methods were used in three studies, and one study used a standardized questionnaire. Several of the indirect methods have validity indicators for measuring adherence in different study populations and to different medications. Only one study provides validity indicators for the MAT questionnaire specifically adapted for statins. The methods for measuring adherence to statins in secondary cardiovascular prevention were predominantly indirect, relying on prescription and supply records and self-report methods. Pill counting, electronic monitoring, and direct measurement via LC–MS/MS were less commonly used. Persistence was primarily measured through prescription refill records. None of the indirect methods was validated; thus, their use for measuring adherence to statins is not recommended. There is a need for new validated tools, incorporating a gender perspective, to measure adherence to statins in this population. PROSPERO CRD42023463981.

This study aimed to determine the CRC screening coverage of people aged between 50 and 69 years who were living in Spain in 2017 and describe the factors associated with not having had a faecal occult blood test (FOBT). A cross-sectional study was performed using data from the Spanish National Health Survey 2017. We analysed 7568 individuals between the ages of 50 and 69 years. The proportion of respondents between 50 and 69 years old who had had an FOBT was 29.0% (n = 2191). The three autonomous communities with the lowest proportion of respondents who had had an FOBT were Extremadura (8.7%, n = 16), Ceuta–Melilla (10.4%, n = 3), and Andalucia (14.1%, n = 186). The variables associated with not having had an FOBT were being 50–54 years old (PR = 1.09; 95% CI 1.04–1.14), having been born outside of Spain (PR = 1.11; 95% CI 1.06–1.16), not having been vaccinated against the flu (PR = 1.09; 95% CI 1.04–1.15), never having had a colonoscopy (PR = 1.49; 95% CI 1.40–1.59), not having had an ultrasound scan in the last year (PR = 1.09; 95% CI 1.04–1.14), and not having seen a primary care physician in the last month (PR = 1.08; 95% CI 1.04–1.12). The factors associated with not getting an FOBT were young age, having been born outside of Spain, not having been vaccinated against the flu in the last campaign, and not making frequent use of healthcare services.

Background: Cardiovascular diseases are becoming more frequent throughout the world. Adherence to both pharmacological and non-pharmacological treatment, as well as lifestyles, is important for good management and control of the disease. This study aims to explore the opinions and perceptions of patients with ischemic heart disease on the difficulties associated with therapeutic adherence. Methods: An interpretive phenomenological study was carried out using focus groups and one semi-structured interview. The MAXQDA qualitative data analysis program was used for inductive interpretation of the group discourses and interview. Data were coded, and these were grouped by categories and then consolidated under the main themes identified. Results: Two in-person focus groups and one remote semi-structured interview were performed. Twelve participants (6 men and 6 women) from the Hospital de San Juan de Alicante participated, two of them being family companions . The main themes identified were aspects related to the individual, heart disease, drug treatment, and the perception of the health care system. Conclusions: Adhering to recommendations on healthy behaviors and taking prescribed medications for cardiovascular disease was important for most participants. However, they sometimes found polypharmacy difficult to manage, especially when they did not perceive the symptoms of their disease. Participants related the concept of fear to therapeutic adherence, believing that the latter increased with the former. The relationship with health professionals was described as optimal, but, nevertheless, the coordination of the health care system was seen as limited.

Aims To identify the obstacles hindering the appropriate management of chronic obstructive pulmonary disease (COPD) in Spain based on consensus amongst clinicians and administrators. Methods A two‐round modified Delphi questionnaire was sent to clinicians (pulmonologists and GPs) and administrators, all experts in COPD. The scientific committee developed the statements and selected the participating experts. Four areas were explored: diagnosis, training, treatment, and clinical management. Panellists’ agreement was assessed using a 9‐point Likert scale, with scores of 1 to 3 indicating disagreement and 7 to 9, agreement. Consensus was considered to exist when 70% of the participants agreed or disagreed with the statement. Results Respective response rates for the first and second round were 68% and 91% for clinicians, and 60% and 100% for administrators. The statements attracting the highest degree of consensus were: “Not enough nursing resources (time, staff, duties) are allocated for performing spirometry” (85.3% clinicians; 75% administrators); “Nurses need specific training in COPD” (84.8% clinicians; 100% administrators); “Rehabilitation programs are necessary for treating patients with COPD” (94.1% clinicians; 91.7% administrators); and “Integrated care processes facilitate the deployment of educational programs on COPD” (79.4% clinicians; 83.3% administrators). Conclusions This document can inform the development and implementation of specific initiatives addressing the existing obstacles in COPD management. What’s known COPD is a prevalent and underdiagnosed disease that causes substantial morbidity and mortality. The National COPD Strategy established objectives and work programmes to apply in Spain. There are barriers impeding the application of interventions contemplated in the COPD strategy. What’s new Different agents involved in COPD management agree that the main challenges to improve COPD management are resource shortages in primary care nursing and lack of training in the use of COPD clinical guidelines. Clinicians and administrators involved in COPD management support the implementation of urgent measures to tackle the underdiagnosis of COPD, especially in primary care, along with the routine inclusion of respiratory rehabilitation programmes for COPD.