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Noviembre 2013 PDF Imprimir E-mail
Jueves, 05 de Diciembre de 2013 00:00

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SELECCIÓN DE REFERENCIAS BIBLIOGRÁFICAS DE LO PUBLICADO EN RELACIÓN CON ATENCIÓN PRIMARIA

Selección realizada por Antonio Manteca González
 
ACADEMIC MEDICINE
 
Alberti PM, Bonham AC, Kirch DG. Making equity a value in value-based health care. Acad Med 2013;88:1619-1623 [R,I]
24072123             R/C
HACER DE LA EQUIDAD UN VALOR EN LA ATENCIÓN SANITARIA BASADA EN LOS VALORES
 
Doukas DJ, McCullough LB, Wear S, Lehmann LS, Nixon LL, Carrese JA, et al; Project to Rebalance and Integrate Medical Education (PRIME) Investigators. The challenge of promoting professionalism through medical ethics and humanities education. Acad Med 2013;88:1624-1629 [R,I]
24072126             R/C
EL DESAFÍO DE PROMOVER LA PROFESIONALIDAD A TRAVÉS DE LA ÉTICA MÉDICA Y LA FORMACIÓN EN HUMANIDADES
 
Bensadon BA, Teasdale TA, Odenheimer GL. Attitude adjustment: shaping medical students' perceptions of older patients with a geriatrics curriculum. Acad Med 2013;88:1630-1634 [R,I]
24072114             R/C
AJUSTE DE LA ACTITUD: MOLDEAR CON UN CURRÍCULO GERIÁTRICO LAS PERCEPCIONES DE LOS ESTUDIANTES DE MEDICINA SOBRE LOS PACIENTES MAYORES
 
Hoppe RB, King AM, Mazor KM, Furman GE, Wick-Garcia P, Corcoran-Ponisciak H, et al. Enhancement of the assessment of physician-patient communication skills in the United States medical licensing examination. Acad Med 2013;88:1670-1675 [R,I]
24072122             R/C
REFUERZO DE LA EVALUACIÓN DE LAS HABILIDADES EN COMUNICACIÓN ENTRE EL PACIENTE Y EL MÉDICO EN EL EXAMEN DE LICENCIATURA MÉDICA EN LOS ESTADOS UNIDOS
 
ANNALS OF INTERNAL MEDICINE
 
Goldzweig CL, Orshansky G, Paige NM, Towfigh AA, Haggstrom DA, Miake-Lye I, et al. Electronic patient portals: evidence on health outcomes, satisfaction, efficiency, and attitudes: a systematic review. Ann Intern Med 2013;159:677-687 [M,II]
24247673             R/C
PORTALES ELECTRÓNICOS PARA PACIENTES: EVIDENCIA SOBRE RESULTADOS EN SALUD, SATISFACCIÓN, EFICIENCIA Y ACTITUDES: REVISIÓN SISTEMÁTICA
 
Richardson K, Schoen M, French B, Umscheid CA, Mitchell MD, Arnold SE, et al. Statins and cognitive function: a systematic review. Ann Intern Med 2013;159:688-697 [M,II]
ESTATINAS Y FUNCIÓN COGNITIVA: REVISIÓN SISTEMÁTICA
 
Warm EJ, Goetz C. Too smart for primary care? Ann Intern Med 2013;159:709-710 [AO,I]
¿DEMASIADO INTELIGENTE PARA LA ATENCIÓN PRIMARIA?
 
Kussmaul WG 3rd. Too lazy for primary care? Ann Intern Med 2013;159:711-712 [AO,I]
¿DEMASIADO PEREZOSO PARA LA ATENCIÓN PRIMARIA?
 
ARCHIVOS DE BRONCONEUMOLOGIA
 
Martínez C, González FJ, Belda J, González I, Alfageme I, Orejas C, et al. Recomendaciones para la evaluación médica de la capacidad laboral en el enfermo respiratorio crónico. Arch Bronconeumol 2013;49:480-490 [R,II]
24120308             R/C
RECOMENDACIONES PARA LA EVALUACIÓN MÉDICA DE LA CAPACIDAD LABORAL EN EL ENFERMO RESPIRATORIO CRÓNICO
 
ARTHRITIS AND RHEUMATISM
 
van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2013;65:2737-2747 [M,II]
CRITERIOS DE CLASIFICACIÓN DE 2013 PARA LA ESCLEROSIS SISTÉMICA: INCIATIVA DE COLABORACIÓN DEL AMERICAN COLLEGE OF RHEUMATOLOGY Y LA LIGA EUROPEA CONTRA EL REUMATISMO
 
ATENCION PRIMARIA
 
Martínez SP. Medicina socializada frente a Medicina capitalista: ¿personas o dinero? Aten Primaria 2013;45:445-447 [AO,I]
MEDICINA SOCIALIZADA FRENTE A MEDICINA CAPITALISTA: ¿PERSONAS O DINERO?
 
BRITISH JOURNAL OF PSYCHIATRY
 
Shah PJ, Morton MJ. Adults with attention-deficit hyperactivity disorder - diagnosis or normality? Br J Psychiatry 2013;203:317-319 [AO,I]
24187063             R/C
ADULTOS CON TRASTORNO POR DÉFICIT DE ATENCIÓN E HIPERACTIVIDAD ¿DIAGNÓSTICO O NORMALIDAD?
 
Sharpe M. Somatic symptoms: beyond 'medically unexplained'. Br J Psychiatry 2013;203:320-321 [AO,I]
24187064             R/C
SÍNTOMAS SOMÁTICOS: MÁS ALLÁ DE "SIN EXPLICACIÓN MÉDICA"
 
Lam RW, Parikh SV, Ramasubbu R, Michalak EE, Tam EM, Axler A, et al. Effects of combined pharmacotherapy and psychotherapy for improving work functioning in major depressive disorder. Br J Psychiatry 2013;203:358-365 [EC,II]
24029535             R/C
EFECTOS DE LA FARMACOTERAPIA Y LA PSICOTERAPIA COMBINADAS PARA MEJORAR LA FUNCIÓN LABORAL EN EL TRASTORNO DEPRESIVO GRAVE
 
Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Lieb R, et al; EURASMUS Population Based Study Group. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychiatry 2013;203:373-380 [M,II]
24072756             R/C
TABLA TOTAL DE SÍNTOMAS SOMÁTICOS COMO PREDICTOR DE RESULTADOS DE SALUD EN LOS TRASTORNOS DE SÍNTOMAS SOMÁTICOS
 
BRITISH MEDICAL JOURNAL
 
Jordan R, Adab P, Jolly K. Telemonitoring for patients with COPD. BMJ 2013;347:f5932 [AO,I]
TELEMONITORIZACIÓN DE PACIENTES CON EPOC
 
Block JP. A substantial tax on sugar sweetened drinks could help reduce obesity. BMJ 2013;347:f5947 [AO,I]
UN IMPUESTO SUSTANCIAL SOBRE LAS BEBIDAS AZUCARADAS PODRÍA AYUDAR A REDUCIR LA OBESIDAD
 
Ramirez J. Severe hypotension associated with a blocker tamsulosin. BMJ 2013;347:f6492 [AO,I]
HIPOTENSIÓN GRAVE ASOCIADA CON EL BLOQUEADOR TAMSULOSINA
 
Hanefeld J, Lunt N, Smith R. Paying for migrant healthcare. BMJ 2013;347:f6514 [AO,I]
PAGAR POR LA ATENCIÓN SANITARIA A LOS INMIGRANTES
 
Marmot M, Goldblatt P. Importance of monitoring health inequalities. BMJ 2013;347:f6576 [AO,I]
IMPORTANCIA DE MONITORIZAR LAS DESIGUALDADES EN SALUD
 
Dempsey OJ, Miller D. Idiopathic pulmonary fibrosis. BMJ 2013;347:f6579 [AO,I]
FIBROSIS PULMONAR IDIOPÁTICA
 
Hodge A, Jimenez-Soto E. Determinants of childhood mortality. BMJ 2013;347:f6632 [AO,I]
DETERMINANTES DE LA MORTALIDAD INFANTIL
 
Hodgkin P, Taylor J. Power to the people: what will bring about the patient centred revolution? BMJ 2013;347:f6701 [AO,I]
PODER PARA LA GENTE: ¿QUÉ TRAERÁ LA REVOLUCIÓN CENTRADA EN EL PACIENTE?
 
Godlee F. We need to separate “old” and “age”. BMJ 2013;347:f6823 [AO,I]
NECESITAMOS SEPARAR "VIEJO" Y "EDAD"
 
Davies E. Cardiovascular risk guidelines and transparency. BMJ 2013;347:f7022 [AO,I]
GUÍAS DE RIESGO CARDIOVASCULAR Y TRANSPARENCIA
 
Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, Lewis S, et al. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ 2013;347:f6070 [EC,I]
24136634             R/C
EFECTIVIDAD DE LA TELEMONITORIZACIÓN INTEGRADA DENTRO DE LOS SERVICIOS CLÍNICOS EXISTENTES SOBRE LOS INGRESOS HOSPITALARIOS POR EXACERBACIONES DE LA EPOC: ENSAYO ALEATORIZADO CONTROLADO ENMASCARADO PARA EL INVESTIGADOR
 
Briggs AD, Mytton OT, Kehlbacher A, Tiffin R, Rayner M, Scarborough P. Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study. BMJ 2013;347:f6189 [T,I]
24179043             R/C
EFECTO GLOBAL Y ESPECÍFICO SOBRE LA PREVALENCIA DE SOBREPESO Y OBESIDAD DEL IMPUESTO DEL 20% SOBRE LAS BEBIDAS AZUCARADAS EN R.U.: ESTUDIO DE MODELAJE ECONOMÉTRICO Y DE VALORACIÓN DE RIESGO COMPARADO
 
El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ 2013;347:f6234 [M,II]
24169944             R/C
EFECTO DE PROGRAMAS DE EJERCICIO PARA PREVENCIÓN DE CAÍDAS SOBRE LAS HERIDAS PRODUCIDAS POR CAÍDAS EN ANCIANOS RESIDENTES EN LA COMUNIDAD: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE ENSAYOS ALEATORIZADOS CONTROLADOS
 
Bird ST, Delaney JA, Brophy JM, Etminan M, Skeldon SC, Hartzema AG. Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology. BMJ 2013;347:f6320 [S,I]
24192967             R/C
TRATAMIENTO CON TAMSULOSINA PARA LA HIPERPLASIA BENIGNA DE PRÓSTATA Y RIESGO DE HIPOTENSIÓN GRAVE EN HOMBRES ENTRE 40-85 AÑOS EN LOS EE UU: ANÁLISIS DE VENTANA DE RIESGO USANDO METODOLOGÍA INTER E INTRAPACIENTE
 
Chappell LC, Seed PT, Myers J, Taylor RS, Kenny LC, Dekker GA, et al. Exploration and confirmation of factors associated with uncomplicated pregnancy in nulliparous women: prospective cohort study. BMJ 2013;347:f6398 [S,II]
24270055             R/C
EXPLORACIÓN Y CONFIRMACIÓN DE LOS FACTORES ASOCIADOS CON EL EMBARAZO NO COMPLICADO DE MUJERES NULÍPARAS: ESTUDIO DE COHORTE PROSPECTIVA
 
Jones K, Saxon L, Cunningham W, Adams P; Guideline Development Group. Secondary prevention for patients after a myocardial infarction: summary of updated NICE guidance. BMJ 2013;347:f6544 [M,II]
PREVENCIÓN SECUNDARIA EN PACIENTES TRAS INFARTO DE MIOCARDIO: RESUMEN DE LA GUÍA NICE ACTUALIZADA
 
Quint JK, Herrett E, Bhaskaran K, Timmis A, Hemingway H, Wedzicha JA, et al. Effect of ß blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records. BMJ 2013;347:f6650 [S,I]
24270505             R/C
EFECTO DE LOS BETA-BLOQUEANTES SOBRE LA MORTALIDAD TRAS INFARTO DE MIOCARDIO EN ADULTOS CON EPOC: ESTUDIO DE COHORTE POBLACIONAL DE REGISTROS SANITARIOS ELECTRÓNICOS EN R. U.
 
Walker I, Chappell LC, Williamson C. Abnormal liver function tests in pregnancy. BMJ 2013;347:f6055 [R,I]
PRUEBAS DE FUNCIÓN HEPÁTICA ANORMALES EN EL EMBARAZO
 
Thomas R, Mitchell GK, Batstra L. Attention-deficit/hyperactivity disorder: are we helping or harming? BMJ 2013;347:f6172 [R,I]
TRASTORNO POR DÉFICIT DE ATENCIÓN/HIPERACTIVIDAD: ¿ESTAMOS AYUDANDO O PERJUDICANDO?
 
Caldwell PH, Deshpande AV, Gontard AV. Management of nocturnal enuresis. BMJ 2013;347:f6259 [R,I]
TRATAMIENTO DE LA ENEURESIS NOCTURNA
 
Thrumurthy SG, Chaudry MA, Hochhauser D, Mughal M. The diagnosis and management of gastric cancer. BMJ 2013;347:f6367 [R,I]
DIAGNÓSTICO Y MANEJO DEL CÁNCER GÁSTRICO
 
Spijker J, Macinnes J. Population ageing: the timebomb that isn't? BMJ 2013;347:f6598 [R,I]
ENVEJECIMIENTO POBLACIONAL: ¿LA BOMBA RETARDADA QUE NO LO ES?
 
Giles SL, Lester F. Should women with HIV, or at high risk of contracting HIV, use progestogen-containing contraception? BMJ 2013;347:f6695 [R,I]
¿DEBERÍAN LAS MUJERES CON VIH O CON GRAN RIESGO DE CONTRAERLO USAR ANTICONCEPCIÓN CON PROGESTÁGENOS?
 
Weetman AP. Investigating low thyroid stimulating hormone (TSH) level. BMJ 2013;347:f6842 [R,II]
INVESTIGAR LOS NIVELES BAJOS DE TSH
 
CIRCULATION
 
Steinke EE, Jaarsma T, Barnason SA, Byrne M, Doherty S, Dougherty CM, et al; Council on Cardiovascular and Stroke Nursing of the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Sexual counseling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Circulation 2013;128:2075-2096 [M,II]
CONSEJO SEXUAL PARA INDIVIDUOS CON ENFERMEDAD CARDIOVASCULAR Y SUS PAREJAS: DOCUMENTO DE CONSENSO DE LA AHA Y DE LA CCNAP DE LA ESC
 
Marijon E, Le Heuzey JY, Connolly S, Yang S, Pogue J, Brueckmann M, et al; RE-LY Investigators. Causes of death and influencing factors in patients with atrial fibrillation: a competing-risk analysis from the randomized evaluation of long-term anticoagulant therapy study. Circulation 2013;128:2192-2201 [EC,II]
24016454             R/C
CAUSAS DE MUERTE Y LOS FACTORES QUE INFLUYEN EN ELLA EN PACIENTES CON FIBRILACIÓN AURICULAR: ANÁLISIS DE RIESGO A PARTIR DE LA EVALUACIÓN ALEATORIZADA DEL ESTUDIO DE TRATAMIENTO ANTICOAGULANTE A LARGO PLAZO
 
Rahimi K, Macmahon S. Blood pressure management in the 21st century: maximizing gains and minimizing waste. Circulation 2013;128:2283-2285 [AO,I]
TRATAMIENTO DE LA PRESIÓN ARTERIAL EN EL SIGLO 21: MAXIMIZAR LAS GANANCIAS Y MINIMIZAR LAS PÉRDIDAS
 
Wennberg PW. Approach to the patient with peripheral arterial disease. Circulation 2013;128:2241-2250 [R,I]
ABORDAJE DEL PACIENTE CON ENFERMEDAD ARTERIAL PERIFÉRICA
 
Strath SJ, Kaminsky LA, Ainsworth BE, Ekelund U, Freedson PS, Gary RA, et al; American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health and Cardiovascular, Exercise, Cardiac Rehabilitation and Prevention Committee of the Council on Clinical Cardiology, and Council. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association. Circulation 2013;128:2259-2279 [M,II]
GUÍA PARA EVALUAR LA ACTIVIDAD FÍSICA: APLICACIONES EN LA CLÍNICA Y EN LA INVESTIGACIÓN: DECLARACIÓN CIENTÍFICA DE LA AHA
 
Fleg JL, Forman DE, Berra K, Bittner V, Blumenthal JA, Chen MA, et al; American Heart Association Committees on Older Populations and Exercise Cardiac Rehabilitation and Prevention of the Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Lifestyle and Cardiometabolic He. Secondary prevention of atherosclerotic cardiovascular disease in older adults: a scientific statement from theAmerican Heart Association. Circulation 2013;128:2422-2446 [M,II]
PREVENCIÓN SECUNDARIA DE LA ENFERMEDAD CARDIOVASCULAR ATEROSCLERÓTICA EN ANCIANOS: DECLARACIÓN CIENTÍFICA DE LA AHA
 
Thukkani AK, Bhatt DL. Renal denervation therapy for hypertension. Circulation 2013;128:2251-2254 [AO,I]
TRATAMIENTO MEDIANTE DENERVACIÓN RENAL EN LA HIPERTENSIÓN
 
Simon DI, Simon NM. Plasminogen activator inhibitor-1: a novel therapeutic target for hypertension? Circulation 2013;128:2286-2288 [AO,I]
INHIBIDOR 1 DEL ACTIVADOR DEL PLASMINÓGENO: NUEVA DIANA TERAPÉUTICA EN LA HIPERTENSIÓN
 
Mortensen SP, Boushel R. High-density lipoprotein: a new therapeutic target for glucose intolerance? Circulation 2013;128:2349-2350 [AO,I]
HDL: ¿NUEVA DIANA TERAPÉUTICA EN LA INTOLERANCIA A LA GLUCOSA?
 
Puri R, Nissen SE, Libby P, Shao M, Ballantyne CM, Barter PJ, et al. C-Reactive protein, but not low-density lipoprotein cholesterol levels, associate with coronary atheroma regression and cardiovascular events after maximally intensive statin therapy. Circulation 2013;128:2395-2403 [T,II]
24043299             R/C
LOS NIVELES DE PROTEÍNA C REACTIVA Y NO LOS DE LDL-COLESTEROL SE ASOCIAN CON LA REGRESIÓN DEL ATEROMA CORONARIO Y LOS ACONTECIMIENTOS CARDIOVASCULARES TRAS TRATAMIENTO MÁXIMAMENTE INTENSIVO CON ESTATINAS
 
Lavie CJ, Dinicolantonio JJ, Milani RV, O'Keefe JH. Vitamin D and cardiovascular health. Circulation 2013;128:2404-2406 [AO,I]
VITAMINA D Y SALUD CARDIOVASCULAR
 
DIABETES CARE
 
Häring HU, Merker L, Seewaldt-Becker E, Weimer M, Meinicke T, Woerle HJ, et al; EMPA-REG METSU Trial Investigators. Empagliflozin as add-on to metformin plus sulfonylurea in patients with type 2 diabetes: a 24-week, randomized, double-blind, placebo-controlled trial. Diabetes Care 2013;36:3396-3404 [EC,II]
23963895             R/C
EMPAGLIFLOZINA AÑADIDA A METFORMINA MÁS SULFONILUREA EN PACIENTES CON DIABETES TIPO 2: ENSAYO DE 24 SEMANAS ALEATORIZADO, DOBLE CIEGO, CONTROLADO CON PLACEBO
 
Khunti K, Wolden ML, Thorsted BL, Andersen M, Davies MJ. Clinical inertia in people with type 2 diabetes: a retrospective cohort study of more than 80,000 people. Diabetes Care 2013;36:3411-3417 [S,II]
23877982             R/C
INERCIA CLÍNICA EN PERSONAS CON DIABETES TIPO 2: ESTUDIO RETROSPECTIVO DE COHORTE DE MÁS DE 80.000 PERSONAS
 
Engwerda EE, Tack CJ, de Galan BE. Needle-free jet injection of rapid-acting insulin improves early postprandial glucose control in patients with diabetes. Diabetes Care 2013;36:3436-3441 [EC,I]
24089542             R/C
UNA INYECCIÓN DE INSULINA DE ACCIÓN RÁPIDA POR CHORRO SIN AGUJA MEJORA EL CONTROL DE LA GLUCOSA POSTPRANDIAL EN PACIENTES CON DIABETES
 
Groop PH, Cooper ME, Perkovic V, Emser A, Woerle HJ, von Eynatten M. Linagliptin lowers albuminuria on top of recommended standard treatment in patients with type 2 diabetes and renal dysfunction. Diabetes Care 2013;36:3460-3468 [EC,II]
24026560             R/C
LA LINAGLIPTINA DESCIENDE LA ALBUMINURIA POR ENCIMA DEL TRATAMIENTO ESTÁNDAR RECOMENDADO EN PACIENTES CON DIABETES TIPO 2 Y DISFUNCIÓN RENAL
 
Radomska E, Sadowski M, Kurzawski J, Gierlotka M, Polonski L. ST-Segment elevation myocardial infarction in women with type 2 diabetes. Diabetes Care 2013;36:3469-3475 [T,I]
24089535             R/C
INFARTO DE MIOCARDIO CON ELEVACIÓN DEL SEGMENTO ST EN MUJERES CON DIABETES TIPO 2
 
van der Heijden AA, Van't Riet E, Bot SD, Cannegieter SC, Stehouwer CD, Baan CA, et al. Risk of a recurrent cardiovascular event in individuals with type 2 diabetes or intermediate hyperglycemia: the Hoorn study. Diabetes Care 2013;36:3498-3502 [S,II]
23877981             R/C
RIESGO DE ACONTECIMIENTO CARDIOVASCULAR RECURRENTE EN INDIVIDUOS CON DIABETES TIPO 2 O HIPERGLUCEMIA INTERMEDIA: ESTUDIO HOORN
 
Stürmer T, Marquis MA, Zhou H, Meigs JB, Lim S, Blonde L, et al. Cancer incidence among those initiating insulin therapy with glargine versus human NPH insulin. Diabetes Care 2013;36:3517-3525 [S,II]
23877991             R/C
INCIDENCIA DE CÁNCER ENTRE LOS QUE INICIAN TERAPIA CON INSULINA GLARGINA FRENTE A INSULINA HUMANA NPH
 
Elks CE, Ong KK, Scott RA, van der Schouw YT, Brand JS, Wark PA, et al; InterAct Consortium. Age at menarche and type 2 diabetes risk: the EPIC-InterAct study. Diabetes Care 2013;36:3526-3534 [S,II]
24159179             R/C
EDAD DE LA MENARQUIA Y RIESGO DE DIABETES TIPO 2: ESTUDIO EPIC-INTERACT
 
Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2013;36:3821-3842 [R,III]
RECOMENDACIONES NUTRICIONALES EN EL MANEJO DE ADULTOS CON DIABETES
 
Vigersky RA, Fitzner K, Levinson J; Diabetes Working Group. Barriers and potential solutions to providing optimal guideline-driven care to patients with diabetes in the U.S. Diabetes Care 2013;36:3843-3849 [R,II]
24159181             R/C
BARRERAS Y SOLUCIONES POTENCIALES PARA PROPORCIONAR ATENCIÓN ÓPTIMA SEGÚN LAS GUÍAS A PACIENTES CON DIABETES EN EE UU
 
DRUGS
 
Nordstrom K, Allen MH. Alternative delivery systems for agents to treat acute agitation: progress to date. Drugs 2013;73:1783-1792 [R,I]
24151084             R/C
SISTEMAS ALTERNATIVOS DE ADMINISTRACIÓN DE AGENTES PARA TRATAR LA AGITACIÓN AGUDA: PROGRESO HASTA LA FECHA
 
Keating GM. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria. Drugs 2013;73:1951-1966 [R,II]
24202878             R/C
FOSFOMICINA TROMETAMOL: REVISIÓN DE SU USO COMO TRATAMIENTO EN DOSIS ORAL SIMPLE EN PACIENTES CON INFECCIONES AGUDAS DE VÍAS BAJAS URINARIAS Y MUJERES EMBARAZADAS CON BACTERIURIA ASINTOMÁTICA
 
ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA
 
Otero L, Vazquez F. Neisseria gonorrhoeae multirresistente: ¿regreso al pasado? Enferm Infecc Microbiol Clin 2013;31:565-567 [AO,I]
NEISSERIA GONORRHOEAE MULTIRRESISTENTE: ¿REGRESO AL PASADO?
 
Panel de expertos de GeSIDA y Plan Nacional sobre el Sida. Documento de consenso de GeSIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (actualización enero 2013) Enferm Infecc Microbiol Clin 2013;31:602.e1-602.e98 [M,II]
24161378             R/C
DOCUMENTO DE CONSENSO DE GESIDA/PLAN NACIONAL SOBRE EL SIDA RESPECTO AL TRATAMIENTO ANTIRRETROVIRAL EN ADULTOS INFECTADOS POR EL VIRUS DE LA INMUNODEFICIENCIA HUMANA (ACTUALIZACIÓN ENERO 2013)
 
Panel of Experts of GESIDA and Spanish Secretariat for the National Plan on AIDS. Resumen del Documento de Consenso de GeSIDA/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (actualización enero 2013) Enferm Infecc Microbiol Clin 2013;31:602.e1-602.e98 [M,II]
24156952             R/C
RESUMEN DEL DOCUMENTO DE CONSENSO DE GESIDA/PLAN NACIONAL SOBRE EL SIDA RESPECTO AL TRATAMIENTO ANTIRRETROVIRAL EN ADULTOS INFECTADOS POR EL VIRUS DE LA INMUNODEFICIENCIA HUMANA (ACTUALIZACIÓN ENERO 2013)
 
EUROPEAN HEART JOURNAL
 
Allison TG. Changing medical culture to promote physical activity in secondary prevention of coronary artery disease. Eur Heart J 2013;34:3245-3247 [AO,I]
CAMBIAR LA CULTURA MÉDICA PARA PROMOVER LA ACTIVIDAD FÍSICA EN LA PREVENCIÓN SECUNDARIA DE LA ENFERMEDAD ARTERIAL CORONARIA
 
Rigotti NA, Clair C. Managing tobacco use: the neglected cardiovascular disease risk factor. Eur Heart J 2013;34:3259-3267 [R,I]
24014389             R/C
MANEJO DEL USO DEL TABACO: EL FACTOR DE RIESGO DE ENFERMEDAD CARDIOVASCULAR DESCUIDADO
 
Kostner KM, März W, Kostner GM. When should we measure lipoprotein (a)? Eur Heart J 2013;34:3268-3276 [R,I]
23735860             R/C
¿CUÁNDO DEBERÍAMOS MEDIR LA LIPOPROTEÍNA (A)?
 
Hadamitzky M, Täubert S, Deseive S, Byrne RA, Martinoff S, Schömig A, et al. Prognostic value of coronary computed tomography angiography during 5 years of follow-up in patients with suspected coronary artery disease. Eur Heart J 2013;34:3277-3285 [S,I]
24067508             R/C
VALOR PRONÓSTICO DE LA ANGIOGRAFÍA MEDIANTE TAC CORONARIO DURANTE 5 AÑOS DE SEGUIMIENTO EN PACIENTES CON SOSPECHA DE ENFERMEDAD ARTERIAL CORONARIA
 
Stewart R, Held C, Brown R, Vedin O, Hagstrom E, Lonn E, et al. Physical activity in patients with stable coronary heart disease: an international perspective. Eur Heart J 2013;34:3286-3293 [T,I]
24014220             R/C
ACTIVIDAD FÍSICA EN PACIENTES CON ENFERMEDAD CARDIACA CORONARIA ESTABLE: PERSPECTIVA INTERNACIONAL
 
GACETA SANITARIA
 
Ramos M, Taltavull M, Piñeiro P, Nieto R, Llagostera M. Actitudes de las personas usuarias de atención primaria ante el cribado del cáncer colorrectal. Gac Sanit 2013;27:516-520 [C,I]
23280043             R/C
ACTITUDES DE LAS PERSONAS USUARIAS DE ATENCIÓN PRIMARIA ANTE EL CRIBADO DEL CÁNCER COLORRECTAL
 
Costa D, Soares JJ, Lindert J, Hatzidimitriadou E, Karlsso A, Sundin O, et al. La violencia de pareja en Europa: diseño y métodos de un estudio multinacional. Gac Sanit 2013;27:558-561 [T,I]
23643717             R/C
LA VIOLENCIA DE PAREJA EN EUROPA: DISEÑO Y MÉTODOS DE UN ESTUDIO MULTINACIONAL
 
GUT
 
Pérez-Cobas AE, Gosalbes MJ, Friedrichs A, Knecht H, Artacho A, Eismann K, et al. Gut microbiota disturbance during antibiotic therapy: a multi-omic approach. Gut 2013;62:1591-1601 [T,I]
23236009             R/C
ALTERACIÓN DE LA FLORA BACTERIANA INTESTINAL DURANTE EL TRATAMIENTO ANTIBIÓTICO: ABORDAJE...
 
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
 
Moses H 3rd, Matheson DH, Dorsey ER, George BP, Sadoff D, Yoshimura S. The anatomy of health care in the United States. JAMA 2013;310:1947-1963 [R,II]
24219951            R/C
ANATOMÍA DE LA ATENCIÓN SANITARIA EN LOS ESTADOS UNIDOS
 
McLean RC, Jessup M. The challenge of treating heart failure: a diverse disease affecting diverse populations. JAMA 2013;310:2033-2034 [AO,I]
EL RETO DE TRATAR LA INSUFICIENCIA CARDIACA: UNA ENFERMEDAD DIVERSA QUE AFECTA A POBLACIONES DIVERSAS
 
Gaziano JM, Gaziano TA. What's new with measuring cholesterol? JAMA 2013;310:2043-2044 [AO,I]
¿QUÉ HAY DE NUEVO EN LA MEDICIÓN DEL COLESTEROL?
 
Martin SS, Blaha MJ, Elshazly MB, Toth PP, Kwiterovich PO, Blumenthal RS, et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA 2013;310:2061-2068 [T,I]
24240933             R/C
COMPARACIÓN DE UN NUEVO MÉTODO FRENTE A LA ECUACIÓN DE FRIEDEWALD PARA CALCULAR LOS NIVELES DE COLESTEROL LDL A PARTIR DEL PERFIL LIPÍDICO ESTÁNDAR
 
Brett AS. Oral fluoroquinolone use and retinal detachment: reconciling conflicting findings in observational research. JAMA 2013;310:2151-2153 [AO,I]
USO DE FLUOROQUINOLONA ORAL Y DESPRENDIMIENTO DE RETINA: RECONCILIAR HALLAZGOS CONFLICTIVOS EN LA INVESTIGACIÓN OBSERVACIONAL
 
Pasternak B, Svanström H, Melbye M, Hviid A. Association between oral fluoroquinolone use and retinal detachment. JAMA 2013;310:2184-2190 [S,II]
24281462             R/C
ASOCIACIÓN ENTRE USO DE FLUOROQUINOLONA ORAL Y DESPRENDIMIENTO DE RETINA
 
JAMA INTERNAL MEDICINE
 
Willey J, Gonzalez-Castellon M. Cholesterol level and stroke: a complex relationship. JAMA Intern Med 2013;173:1765-1766 [AO,I]
NIVELES DE COLESTEROL E ICTUS: UNA RELACIÓN COMPLEJA
 
Gill TM, Murphy TE, Gahbauer EA, Allore HG. The course of disability before and after a serious fall injury. JAMA Intern Med 2013;173:1780-1786 [S,II]
23958741             R/C
EL CURSO DE LA DISCAPACIDAD ANTES Y DESPUÉS DE UNA HERIDA GRAVE POR CAÍDA
 
Smith-Bindman R, Lebda P, Feldstein VA, Sellami D, Goldstein RB, Brasic N, et al.
Risk of thyroid cancer based on thyroid ultrasound imaging characteristics: results of a population-based study. JAMA Intern Med 2013;173:1788-1796 [CC,I]
23978950             R/C
RIESGO DE CÁNCER DE TIROIDES BASADO EN LAS CARACTERÍSTICAS DE LA ECOGRAFÍA TIROIDEA: RESULTADOS DE UN ESTUDIO POBLACIONAL
 
Nyweide DJ, Anthony DL, Bynum JP, Strawderman RL, Weeks WB, Casalino LP, et al. Continuity of care and the risk of preventable hospitalization in older adults. JAMA Intern Med 2013;173:1879-1885 [S,II]
24043127             R/C
CONTINUIDAD DE LA ATENCIÓN Y RIESGO DE HOSPITALIZACIÓN PREVENIBLE EN ANCIANOS
 
Gupta R, Bodenheimer T. How primary care practices can improve continuity of care. JAMA Intern Med 2013;173:1885-1886 [AO,I]
CÓMO LAS CONSULTAS DE ATENCIÓN PRIMARIA PUEDEN MEJORAR LA CONTINUIDAD DE LA ATENCIÓN
 
JAMA PSYCHIATRY
 
Ressler KJ, Rothbaum BO. Augmenting obsessive-compulsive disorder treatment: from brain to mind. JAMA Psychiatry 2013;70:1129-1131 [AO,I]
24026506             R/C
AUMENTAR EL TRATAMIENTO DEL TRASTORNO OBSESIVO-COMPULSIVO: DEL CEREBRO A LA MENTE
 
Beardslee WR, Brent DA, Weersing VR, Clarke GN, Porta G, Hollon SD, et al. Prevention of depression in at-risk adolescents: longer-term effects. JAMA Psychiatry 2013;70:1161-1170 [EC,II]
24005242             R/C
PREVENCIÓN DE LA DEPRESIÓN EN LOS ADOLESCENTES EN RIESGO: EFECTOS A LARGO PLAZO
 
MEDICINA CLINICA
 
Pons JM, Argimón JM. De la parsimonia en medicina. Med Clin (Barc) 2013;141:387-389 [AO,II]
DE LA PARSIMONIA EN MEDICINA
 
Molina M, Gonzalez R, Folgado J, Real JT, Martínez-Hervás S, Priego A, et al. Correlación entre las concentraciones plasmáticas de homocisteína y la polineuropatía diabética evaluada con la prueba del monofilamento de Semmes-Weinstein en pacientes con diabetes tipo 2. Med Clin (Barc) 2013;141:382-386 [T,I]
23332627             R/C
CORRELACIÓN ENTRE LAS CONCENTRACIONES PLASMÁTICAS DE HOMOCISTEÍNA Y LA POLINEUROPATÍA DIABÉTICA EVALUADA CON LA PRUEBA DEL MONOFILAMENTO DE SEMMES-WEINSTEIN EN PACIENTES CON DIABETES TIPO 2
 
Reyes-Alcázar V, Cambil J, Herrera-Usagre M; SADECA. Revisión sistemática sobre recomendaciones de seguridad del paciente para centros sociosanitarios. Med Clin (Barc) 2013;141:397-405 [M,III]
23597954             R/C
REVISIÓN SISTEMÁTICA SOBRE RECOMENDACIONES DE SEGURIDAD DEL PACIENTE PARA CENTROS SOCIOSANITARIOS
 
Millán J, Alegría E, Guijarro C, Lozano JV, Vitale GC, González-Timón B, et al. Dislipemia en población diabética tratada con estatinas. Resultados del estudio DYSIS en España. Med Clin (Barc) 2013;141:430-436 [S,II]
23246165             R/C
DISLIPEMIA EN POBLACIÓN DIABÉTICA TRATADA CON ESTATINAS. RESULTADOS DEL ESTUDIO DYSIS EN ESPAÑA
 
Santiago-Ruiz JL, Manzano L. Predictores pronósticos en el paciente anciano con insuficiencia cardiaca: «A veces lo más sencillo es lo mejor». Med Clin (Barc) 2013;141:440-441 [AO,I]
PREDICTORES PRONÓSTICOS EN EL PACIENTE ANCIANO CON INSUFICIENCIA CARDIACA: «A VECES LO MÁS SENCILLO ES LO MEJOR»
 
Papaseit E, Pérez-Mañá C, Torrens M, Farré M. Reacciones adversas de medicamentos relacionadas con el abuso y formas farmacéuticas disuasorias. Med Clin (Barc) 2013;141:454-458 [R,I]
REACCIONES ADVERSAS DE MEDICAMENTOS RELACIONADAS CON EL ABUSO Y FORMAS FARMACÉUTICAS DISUASORIAS
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
Rodríguez-Artalejo F. Potenciar la prevención cardiovascular primordial y primaria para aumentar la esperanza de vida. Rev Esp Cardiol 2013;66:837-838 [AO,I]
POTENCIAR LA PREVENCIÓN CARDIOVASCULAR PRIMORDIAL Y PRIMARIA PARA AUMENTAR LA ESPERANZA DE VIDA
 
Anguita M; Grupo de Trabajo de la SEC sobre la guía de hipertensión arterial ESC/ESH 2013, revisores expertos de la guía de hipertensión arterial ESC/ESH 2013 y Comité de Guías de Práctica Clínica de la SEC. Comentarios a la guía de práctica clínica de la ESC/ESH 2013 para el manejo de la hipertensión arterial. Un informe del Grupo de Trabajo del Comité de Guías de Práctica Clínica de la Sociedad Española de Cardiología. Rev Esp Cardiol 2013;66:842-847 [AO,II]
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COMENTARIOS A LA GUÍA DE PRÁCTICA CLÍNICA DE LA ESC/ESH 2013 PARA EL MANEJO DE LA HIPERTENSIÓN ARTERIAL. UN INFORME DEL GRUPO DE TRABAJO DEL COMITÉ DE GUÍAS DE PRÁCTICA CLÍNICA DE LA SOCIEDAD ESPAÑOLA DE CARDIOLOGÍA
 
García JM. Contribuciones de la mortalidad cardiovascular a la esperanza de vida de la población española de 1980 a 2009. Rev Esp Cardiol 2013;66:848-853 [T,II]
24012213             R/C
CONTRIBUCIONES DE LA MORTALIDAD CARDIOVASCULAR A LA ESPERANZA DE VIDA DE LA POBLACIÓN ESPAÑOLA DE 1980 A 2009
 
Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M et al. Guía de práctica clínica de la ESH/ESC 2013 para el manejo de la hipertensión arterial. Rev Esp Cardiol. 2013;66:880.e1-880.e64 [M,III]
GUÍA DE PRÁCTICA CLÍNICA DE LA ESH/ESC 2013 PARA EL MANEJO DE LA HIPERTENSIÓN ARTERIAL
 
THE LANCET
 
Lynskey MT, Strang J. The global burden of drug use and mental disorders. Lancet 2013;382:1540-1542 [AO,I]
LA CARGA MUNDIAL DE USO DE DROGAS Y TRASTORNOS MENTALES
 
Hajek P. Electronic cigarettes for smoking cessation. Lancet 2013;382:1614-1616 [AO,I]
CIGARRILLOS ELECTRÓNICOS PARA DEJAR DE FUMAR
 
Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013;382:1629-1637 [EC,II]
24029165             R/C
CIGARRILLOS ELECTRÓNICOS PARA DEJAR DE FUMAR: ENSAYO CONTROLADO ALEATORIZADO
 
Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet 2013;382:1656-1664 [R,I]
23845860             R/C
ALERGIA ALIMENTARIA MEDIADA POR IgE EN NIÑOS
 
Statins: new US guideline sparks controversy. Lancet 2013;382:1680 [AO,I]
ESTATINAS: LA NUEVA GUÍA ESTADOUNIDENSE ENCIENDE LA CONTROVERSIA
 
The global dominance of diabetes. Lancet 2013;382:1680 [AO,I]
PREPONDERANCIA MUNDIAL DE LA DIABETES
 
May AE. Antiplatelet therapy after coronary stenting: for how long? Lancet 2013;382:1684-1685 [AO,I]
TERAPIA ANTIPLAQUETARIA TRAS IMPLANTACIÓN DE STENT CORONARIO: ¿POR CUÁNTO TIEMPO?
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
Bair-Merritt M, Zuckerman B, Augustyn M, Cronholm PF. Silent victims--an epidemic of childhood exposure to domestic violence. N Engl J Med 2013;369:1673-1675 [AO,I]
LAS VÍCTIMAS SILENCIOSAS: EPIDEMIA DE EXPOSICIÓN DE LA INFANCIA A LA VIOLENCIA DOMÉSTICA
 
Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, et al. Cost-effectiveness of HIV treatment as prevention in serodiscordant couples. N Engl J Med 2013;369:1715-1725 [CE,I]
24171517             R/C
RENTABILIDAD DEL TRATAMIENTO DEL VIH COMO PREVENCIÓN EN PAREJAS SERODISCORDANTES
 
Stillman M, Tailor M. Dead man walking. N Engl J Med 2013;369:1880-1881 [AO,II]
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MUERTO ANDANTE
 
Fried LF, Emanuele N, Zhang JH, Brophy M, Conner TA, Duckworth W, et al; VA NEPHRON-D Investigators. Combined Angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013;369:1892-1903 [EC,II]
24206457             R/C
INHIBICIÓN COMBINADA CON ANGIOTENSINA PARA EL TRATAMIENTO DE LA NEFROPATÍA DIABÉTICA
 
Volkow ND, Swanson JM. Clinical practice: Adult attention deficit-hyperactivity disorder. N Engl J Med 2013;369:1935-1944 [R,I]
24224626             R/C
PRÁCTICA CLÍNICA: TRASTORNO POR DÉFICIT DE ATENCIÓN-HIPERACTIVIDAD
 
de Zeeuw D. The end of dual therapy with renin-angiotensin-aldosterone system blockade? N Engl J Med 2013;369:1960-1962 [AO,I]
¿EL FIN DE LA TERAPIA DUAL CON BLOQUEO DEL SISTEMA RENINA-ANGIOTENSINA-ALDOSTERONA?
 
Bao Y, Han J, Hu FB, Giovannucci EL, Stampfer MJ, Willett WC, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med 2013;369:2001-2011 [S,II]
24256379             R/C
ASOCIACIÓN DEL CONSUMO DE FRUTOS SECOS Y MORTALIDAD TOTAL Y POR CAUSAS ESPECÍFICAS
 
Barouch DH. The quest for an HIV-1 vaccine--moving forward. N Engl J Med 2013;369:2073-2076 [AO,I]
LA BÚSQUEDA DE UNA VACUNA PARA EL VIH-1--AVANCES
 
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, Halperin JL, et al; ENGAGE AF-TIMI 48 Investigators. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013;369:2093-2104 [EC,II]
24251359             R/C
EDOXABAN FRENTE A WARFARINA EN PACIENTES CON FIBRILACIÓN AURICULAR
 
van Panhuis WG, Grefenstette J, Jung SY, Chok NS, Cross A, Eng H, et al. Contagious diseases in the United States from 1888 to the present. N Engl J Med 2013;369:2152-2158 [R,I]
ENFERMEDADES CONTAGIOSAS EN LOS ESTADOS UNIDOS DESDE 1888 HASTA EL PRESENTE
 
THORAX
 
Suissa S, Patenaude V, Lapi F, Ernst P. Inhaled corticosteroids in COPD and the risk of serious pneumonia. Thorax 2013;68:1029-1036 [S,II]
24130228             R/C
CORTICOIDES INHALADOS EN LA EPOC Y RIESGO DE NEUMONÍA GRAVE
 
Hajek P, McRobbie H, Myers K. Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis. Thorax 2013; 68:1037-1042 [M,II]
23404838             R/C
EFICACIA DE LA CISTINA PARA AYUDAR AL ABANDONO DEL TABACO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
 
ACADEMIC MEDICINE
 
For more than half a century, scientific research has documented widespread avoidance and even denial of aging. Though nothing new, aversive reactions to the elderly are not only unfortunate but dangerous today, as increasing life expectancy and consequent demand for specialized geriatric medical care vastly outpace the supply of qualified clinicians equipped to provide it. This discrepancy has led to a crisis that is not easily resolved. At the same time, geriatrics reports the highest level of physician satisfaction among medical specialties. How can this apparent disconnect be explained, and what can be done about it? Citing evidence from medicine and other health care disciplines, the authors address these questions by emphasizing the role of aging-related attitudes, a complex but theoretically modifiable construct. Successful educational interventions are described, including the authors' experience at the helm of a monthlong geriatrics clerkship for fourth-year medical students. Novel suggestions are provided to combat the daunting challenges to achieving a workforce that is sufficient both in number and training to effectively meet the needs of the fastest-growing segment of the U.S. population. As patients continue to age across most medical specialties, the importance of geriatric curricula, particularly those sensitizing learners to the need for a systems-based, biopsychosocial (i.e., interdisciplinary) model of care, cannot be overemphasized. Such training, it is argued, should be a standard component of medical education, and future research should focus on identifying specific curricular content and teaching methods that most effectively achieve this end.
The National Board of Medical Examiners (NBME) reviewed all components of the United States Medical Licensing Examination as part of a strategic planning activity. One recommendation generated from the review called for enhancements of the communication skills component of the Step 2 Clinical Skills (Step 2 CS) examination. To address this recommendation, the NBME created a multidisciplinary team that comprised experts in communication content, communication measurement, and implementation of standardized patient (SP)-based examinations. From 2007 through 2012, the team reviewed literature in physician-patient communication, examined performance characteristics of the Step 2 CS exam, observed case development and quality assurance processes, interviewed SPs and their trainers, and reviewed video recordings of examinee-SP interactions. The authors describe perspectives gained by their team from the review process and outline the resulting enhancements to the Step 2 CS exam, some of which were rolled out in June 2012.
Equity in health and health care in America continues to be a goal unmet. Certain demographic groups in the United States-including racial and ethnic minorities and individuals with lower socioeconomic status-have poorer health outcomes across a wide array of diseases, and have higher all-cause mortality. Yet despite growing understanding of how social-, structural-, and individual-level factors maintain and create inequities, solutions to reduce or eliminate them have been elusive. In this article, the authors envision how disparities-related provisions in the Affordable Care Act and other recent legislation could be linked with new value-based health care requirements and payment models to create incentives for narrowing health care disparities and move the nation toward equity.Specifically, the authors explore how recent legislative actions regarding payment reform, health information technology, community health needs assessments, and expanding health equity research could be woven together to build an evidence base for solutions to health care inequities. Although policy interventions at the clinical and payer levels alone will not eliminate disparities, given the significant role the social determinants of health play in the etiology and maintenance of inequity, such policies can allow the health care system to better identify and leverage community assets; provide high-quality, more equitable care; and demonstrate that equity is a value in health.
Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.
 
ANNALS OF INTERNAL MEDICINE
 
Evidence that patient portals improve health outcomes, cost, or utilization is insufficient. Patient attitudes are generally positive, but more widespread use may require efforts to overcome racial, ethnic, and literacy barriers. Portals represent a new technology with benefits that are still unclear. Better understanding requires studies that include details about context, implementation factors, and cost.
Larger and better-designed studies are needed to draw unequivocal conclusions about the effect of statins on cognition. Published data do not suggest an adverse effect of statins on cognition; however, the strength of available evidence is limited, particularly with regard to high-dose statins.
 
ARCHIVOS DE BRONCONEUMOLOGIA
 
Las enfermedades respiratorias crónicas con frecuencia provocan alteraciones en las funciones y/o en la estructura del aparato respiratorio que condicionan limitaciones en diferentes actividades de la vida de las personas que las padecen. En los pacientes más jóvenes y con una vida laboral activa estas limitaciones pueden suponer dificultades para el desempeño de su trabajo habitual. El artículo 41 de la Constitución Española establece que «los poderes públicos mantendrán un régimen público de Seguridad Social para todos los ciudadanos que garantice la asistencia y prestaciones sociales suficientes en casos de necesidad». En este marco se encuadra la evaluación de la incapacidad laboral como un proceso de naturaleza mixta (médico-legal) que tiene por objeto determinar si procede o no el reconocimiento del derecho a una prestación que sustituya las rentas que deja de percibir una persona al no poder desempeñar su trabajo, como consecuencia de una pérdida de la salud.
El papel de neumólogo es imprescindible en la evaluación del diagnóstico, tratamiento, pronóstico y capacidad funcional de los enfermos respiratorios. Estas recomendaciones tratan de acercar el complejo ámbito de la valoración de la capacidad laboral a los neumólogos y cirujanos torácicos, ofreciendo unas pautas de actuación que les permitan asesorar a sus propios pacientes acerca de su incorporación a la vida laboral.
 
BRITISH JOURNAL OF PSYCHIATRY
 
Somatic symptoms may be classified as either 'medically explained' or 'medically unexplained' - the former being considered medical and the latter psychiatric. In healthcare systems focused on disease, this distinction has pragmatic value. However, new scientific evidence and psychiatric classification urge a more integrated approach with important implications for psychiatry.
Total somatic symptom score provides a predictor of health status and healthcare use over and above the effects of anxiety, depression and general medical illnesses.
Attention-deficit hyperactivity disorder in adults evokes extreme responses within British psychiatrists, because its diagnostic validity and pharmacological treatments are heavily contested. We propose a model that accommodates apparently divergent evidence, and provides a clinical framework for clinicians and patients, allowing safe, responsible and ethically balanced clinical practice.
Combined treatment with escitalopram and telephone-administered CBT significantly improved some self-reported work functioning outcomes, but not symptom-based outcomes, compared with escitalopram alone.
 
BRITISH MEDICAL JOURNAL
 
A 20% tax on sugar sweetened drinks would lead to a reduction in the prevalence of obesity in the UK of 1.3% (around 180?000 people). The greatest effects may occur in young people, with no significant differences between income groups. Both effects warrant further exploration. Taxation of sugar sweetened drinks is a promising population measure to target population obesity, particularly among younger adults.
This study identified factors associated with normal pregnancy through adoption of a novel hypothesis generating approach, which has shifted the emphasis away from adverse outcomes towards uncomplicated pregnancies. Although confirmation in other cohorts is necessary, this study implies that individually targeted lifestyle interventions (normalising maternal weight, increasing prepregnancy fruit intake, reducing blood pressure, stopping misuse of drugs) may increase the likelihood of normal pregnancy outcomes.
The use of ß blockers started either at the time of hospital admission for myocardial infarction or before a myocardial infarction is associated with improved survival after myocardial infarction in patients with COPD.
We observed a temporal association between tamsulosin use for benign prostatic hyperplasia and severe hypotension during the first eight weeks after initiating treatment and the first eight weeks after restarting treatment. This association suggests that physicians should focus on improving counseling strategies to warn patients regarding the "first dose phenomenon" with tamsulosin.
Exercise programmes designed to prevent falls in older adults also seem to prevent injuries caused by falls, including the most severe ones. Such programmes also reduce the rate of falls leading to medical care.
In participants with a history of admission for exacerbations of COPD, telemonitoring was not effective in postponing admissions and did not improve quality of life. The positive effect of telemonitoring seen in previous trials could be due to enhancement of the underpinning clinical service rather than the telemonitoring communication
 
CIRCULATION
 
The majority of deaths are not related to stroke in a contemporary anticoagulated atrial fibrillation population. These results emphasize the need to identify interventions beyond effective anticoagulation to further reduce mortality in atrial fibrillation.
Following 24 months of potent statin therapy, on-treatment CRP levels associated with MACE. Inflammation may be an important driver of residual cardiovascular risk in patients with coronary artery disease despite aggressive statin therapy.
 
DIABETES CARE
 
There are delays in treatment intensification in people with type 2 diabetes despite suboptimal glycemic control. A substantial proportion of people remain in poor glycemic control for several years before intensification with OADs and insulin.
Empagliflozin 10 and 25 mg for 24 weeks as add-on to metformin plus sulfonylurea improved glycemic control, weight, and systolic blood pressure and were well tolerated
Linagliptin administered in addition to stable RAAS inhibitors led to a significant reduction in albuminuria in patients with type 2 diabetes and renal dysfunction. This observation was independent of changes in glucose level or SBP. Further research to prospectively investigate the renal effects of linagliptin is underway.
The considerably more rapid insulin absorption after administration by jet injector translated to a significant if modest decrease in postprandial hyperglycemia in patients with type 1 and type 2 diabetes. The improved early postprandial glucose control may specifically benefit patients who have difficulty in limiting postprandial glucose excursions.
Individuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient's risk profile before the first event.
Type 2 diabetes was a significant independent risk factor for in-hospital and 1-year mortality in women with STEMI. Women with diabetes had the poorest early and 1-year prognoses after STEMI when compared with women without diabetes and men with diabetes. Although pPCI improves the long-term prognosis of women with diabetes, it is used less frequently than in women without diabetes or men with diabetes.
Women with history of early menarche have higher risk of type 2 diabetes in adulthood. Less than half of this association appears to be mediated by higher adult BMI, suggesting that early pubertal development also may directly increase type 2 diabetes risk.
The cost of diabetes, driven primarily by the cost of preventable diabetes complications, will continue to increase with the epidemic rise in its prevalence in the U.S. The Diabetes Working Group (DWG), a consortium of professional organizations and individuals, was created to examine the barriers to better diabetes care and to recommend mitigating solutions. We consolidated three sets of guidelines promulgated by national professional organizations into 29 standards of optimal care and empanelled independent groups of diabetes care professionals to estimate the minimum and maximum time needed to achieve those standards of care for each of six clinical vignettes representing typical patients seen by diabetes care providers. We used a standards-of-care economic model to compare provider costs with reimbursement and calculated "reimbursement gaps." The reimbursement gap was calculated using the maximum and minimum provider cost estimate (reflecting the baseline- and best-case provider time estimates from the panels). The cost of guideline-driven care greatly exceeded reimbursement in almost all vignettes, resulting in estimated provider "losses" of 470,000-750,000 USD/year depending on the case mix. Such "losses" dissuade providers of diabetes care from using best practices as recommended by national diabetes organizations. The DWG recommendations include enhancements in care management, workforce supply, and payment reform.
Patients initiating insulin glargine rather than NPH do not seem to be at an increased risk for cancer. While our study contributes significantly to our evidence base for long-term effects, this evidence is very limited mainly based on actual dynamics in insulin prescribing.
 
DRUGS
 
Psychomotor agitation is often associated with aggression. It is important to identify agitation early and achieve results quickly in order to prevent aggressive behavior. Strategies may include verbal de-escalation techniques, reduced stimulation, medications, or a combination of approaches. Historically, pharmacological treatments for agitation have been delivered using oral and intramuscular formulations. Although the types of medication available have not changed dramatically, different formulations have been developed recently to aid in treating this difficult condition. This paper will detail some of the newer, more novel formulations used to deliver medications to treat agitation. Formulations to be described include orally disintegrating tablets, sublingual, buccal and intranasal forms, as well as an inhalation form. Each form has a unique purpose and will aid in treatment of different populations at different levels of agitation. Of note, of the medication formulations to be discussed, only inhaled loxapine is FDA approved for acute agitation in schizophrenia and bipolar disorder and no medications are approved for 'agitation' outside of a specific disease state. The orally disintegrating tablets of olanzapine, risperidone, and aripiprazole are swallowed and enter the circulation via the portal system. They do not have a more rapid onset of action than the standard oral tablets but are useful for patients that might otherwise divert the medication. The sublingual, buccal and intranasal formulations include asenapine and midazolam. Absorption by this route is more rapid and avoids first-pass metabolism. Finally, inhaled loxapine enters the alveoli and appears quickly in the arterial circulation. All of these novel formulations require at least some cooperation but have the potential to prevent escalation and improve the experience of patients and could be considered when negotiation is possible.
Fosfomycin trometamol (fosfomycin tromethamine) [Monuril(®), Monurol(®), Monural(®)] is approved in numerous countries worldwide, mainly for the treatment of uncomplicated urinary tract infections (UTIs). Fosfomycin has good in vitro activity against common uropathogens, such as Escherichia coli (including extended-spectrum ß-lactamase-producing E. coli), Proteus mirabilis, Klebsiella pneumoniae and Staphylococcus saprophyticus, and the susceptibility of uropathogens to fosfomycin has remained relatively stable over time. A single oral dose of fosfomycin trometamol 3 g (the approved dosage) achieves high concentrations in urine. Results of recent randomized trials indicate that single-dose fosfomycin trometamol had similar clinical and/or bacteriological efficacy to 3- to 7-day regimens of ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin in women with uncomplicated lower UTIs. In addition, single-dose fosfomycin trometamol had similar bacteriological efficacy to a 5-day course of cefuroxime axetil or a 7-day course of amoxicillin/clavulanic acid in pregnant women with asymptomatic bacteriuria, and similar clinical and/or bacteriological efficacy to a 5-day course of cefuroxime axetil or amoxicillin/clavulanic acid or a 3-day course of ceftibuten in pregnant women with a lower UTI. Single-dose fosfomycin trometamol was generally well tolerated, with gastrointestinal adverse events (e.g. diarrhoea, nausea) reported most commonly. In conclusion, single-dose fosfomycin trometamol is an important option for the first-line empirical treatment of uncomplicated lower UTIs.
 
ENFERMEDADES INFECCIOSA Y MICROBIOLOGIA CLINICA
 
Este nuevo documento actualiza las recomendaciones previas respecto a cuándo y con qué regímenes iniciar el TAR, cómo monitorizarlo y qué hacer cuando fracasa o desarrolla toxicidad. Asimismo actualiza los criterios específicos del TAR ante la presencia de diversas comorbilidades y situaciones especiales.
In the present update of the guidelines, a starting combination antiretroviral treatment (cART) is recommended in symptomatic patients, in pregnant women, in serodiscordant couples with a high risk of transmission, in patients co-infected with hepatitis B virus requiring treatment, and in patients with HIV-related nephropathy. Guidelines on cART are included in the event of a concurrent diagnosis of HIV infection with an AIDS-defining event. In asymptomatic naïve patients, cART is recommended if the CD4+ lymphocyte count is <500 cells/µL; if the CD4+ lymphocyte count is >500 cells/µL, cART can be delayed, although it may be considered in patients with liver cirrhosis, chronic infection due to hepatitis C virus, high cardiovascular risk, plasma viral load (PVL) >105 copies/mL, CD4+ lymphocyte percentage <14%, cognitive impairment, and age >55 years. cART in naïve patients requires a combination of 3 drugs, and its aim is to achieve undetectable PVL. Treatment adherence plays a key role in sustaining a favorable response. cART can, and should be, changed if virological failure occurs, in order to return to undetectable PVL. Approaches to cART in acute HIV infection, in women, in pregnancy, in tuberculosis, and post-exposure prophylaxis are also examined.
 
EUROPEAN HEART JOURNAL
 
Cigarette smoking is a major risk factor for cardiovascular disease (CVD) and the leading avoidable cause of death worldwide. Exposure to secondhand smoke (SHS) increases the risk of CVD among non-smokers. Smoking cessation benefits all smokers, regardless of age or amount smoked. The excess risk of CVD is rapidly reversible, and stopping smoking after a myocardial infarction reduces an individual's risk of CVD mortality by 36% over 2 years. Smoking cessation is a key component of primary and secondary CVD prevention strategies, but tobacco use often receives less attention from cardiologists than other risk factors, despite the availability of proven treatments that improve smoking cessation rates. Both psychosocial counselling and pharmacotherapy are effective methods to help smokers quit, but they are most effective when used together. The first-line medications licensed to aid smoking cessation, nicotine replacement therapy, bupropion and varenicline, are effective in and appropriate for patients with CVD. An evidence-based approach for physicians is to routinely ask all patients about smoking status and SHS exposure, advise all smokers to quit and all patients to adopt smoke-free policies for their home and car, and offer all smokers in the office or hospital brief counselling, smoking cessation pharmacotherapy, and referral to local programmes where psychosocial support can be sustained in person or by telephone. Like other chronic diseases, tobacco use requires a long-term management strategy. It deserves to be managed as intensively as other CVD risk factors.
In this international study, low physical activity was only partly explained by cardiovascular symptoms. Potentially modifiable societal and health system factors are important determinants of physical inactivity in patients with chronic CHD.
Data from CCTA predict both death and myocardial infarction as well as need for subsequent revascularizations out to 5 years. CCTA imaging may be a valuable tool in the assessment of long-term prognosis in patients with suspected CAD.
Recently published epidemiological and genetic studies strongly suggest a causal relationship of elevated concentrations of lipoprotein (a) [Lp(a)] with cardiovascular disease (CVD), independent of low-density lipoproteins (LDLs), reduced high density lipoproteins (HDL), and other traditional CVD risk factors. The atherogenicity of Lp(a) at a molecular and cellular level is caused by interference with the fibrinolytic system, the affinity to secretory phospholipase A2, the interaction with extracellular matrix glycoproteins, and the binding to scavenger receptors on macrophages. Lipoprotein (a) plasma concentrations correlate significantly with the synthetic rate of apo(a) and recent studies demonstrate that apo(a) expression is inhibited by ligands for farnesoid X receptor. Numerous gaps in our knowledge on Lp(a) function, biosynthesis, and the site of catabolism still exist. Nevertheless, new classes of therapeutic agents that have a significant Lp(a)-lowering effect such as apoB antisense oligonucleotides, microsomal triglyceride transfer protein inhibitors, cholesterol ester transfer protein inhibitors, and PCSK-9 inhibitors are currently in trials. Consensus reports of scientific societies are still prudent in recommending the measurement of Lp(a) routinely for assessing CVD risk. This is mainly caused by the lack of definite intervention studies demonstrating that lowering Lp(a) reduces hard CVD endpoints, a lack of effective medications for lowering Lp(a), the highly variable Lp(a) concentrations among different ethnic groups and the challenges associated with Lp(a) measurement. Here, we present our view on when to measure Lp(a) and how to deal with elevated Lp(a) levels in moderate and high-risk individuals.
 
GACETA SANITARIA
 
La oportunidad de un diagnóstico precoz es el elemento clave para promover la participación en un programa de cribado del cáncer colorrectal. Las diferentes percepciones de hombres y mujeres modulan su predisposición a participar. En concreto, la preocupación por la salud de los hombres y en especial el temor de las mujeres a que se les diagnostique un cáncer son factores a tener en cuenta.
Un protocolo común de investigación con el mismo cuestionario estructurado puede proporcionar estimaciones precisas de la frecuencia de violencia de la pareja íntima en la población general, a pesar de las limitaciones existentes en la creación de muestras probabilísticas y en los métodos de administración.
 
GUT
 
This proof-of-concept study provides an extensive description of gut microbiota responses to follow-up ß-lactam therapy. The results demonstrate that ABs targeting specific pathogenic infections and diseases may alter gut microbial ecology and interactions with host metabolism at a much higher level than previously assumed.
 
JAMA
 
Health care in the United States includes a vast array of complex interrelationships among those who receive, provide, and finance care. In this article, publicly available data were used to identify trends in health care, principally from 1980 to 2011, in the source and use of funds ("economic anatomy"), the people receiving and organizations providing care, and the resulting value created and health outcomes. In 2011, US health care employed 15.7% of the workforce, with expenditures of $2.7 trillion, doubling since 1980 as a percentage of US gross domestic product (GDP) to 17.9%. Yearly growth has decreased since 1970, especially since 2002, but, at 3% per year, exceeds any other industry and GDP overall. Government funding increased from 31.1% in 1980 to 42.3% in 2011. Despite the increases in resources devoted to health care, multiple health metrics, including life expectancy at birth and survival with many diseases, shows the United States trailing peer nations. The findings from this analysis contradict several common assumptions. Since 2000, (1) price (especially of hospital charges [+4.2%/y], professional services [3.6%/y], drugs and devices [+4.0%/y], and administrative costs [+5.6%/y]), not demand for services or aging of the population, produced 91% of cost increases; (2) personal out-of-pocket spending on insurance premiums and co-payments have declined from 23% to 11%; and (3) chronic illnesses account for 84% of costs overall among the entire population, not only of the elderly. Three factors have produced the most change: (1) consolidation, with fewer general hospitals and more single-specialty hospitals and physician groups, producing financial concentration in health systems, insurers, pharmacies, and benefit managers; (2) information technology, in which investment has occurred but value is elusive; and (3) the patient as consumer, whereby influence is sought outside traditional channels, using social media, informal networks, new public sources of information, and self-management software. These forces create tension among patient aims for choice, personal care, and attention; physician aims for professionalism and autonomy; and public and private payer aims for aggregate economic value across large populations. Measurements of cost and outcome (applied to groups) are supplanting individuals' preferences. Clinicians increasingly are expected to substitute social and economic goals for the needs of a single patient. These contradictory forces are difficult to reconcile, creating risk of growing instability and political tensions. A national conversation, guided by the best data and information, aimed at explicit understanding of choices, tradeoffs, and expectations, using broader definitions of health and value, is needed.
In this cohort study based on the general Danish population, oral fluoroquinolone use was not associated with increased risk of retinal detachment. Given its limited power, this study can only rule out more than a 3-fold increase in the relative risk associated with current fluoroquinolone use; however, any differences in absolute risk are likely to be of minor, if any, clinical significance.
A novel method to estimate LDL-C using an adjustable factor for the TG:VLDL-C ratio provided more accurate guideline risk classification than the Friedewald equation. These findings require external validation, as well as assessment of their clinical importance. The implementation of these findings into clinical practice would be straightforward and at virtually no cost.
 
JAMA INTERNAL MEDICINE
 
Thyroid ultrasound imaging could be used to identify patients who have a low risk of cancer for whom biopsy could be deferred. On the basis of these results, these findings should be validated in a large prospective cohort.
The functional trajectories before and after a serious fall injury are quite varied but highly interconnected, suggesting that the likelihood of recovery is greatly constrained by the prefall trajectory.
Among fee-for-service Medicare beneficiaries older than 65 years, higher continuity of ambulatory care is associated with a lower rate of preventable hospitalization.
 
JAMA PSYCHIATRY
 
The article "Cognitive-Behavioral Therapy vs Risperidone for Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder: A Randomized Clinical Trial" by Simpson et al1 in this issue reports that exposure/ritual prevention (EX/RP) is without question more effective than risperidone or placebo in augmenting serotonin reuptake inhibitor (SRI) response in an 8-week randomized clinical trial with 100 participants. Simpson et al call for a change in practice, because augmentation for SRI nonresponders with atypical antipsychotics is recommended in the American Psychiatric Association guidelines.2 This is a well-controlled randomized clinical trial worthy of strong conclusions. Simpson et al have a track record of well-controlled combination studies in obsessive-compulsive disorder (OCD), and the conclusion that EX/RP should be considered first for SRI treatment augmentation is supported by the current data.
The CBP program showed significant sustained effects compared with UC in preventing the onset of depressive episodes in at-risk youth over a nearly 3-year period. Important next steps will be to strengthen the CBP intervention to further enhance its preventive effects, improve intervention outcomes when parents are currently depressed, and conduct larger implementation trials to test the broader public health impact of the CBP program for preventing depression in youth
 
MEDICINA CLINICA
 
Las enfermedades cardiovasculares son la primera causa de morbimortalidad en pacientes con DM2. El estudio DYSIS muestra que la mayoría de los pacientes tratados con estatinas no alcanzan los objetivos lipídicos recomendados por las guías. En el presente estudio se constata que más de la mitad de los diabéticos tratados con estatinas tiene el colesterol LDL fuera de control, el grado de control de la dislipemia es muy limitado a pesar del tratamiento con estatinas, lo que puede determinar la necesidad de una terapia combinada para el tratamiento eficaz de la dislipemia diabética.
El objetivo de esta revisión sistemática se centra en la búsqueda de recomendaciones sobre seguridad del paciente que en diferentes contextos sociosanitarios (residencias para personas de edad avanzada y centros de estancia prolongada) se orientan a lograr una atención más segura. Se seleccionaron 134 artículos en MEDLINE, EMBASE y CINAHL hasta octubre de 2012. De ellos, 17 cumplían finalmente los criterios de inclusión, y 5 estudios más se añadieron en la búsqueda secundaria. Fueron escasos los estudios con un nivel de evidencia científica alto o muy alto según la escala SIGN. Los estudios analizados se centran principalmente en el personal de enfermería. La mayoría de las recomendaciones se basan en aspectos relacionados con la medicación, la formación del personal, las úlceras por presión o caídas, la adherencia a guías y protocolos, así como aspectos relacionados con la cultura organizacional.
La homocisteína plasmática y la HbA1c son los factores biológicos independientes y modificables que se asociaron con la presencia de PND evaluada con la prueba del monofilamento de SW.
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
La nueva guía ESC-ESH 2013 sobre HTA nos parece un documento de gran interés, que presenta de manera clara las nuevas evidencias y realiza recomendaciones prácticas concretas basadas en su mayor parte en un alto nivel de evidencia, todo ello sin llegar a ser una guía rupturista respecto a las previas. El número de recomendaciones de nivel C no es elevado, lo que aporta solidez a la guía. La aplicación de las nuevas recomendaciones debe suponer un impacto positivo en la calidad y eficiencia de la atención al paciente con HTA. Para ello, es fundamental lograr un consenso con las diferentes sociedades científicas que también tratan la HTA (nefrología, medicina interna, atención primaria, etc.) para llevar a la práctica acciones de difusión conjuntas y en el mismo sentido. No parece racional tener guías sobre la misma patología avaladas cada una por una sociedad diferente, con diferentes mensajes y con estrategias diagnósticas y terapéuticas en muchos casos distintas.
El descenso de la mortalidad cardiovascular se torna el principal contribuyente a la esperanza de vida española en las últimas tres décadas, principalmente en las edades avanzadas.
 
THE LANCET
 
E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches, and few adverse events. Uncertainty exists about the place of e-cigarettes in tobacco control, and more research is urgently needed to clearly establish their overall benefits and harms at both individual and population levels.
Food allergy is a serious health issue affecting roughly 4% of children, with a substantial effect on quality of life. Prognosis is good for the most frequent allergens with almost all children outgrowing their allergy. However, the long-term implications for disease burden are substantial for children with persistent allergies (eg, peanuts, tree nuts, fish, and shellfish) and for those with high concentrations of milk, egg, and wheat IgE. Antigen avoidance has been the time-honoured approach both for prevention and treatment. However, findings from studies done in the past 5 years show that early contact with food can induce tolerance and desensitisation to foods. We review the epidemiology, natural history, and management of food allergy, and discuss the areas of controversy and future directions in research and clinical practice.
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
In South Africa, early ART was cost-saving over a 5-year period. In both South Africa and India, early ART was projected to be very cost-effective over a lifetime. With individual, public health, and economic benefits, there is a compelling case for early ART for serodiscordant couples in resource-limited settings.
A year after seeing a physician for abdominal pain and obstipation and being told he couldn't be adequately evaluated without insurance, an uninsured man is diagnosed with metastatic colon cancer. Like thousands of other Americans, he will die for lack of insurance.
Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes.
Short-term trials involving adults with ADHD have shown significant improvements in symptoms with stimulants and atomoxetine; however, data on long-term benefits and risks of these medications, particularly among older persons, have been insufficient.
In two large, independent cohorts of nurses and other health professionals, the frequency of nut consumption was inversely associated with total and cause-specific mortality, independently of other predictors of death.
Combination therapy with an ACE inhibitor and an ARB was associated with an increased risk of adverse events among patients with diabetic nephropathy
 
THORAX
 
Cytisine is an effective treatment for smoking cessation with efficacy comparable to that of other currently licensed treatments. Given its low cost and potential for public health benefit, expedited licensing of cytisine for smoking cessation is warranted.
ICS use by patients with COPD increases the risk of serious pneumonia. The risk is particularly elevated and dose related with fluticasone. While residual confounding cannot be ruled out, the results are consistent with those from recent randomised trials.

 

 

                      

 

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