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Objective
To determine the prevalence and profiles of people with advanced chronic diseases in Primary Care and to analyse the elements related to their mortality in order to orient strategies for improvement in this level of care. Design
An observational, analytical and prospective study during 3 years conducted on a cohort of patients with palliative needs. Location
Three Primary Care teams of Osona (Catalonia). Participants
A total of 251 people identified as advanced patients using a systematic population-based strategy that included the NECPAL tool. | S0212656716306187 | Find your 1%: prevalence and mortality of a community cohort of people with advanced chronic disease and palliative needs | [
"Palliative care",
"Primary care",
"Community",
"Mortality",
"Prevalence"
] | Objective
To determine the prevalence and profiles of people with advanced chronic diseases in Primary Care and to analyse the elements related to their mortality in order to orient strategies for improvement in this level of care.
Design
An observational, analytical and prospective study during 3 years conducted on a cohort of patients with palliative needs.
Location
Three Primary Care teams of Osona (Catalonia).
Participants
A total of 251 people identified as advanced patients using a systematic population-based strategy that included the NECPAL tool.
Main measurements
Basic demographic and clinical profile (age, gender, type of residence, health stratification level and main disease); date, place, and cause of eventual deaths.
Results
1% of the adult Primary Care population suffer from advanced diseases, of which 56.6% are women, and with a median age of 85 years.
<dis>Dementia</dis> or advanced frailty is observed in 49.3%, and only 13.7% have cancer.
Just under one-quarter (24.3%) live in nursing homes.
The accumulated mortality at 3 years is 62.1%, with a median survival of 23 months.
Factors significantly associated with the likelihood of dying are cancer, female gender, and over-aging.
Patients died at their home (47.3%), in an intermediate care hospital (37.2%), or in an acute care hospital (15.5%), depending on certain explanatory factors.
Conclusions
The prevalence and characteristics of advanced community-based disease coincide with that reported in the literature.
Potentially, Primary Care is the reference level of care for these patients, especially if it incorporates nursing homes as a usual field of practice. | Objective
To determine the prevalence and profiles of people with advanced chronic diseases in Primary Care and to analyse the elements related to their mortality in order to orient strategies for improvement in this level of care.
Design
An observational, analytical and prospective study during 3 years conducted on a cohort of patients with palliative needs.
Location
Three Primary Care teams of Osona (Catalonia).
Participants
A total of 251 people identified as advanced patients using a systematic population-based strategy that included the NECPAL tool.
Main measurements
Basic demographic and clinical profile (age, gender, type of residence, health stratification level and main disease); date, place, and cause of eventual deaths.
Results
1% of the adult Primary Care population suffer from advanced diseases, of which 56.6% are women, and with a median age of 85 years.
Dementia or advanced frailty is observed in 49.3%, and only 13.7% have cancer.
Just under one-quarter (24.3%) live in nursing homes.
The accumulated mortality at 3 years is 62.1%, with a median survival of 23 months.
Factors significantly associated with the likelihood of dying are cancer, female gender, and over-aging.
Patients died at their home (47.3%), in an intermediate care hospital (37.2%), or in an acute care hospital (15.5%), depending on certain explanatory factors.
Conclusions
The prevalence and characteristics of advanced community-based disease coincide with that reported in the literature.
Potentially, Primary Care is the reference level of care for these patients, especially if it incorporates nursing homes as a usual field of practice. | [] | English_Training_0 | [
"Palliative Care",
"Palliative care physician",
"Palliative care nurse",
"Palliative care service",
"Specialist palliative care",
"Primary Health Care",
"Primary Care Physicians",
"Primary care clinic",
"Primary care provider",
"Primary Care Nursing",
"Community Pharmacies",
"Biological Community",
"Community Pharmacists",
"community development",
"Community Dentistry",
"Maternal Mortality",
"Infant Mortality",
"Mortality Vital Statistics",
"Perinatal mortality demographics",
"Fetal Mortality Statistics",
"Statistical Prevalence",
"Prevalence aspects",
"Problem family prevalence details",
"Problem family prevalence details:Pn:Pt:^Patient:Nom",
"PhenX measure - oral health - periodontal disease - prevalence"
] | [
"C0030231",
"C0586875",
"C3714595",
"C0587605",
"C1273400",
"C0033137",
"C0033131",
"C1552443",
"C2735026",
"C2936627",
"C0009478",
"C1253910",
"C0402003",
"C0009465",
"C0009464",
"C0024923",
"C0021278",
"C0026565",
"C0031062",
"C1449632",
"C0033105",
"C0220900",
"C5890738",
"C5890739",
"C3166072"
] | [
"Palliative care",
"Primary care",
"Community",
"Mortality",
"Prevalence",
"Palliative Care",
"Palliative care physician",
"Palliative care nurse",
"Palliative care service",
"Specialist palliative care",
"Primary Health Care",
"Primary Care Physicians",
"Primary care clinic",
"Primary care provider",
"Primary Care Nursing",
"Community Pharmacies",
"Biological Community",
"Community Pharmacists",
"community development",
"Community Dentistry",
"Maternal Mortality",
"Infant Mortality",
"Mortality Vital Statistics",
"Perinatal mortality demographics",
"Fetal Mortality Statistics",
"Statistical Prevalence",
"Prevalence aspects",
"Problem family prevalence details",
"Problem family prevalence details:Pn:Pt:^Patient:Nom",
"PhenX measure - oral health - periodontal disease - prevalence"
] | [
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Abstract
Holoprosencephaly (HPE) is characterized by a spectrum of central nervous system anomalies arising from a failure in the differentiation and division of the prosencephalon. Approximately 50% of the causes are chromosomal, the most frequent being trisomies 13 and 18. A familial form has occasionally been described. There are three types of HPE: alobar, semilobar and lobar. | S0210573X08000270 | Semilobar holoprosencephaly in 2 successive pregnancies | [
"Holoprosencephaly",
"Craniofacial malformation",
"Prenatal diagnosis"
] | Abstract
Holoprosencephaly (HPE) is characterized by a spectrum of central nervous system anomalies arising from a failure in the differentiation and division of the prosencephalon.
Approximately 50% of the causes are chromosomal, the most frequent being trisomies 13 and 18.
A familial form has occasionally been described.
There are three types of HPE: alobar, semilobar and lobar.
We present the case of a 33-year-old woman who showed identical ultrasonographic findings compatible with semilobar HPE in the second trimester of two successive pregnancies.
Both parents had normal karyotypes, but <dis>mild mental retardation</dis>.
Both pregnancies were finalized by dilation and extraction abortion in weeks 21 and 20, respectively.
Histopathological analysis confirmed HPE in both fetuses.
Given these findings, cerebral magnetic resonance imaging was performed in both parents to exclude familial HPE.
The mother showed slight asymmetry in ventricular size and fornix with no other abnormalities.
Study of the father confirmed our suspicions and showed partial agenesis of the corpus callosum in the medial and posterior portions, as well as a defect in the morphology of the lateral ventricles and a single pericallosal artery.
The cerebral sickle showed little development. | Abstract
Holoprosencephaly (HPE) is characterized by a spectrum of central nervous system anomalies arising from a failure in the differentiation and division of the prosencephalon.
Approximately 50% of the causes are chromosomal, the most frequent being trisomies 13 and 18.
A familial form has occasionally been described.
There are three types of HPE: alobar, semilobar and lobar.
We present the case of a 33-year-old woman who showed identical ultrasonographic findings compatible with semilobar HPE in the second trimester of two successive pregnancies.
Both parents had normal karyotypes, but mild mental retardation.
Both pregnancies were finalized by dilation and extraction abortion in weeks 21 and 20, respectively.
Histopathological analysis confirmed HPE in both fetuses.
Given these findings, cerebral magnetic resonance imaging was performed in both parents to exclude familial HPE.
The mother showed slight asymmetry in ventricular size and fornix with no other abnormalities.
Study of the father confirmed our suspicions and showed partial agenesis of the corpus callosum in the medial and posterior portions, as well as a defect in the morphology of the lateral ventricles and a single pericallosal artery.
The cerebral sickle showed little development. | [] | English_Training_4 | [
"Holoprosencephaly",
"Alobar Holoprosencephaly",
"Holoprosencephaly 2",
"HOLOPROSENCEPHALY 5",
"Holoprosencephaly 4",
"Prenatal Diagnosis technique",
"Prenatal diagnosis finding",
"Prenatal diagnosis:Find:Pt:^Patient:Nom"
] | [
"C0079541",
"C0431363",
"C1834877",
"C1864827",
"C1840528",
"C0033053",
"C4554712",
"C4554711"
] | [
"Holoprosencephaly",
"Craniofacial malformation",
"Prenatal diagnosis",
"Holoprosencephaly",
"Alobar Holoprosencephaly",
"Holoprosencephaly 2",
"HOLOPROSENCEPHALY 5",
"Holoprosencephaly 4",
"Prenatal Diagnosis technique",
"Prenatal diagnosis finding",
"Prenatal diagnosis:Find:Pt:^Patient:Nom"
] | [
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] |
"Abstract\nBackground\nCorpus callosum (CC) size has been associated with cognitive and emotional de(...TRUNCATED) | S1134593412000309 | Suicidal behavior is associated with reduced corpus callosum area | [
"Corpus callosum",
"Magnetic resonance imaging",
"Suicidal behavior"
] | "Abstract\nBackground\nCorpus callosum (CC) size has been associated with <dis>cognitive and emotion(...TRUNCATED) | "Abstract\nBackground\nCorpus callosum (CC) size has been associated with cognitive and emotional de(...TRUNCATED) | [{"offsets":[71,114],"text":"cognitive and emotional deficits","type":"DISABILITY"},{"offsets":[129,(...TRUNCATED) | English_Training_7 | ["Corpus Callosum","Corpus callosum splenium","Entire corpus callosum","Agenesis of corpus callosum"(...TRUNCATED) | ["C0010090","C0152319","C1284613","C0175754","C0431369","C0024485","C3898221","C1136216","C0587658",(...TRUNCATED) | ["Corpus callosum","Magnetic resonance imaging","Suicidal behavior","Corpus Callosum","Corpus callos(...TRUNCATED) | [0.0067529925145208836,-0.0293724425137043,0.0069777341559529305,0.020630182698369026,0.010166335850(...TRUNCATED) |
"Abstract\n Introduction\nThe studies that have evaluated the effectiveness of bilateral cochlear im(...TRUNCATED) | S0001651915001363 | "Comparative study between unilateral and bilateral cochlear implantation in children of 1 and 2 yea(...TRUNCATED) | ["Bilateral cochlear implant","Sensorineural hearing loss","Residual hearing","Spoken language","Chi(...TRUNCATED) | "Abstract\n Introduction\nThe studies that have evaluated the effectiveness of bilateral cochlear im(...TRUNCATED) | "Abstract\n Introduction\nThe studies that have evaluated the effectiveness of bilateral cochlear im(...TRUNCATED) | [] | English_Training_11 | ["Sensorineural Hearing Loss (disorder)","Congenital sensorineural hearing loss","Split-Hand-Foot Ma(...TRUNCATED) | ["C0018784","C1865866","C1857344","C5567465","C5399980","C5551978","C5551979","C5575646","C5552098",(...TRUNCATED) | ["Bilateral cochlear implant","Sensorineural hearing loss","Residual hearing","Spoken language","Chi(...TRUNCATED) | [-0.01139846257865429,-0.022314324975013733,-0.028454890474677086,-0.0020224761683493853,0.006876212(...TRUNCATED) |
" Summary\nXanthogranulomas of the choroids plexus (XG) are benign tumours of debatable etiology w(...TRUNCATED) | S113014730570381X | Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review | [
"Xanthogranuloma",
"Third ventricle tumour",
"MRI"
] | " Summary\nXanthogranulomas of the choroids plexus (XG) are benign tumours of debatable etiology w(...TRUNCATED) | " Summary\nXanthogranulomas of the choroids plexus (XG) are benign tumours of debatable etiology w(...TRUNCATED) | [{"offsets":[324,364],"text":"gait and urinary disturbances","type":"DISABILITY"},{"offsets":[369,40(...TRUNCATED) | English_Training_15 | ["Xanthogranuloma","Juvenile Xanthogranuloma","Multiple eruptive juvenile xanthogranuloma","MRI Scan(...TRUNCATED) | [
"C5234857",
"C0043324",
"C5887061",
"C0917711",
"C0412685",
"C0412705",
"C1960809",
"C2117023"
] | ["Xanthogranuloma","Third ventricle tumour","MRI","Xanthogranuloma","Juvenile Xanthogranuloma","Mult(...TRUNCATED) | [0.02112312614917755,0.0060186670161783695,0.015922393649816513,0.0017197472043335438,0.046014707535(...TRUNCATED) |
"Abstract\n Fibromyalgia (FM) was accepted as an entity by WHO in 1992. Diagnostic criteria were sta(...TRUNCATED) | S1853002812000237 | Fibromyalgia for neurologists. Disputes frequently consulted | [
"Fibromyalgia",
"Chronic pain"
] | "Abstract\n Fibromyalgia (FM) was accepted as an entity by WHO in 1992.\nDiagnostic criteria were st(...TRUNCATED) | "Abstract\n Fibromyalgia (FM) was accepted as an entity by WHO in 1992.\nDiagnostic criteria were st(...TRUNCATED) | [
{
"offsets": [
277,
323
],
"text": "sleep, attention and mood disorders",
"type": "DISABILITY"
}
] | English_Training_17 | ["Fibromyalgia","Chronic pain","chronic pain (diagnosis)","Chronic pain assessment","Chronic pelvic (...TRUNCATED) | [
"C0016053",
"C0150055",
"C5700083",
"C2735096",
"C1536168",
"C5700084"
] | ["Fibromyalgia","Chronic pain","Fibromyalgia","Chronic pain","chronic pain (diagnosis)","Chronic pai(...TRUNCATED) | [0.011897807940840721,0.0031837671995162964,0.001866044127382338,-0.027936354279518127,0.00668538920(...TRUNCATED) |
"Background and purpose. Pneumonia as a complication of stroke is associated with poor outcomes. The(...TRUNCATED) | S0213485316302080 | "External validation of the A2SD2 and ISAN scales for predicting infectious respiratory complication(...TRUNCATED) | [
"Ischaemic stroke",
"Respiratory infection",
"Outcome",
"Pneumonia",
"Predictive models"
] | "Background and purpose.\nPneumonia as a complication of stroke is associated with poor outcomes. \n(...TRUNCATED) | "Background and purpose.\nPneumonia as a complication of stroke is associated with poor outcomes. \n(...TRUNCATED) | [] | English_Training_20 | ["Lower respiratory tract infection","Acute upper respiratory infection","Severe acute respiratory i(...TRUNCATED) | ["C0149725","C0264222","C3873497","C4759838","C4552842","C0085415","C0032972","C0679250","C0086749",(...TRUNCATED) | ["Ischaemic stroke","Respiratory infection","Outcome","Pneumonia","Predictive models","Lower respira(...TRUNCATED) | [0.012954117730259895,-0.014124823734164238,0.006687849760055542,0.009050961583852768,0.010893979109(...TRUNCATED) |
"Introduction. Transthyretin-related familial amyloid polyneuropathy (TTR-FAP) typically arises as a(...TRUNCATED) | S0213485316301748 | "Familial amyloidosis with polyneuropathy type 1 caused by transthyretin mutation Val50Met (Val30Met(...TRUNCATED) | [
"Transthyretin",
"Hereditary amyloid polyneuropathy",
"Val50Met (Val30Met)",
"Amyloid"
] | "Introduction.\nTransthyretin-related familial amyloid polyneuropathy (TTR-FAP) typically arises as (...TRUNCATED) | "Introduction.\nTransthyretin-related familial amyloid polyneuropathy (TTR-FAP) typically arises as (...TRUNCATED) | [] | English_Training_25 | ["AMYLOIDOSIS, HEREDITARY, TRANSTHYRETIN-RELATED","Transthyretin synthesis inhibitor (disposition)",(...TRUNCATED) | [
"C2751492",
"C4722005",
"C4722429",
"C4722006",
"C0002716",
"C0268382",
"C1456454",
"C0011560",
"C0206245"
] | ["Transthyretin","Hereditary amyloid polyneuropathy","Val50Met (Val30Met)","Amyloid","AMYLOIDOSIS, H(...TRUNCATED) | [-0.01144103892147541,-0.020205574110150337,-0.02726258523762226,-0.010679909028112888,-0.0112849120(...TRUNCATED) |
"Abstract\n Like anyone else, people with Down syndrome can suffer mental health problems that requi(...TRUNCATED) | S1138207410700671 | Depression and Down syndrome | [
"Depression",
"Down syndrome",
"Affective disorders",
"Psychotherapy"
] | "Abstract\n Like anyone else, people with Down syndrome can suffer <dis>mental health problems</dis>(...TRUNCATED) | "Abstract\n Like anyone else, people with Down syndrome can suffer mental health problems that requi(...TRUNCATED) | [
{
"offsets": [
65,
98
],
"text": "mental health problems",
"type": "DISABILITY"
}
] | English_Training_29 | ["Mental Depression","Reactive depression","Endogenous depression","Depression, Neurotic","Depressio(...TRUNCATED) | ["C0011570","C0011579","C0011573","C0282126","C0005587","C0013080","C1860787","C1860786","C0525045",(...TRUNCATED) | ["Depression","Down syndrome","Affective disorders","Psychotherapy","Mental Depression","Reactive de(...TRUNCATED) | [-0.0052893864922225475,-0.0041994256898760796,0.010561687871813774,0.0022803936153650284,0.00007257(...TRUNCATED) |
"Abstract\n The unilateral neglect syndrome is defined as the inability or difficulty to identify, r(...TRUNCATED) | S0048712011000284 | "Evaluation and prognosis of a case of unilateral neglect: Longitudinal study with the Behavioural I(...TRUNCATED) | ["Acquired brain injury","Behavioural Inattention Test","Diagnosis","Evolution","Neurorehabilitation(...TRUNCATED) | "Abstract\n The unilateral neglect syndrome is defined as the inability or difficulty to identify, r(...TRUNCATED) | "Abstract\n The unilateral neglect syndrome is defined as the inability or difficulty to identify, r(...TRUNCATED) | [{"offsets":[211,259],"text":"elementary sensory or motor disorders","type":"DISABILITY"},{"offsets"(...TRUNCATED) | English_Training_30 | ["Diagnosis","Diagnosis Classification - Diagnosis","diagnosis user finding: (diagnosis)","Different(...TRUNCATED) | [
"C0011900",
"C1546899",
"C2063792",
"C0011906",
"C0011911",
"C0237604",
"C2708265",
"C2708264",
"C1551144"
] | ["Acquired brain injury","Behavioural Inattention Test","Diagnosis","Evolution","Neurorehabilitation(...TRUNCATED) | [-0.0071287560276687145,-0.00045752947335131466,0.014130794443190098,0.019430018961429596,-0.0071648(...TRUNCATED) |
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