Publications by authors named "Pilar Sanjuan"

Article Synopsis
  • The study analyzed medication patterns for opioid use disorder (MOUDs) during pregnancies among a cohort of 3,911 expectant mothers with opioid use disorder (OUD) from seven clinical sites.
  • It found that over 90% of pregnancies involving methadone were among publicly insured individuals, and there was an increasing usage of buprenorphine with naloxone and naltrexone in recent years.
  • The research highlighted that most prenatal care and MOUD documentation occurred within the same trimester, but discontinuity in MOUD treatments across trimesters still existed, indicating a need for improved access to care during pregnancy.
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Introduction: As perinatal drug overdoses continue to rise, reliable approaches are needed to monitor overdose trends during pregnancy and postpartum. This analysis aimed to determine the sensitivity, specificity, positive predictive value, and negative predictive value of ICD-9/10-CM codes for drug overdose events among people in the MATernaL and Infant clinical NetworK (MAT-LINK) with medication for opioid use disorder during pregnancy.

Methods: People included in this analysis had electronic health record documentation of medication for opioid use disorder and a known pregnancy outcome from January 1, 2014, through August 31, 2021.

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There is increasing recognition of the crucial need for robust community engagement in health research and clinical trials. Despite this awareness, challenges persist in bridging the gap between researchers and communities. Much of the current discourse focuses on addressing issues such as cultural humility and equitable partnerships.

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Article Synopsis
  • A lot of pregnant women use substances, which can harm both their health and their baby's health.
  • This study looked at how different kinds of substance use and mental health problems might cause women to keep using substances during pregnancy.
  • They found that many women were still using substances close to their delivery date, and having mental health issues made it more likely they would continue to use substances.
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Problem: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.

Period Covered: 2014-2021.

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Emotions and coping play a role in the prognosis of cardiac patients. This two-wave longitudinal study aims to analyze the ability of adaptive and maladaptive coping to predict the emotional well-being of cardiac patients after controlling for their functional physical capacity. Emotional well-being (positive and negative affect), coping strategies, and functional physical capacity were evaluated both at Time 1 (n = 253) and at Time 2 (n = 186), 8 weeks later.

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Background: About 5% of women are pregnant at substance use disorder (SUD) treatment entry, and pregnant women with SUD often belong to marginalized groups experiencing social, economic, and health care barriers associated with stigma from prenatal substance use. Pregnant women in SUD treatment have high rates of trauma and posttraumatic stress disorder (PTSD). This study sought to (1) examine the lived experiences of pregnant individuals with PTSD symptoms in SUD treatment and (2) understand the roles of systematic or contextual barriers to the pursuit of prenatal abstinence.

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Background: Although not routinely assessed, prenatal posttraumatic stress disorder (PTSD) is associated with poor maternal mental health and mother-infant bonding. Prenatal PTSD may also be associated with birth weight and gestational age outcomes, but this remains unclear. This systematic review and meta-analysis investigated the association of prenatal PTSD with risk of low birth weight (LBW) or preterm birth (PTB) (dichotomous medically-defined cut-offs) or with birth weight (BW) or gestational age (GA) (continuous variables).

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There are significant barriers in engaging pregnant and postpartum women that are considered high-risk (e.g., those experiencing substance use and/or substance use disorders (SUD)) into longitudinal research studies.

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Pregnant women with substance use disorder (SUD) comprise an underserved population with complex treatment needs, including complications from trauma histories and comorbid psychological disorders. Using ecological momentary assessment, we examined momentary fluctuations in posttraumatic stress disorder (PTSD) symptoms, prenatal bonding, and substance craving, among pregnant women in SUD treatment who had a history of trauma. We hypothesized that (a) PTSD symptoms and prenatal bonding would each be associated with substance craving and (b) PTSD symptoms would be negatively associated with prenatal bonding, and this would at least partially account for the association between PTSD symptoms and substance craving (i.

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Background: Substance use disorder (SUD) during pregnancy requires efficacious interventions based on understanding the ebb and flow of risk and protective factors for substance use across time. To assess how these fluctuations are associated temporally with substance use, we used ecological momentary assessment (EMA) to evaluate substance use risk (posttraumatic stress disorder [PTSD] symptoms) and protective (prenatal fetal bonding) factors and their associations with prenatal substance use recorded in real time.

Methods: Pregnant women in SUD treatment (N = 33) with prior trauma exposure received smartphones with an EMA application that queried them thrice daily for 28 days about PTSD symptoms, prenatal bonding, and substance use.

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The Gratitude Questionnaire is a short, self-report measure of the disposition to experience gratitude. The Gratitude Questionnaire has been validated in several countries but its factor structure remains controversial. Therefore, the main goal of the study was to examine the factor structure of the Gratitude Questionnaire in a Spanish sample.

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Motivation and coping are two of the most relevant factors associated to well-being. One of our objectives was to describe the motivation to pursue the personal goals, the coping strategies used to pursue them, and the levels of well-being experienced, in a group of people serving prison sentences (n = 175: 143 males and 32 females). We mainly wanted to study the joint contribution of motivation and coping on their well-being.

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Attention impairments are common symptoms of posttraumatic stress disorder (PTSD); however, the nature of these impairments remains elusive. Attention impairment may arise as the result of either excessive response to task-irrelevant stimuli or reduced response to task-relevant information. To test the association between PTSD and response to task-relevant and task-irrelevant stimuli, we used a 3-tone novelty auditory oddball task (AOD).

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Background: The relationship between clinical judgment and the pneumonia severity index (PSI) score in deciding the site of care for patients with community-acquired pneumonia (CAP) has not been well investigated. The objective of the study was to determine the clinical factors that influence decision-making to hospitalize low-risk patients (PSI ≤2) with CAP.

Methods: An observational, prospective, multicenter study of consecutive CAP patients was performed at five hospitals in Spain.

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Introduction: Farmer's lung disease (FLD) is a common form of hypersensitivity pneumonitis possibly underdiagnosed in our midst. The aim of this study was to describe clinical characteristics, evolution and factors that influence the prognosis of patients with FLD.

Patients And Methods: A retrospective study that included all patients diagnosed with FLD presenting an environmental exposure risk, a clinic, lung function and a compatible radiology, in which antigen sensitisation was demonstrated and/or a concordant pathology.

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Background: Limited data are available regarding the impact of the potential validation of the Canadian Thoracic Society (CTS) guidelines recommendations in classifying patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in simple and complex. The aim of the present study was to assess the CTS recommendations regarding risk stratification on clinical outcomes among patients hospitalized with an AECOPD.

Methods: We developed a retrospective cohort study of patients admitted to one tertiary hospital with a diagnosis of AECOPD.

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Benefit finding (BF) is defined as the individual's perception of positive change as a result of coping with an adverse life event. The beneficial effects of BF on well-being could be because BF favors the improvement of resources like self-efficacy, social support and effective coping. The main objective of this longitudinal 8 week study was to explore, in a sample of cardiac patients (n = 51), the combined contribution of BF and these resources to the positive affect.

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Compared to infants born to mothers without PTSD, infants born to mothers with active PTSD develop poorer behavioral reactivity and emotional regulation. However, the association between perinatal maternal PTSD and infant neural activation remains largely unknown. This pilot study (N=14) examined the association between perinatal PTSD severity and infant frontal neural activity, as measured by MEG theta power during rest.

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Background: Negative emotions are linked to the onset and development of coronary heart diseases (CHD), whereas positive emotions are associated with better health and lower mortality rates among patients with these diseases. The objective of this randomised trial was to improve cardiac patients' emotional states using a Programme to Improve Well-being (PIW) based exclusively on positive interventions (those that promote intentional behaviours and thoughts to improve well-being).

Methods: Cardiac patients (n = 108) were randomly assigned to two parallel groups.

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Farmer's lung disease (FLD) is a form of hypersensitivity pneumonitis (HP) caused by inhaling microorganisms from hay or grain stored in conditions of high humidity in the agricultural workplace. It is probably underdiagnosed, especially in northern Spain, where climatic conditions favor the development of this disease. According to previous studies, the most common antigens are usually thermophilic actinomycetes and fungi.

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Risk factors for steroid mood effects are unclear and few studies have examined drugs used concurrently with steroids (e.g., stimulants) or emotion regulation deficits that may have unique mood effects.

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Background: The prevalence of alcohol, tobacco, and other drug (ATOD) use among emergency department (ED) patients is high and many of these patients have unrecognized and unmet substance use treatment needs. Identification of patients in the ED with problem substance use is not routine at this time.

Methods: We examined screening data, including standardized measures of ATOD use (HSI, AUDIT-C, DAST-10), from 14,866 ED patients in six hospitals across the United States.

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Introduction: Clinical probability scores (CPS) determine the pre-test probability of pulmonary embolism (PE) and assess the need for the tests required in these patients. Our objective is to investigate if PE is diagnosed according to clinical practice guidelines.

Materials And Methods: Retrospective study of clinically suspected PE in the emergency department between January 2010 and December 2012.

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