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Noviembre 2014 PDF Imprimir E-mail
Jueves, 04 de Diciembre de 2014 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 

 

Dhaliwal G, Sehgal NL. Demystify leadership in order to cultivate it. Acad Med 2014;89: 1441 [AO,I]

DESMITIFICAR EL LIDERAZGO CON EL FIN DE CULTIVARLO

 

ANNALS OF INTERNAL MEDICINE 

 

Ali MK, Bullard KM, Gregg EW, Del Rio C. A cascade of care for diabetes in the United States: visualizing the gaps. Ann Intern Med 2014;161:681-689 [T,I]

25402511             R/C

CASCADA DE ATENCIÓN A LA DIABETES EN EE UU: VISUALIZAR LAS LAGUNAS

 

Lamberts M, Lip GY, Hansen ML, Lindhardsen J, Olesen JB, Raunsø J, et al. Relation of nonsteroidal anti-inflammatory drugs to serious bleeding and thromboembolism risk in patients with atrial fibrillation receiving antithrombotic therapy: a nationwide cohort study. Ann Intern Med 2014;161:690-698 [S,II]

25402512             R/C

RELACIÓN DE LOS AINE CON SANGRADO GRAVE Y RIESGO DE TROMBOEMBOLISMO EN PACIENTES CON FIBRILACIÓN AURICULAR QUE RECIBEN TERAPIA ANTITROMBÓTICA: ESTUDIO NACIONAL DE COHORTE

 

Crandall CJ, Newberry SJ, Diamant A, Lim YW, Gellad WF, Booth MJ, et al. Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review. Ann Intern Med 2014;161:711-723 [M,II]

25199883             R/C

EFECTIVIDAD COMPARADA DE LOS TRATAMIENTOS FARMACOLÓGICOS PARA PREVENIR FRACTURAS: REVISIÓN SISTEMÁTICA ACTUALIZADA

 

Podolsky SH. Serotherapy for Ebola: back to the future. Ann Intern Med 2014;161:742-743 [AO,I]

25110967

SUEROTERAPIA PARA EL ÉBOLA: REGRESO AL FUTURO

 

Kass N. Ebola, ethics, and public health: what next? Ann Intern Med 2014;161:744-745 [AO,I]

25133473

ÉBOLA, ÉTICA Y SALUD PÚBLICA ¿QUÉ ES LO PRÓXIMO?

 

Del Rio C, Mehta AK, Lyon GM 3rd, Guarner J. Ebola hemorrhagic fever in 2014: the tale of an evolving epidemic. Ann Intern Med 2014;161:746-748 [AO,I]

25133433

FIEBRE HEMORRÁGICA DE ÉBOLA EN 2014: LA HISTORIA DE UNA EPIDEMIA EN DESARROLLO

 

Galvani AP, Ndeffo-Mbah ML, Wenzel N, Childs JE. Ebola vaccination: if not now, when? Ann Intern Med 2014;161):749-750 [AO,I]

VACUNA CONTRA EL ÉBOLA ¿SI NO AHORA, CUÁNDO?

 

Fischer WA 2nd, Hynes NA, Perl TM. Protecting health care workers from Ebola: personal protective equipment is critical but is not enough. Ann Intern Med 2014;161:753-754 [AO,I]

25155746

PROTEGER A LOS TRABAJADORES SANITARIOS DEL ÉBOLA: EL EQUIPO DE PROTECCIÓN INDIVIUAL ES CRÍTICO, PERO NO ES SUFICIENTE

 

Bischoff-Ferrari HA, Meyer O. Comparative effectiveness of pharmacologic treatments to prevent fractures: is this all we need to know? Ann Intern Med 2014;161:755-756 [AO,I]

25199999

EFECTIVIDAD COMPARADA DE LOS TRATAMIENTOS FARMACOLÓGICOS PARA PREVENIR FRACTURAS ¿ESTO ES TODO LO QUE NECESITAMOS SABER?

 

ARCHIVOS DE BRONCONEUMOLOGIA 

 

Buchelli H, Fernandez R, Rubinos G, Martinez C, Rodriguez F, Casan P. Niveles elevados de carboxihemoglobina: fuentes de exposición a monóxido de carbono. Arch Bronconeumol 2014;50:465-468 [T,I]   

                               R/C

NIVELES ELEVADOS DE CARBOXIHEMOGLOBINA: FUENTES DE EXPOSICIÓN A MONÓXIDO DE CARBONO

 

ATENCION PRIMARIA 

 

Sánchez-Celaya M, Tranche S. Documento de consenso sobre la enfermedad renal crónica: una oportunidad de coordinación. Aten Primaria 2014;46:453-454 [AO,I]

25439670

DOCUMENTO DE CONSENSO SOBRE LA ENFERMEDAD RENAL CRÓNICA: UNA OPORTUNIDAD DE COORDINACIÓN

 

Monteserín R, Roberts HC, Sayer AA. Papel de los profesionales de la atención primaria en el manejo de la sarcopenia. Aten Primaria 2014;46:455-456 [AO,I]

25212719

PAPEL DE LOS PROFESIONALES DE LA ATENCIÓN PRIMARIA EN EL MANEJO DE LA SARCOPENIA

 

Madridejos R, Majem L, Puig H, Sanz I, Llobet E, Arce M, et al. «Salut al cor/salud en el corazón»: resultados del programa de educación sanitaria en salud cardiovascular de Mútua Terrassa. Aten Primaria 2014;46:457-463 [EC,I]

24768658             R/C

«SALUT AL COR/SALUD EN EL CORAZÓN»: RESULTADOS DEL PROGRAMA DE EDUCACIÓN SANITARIA EN SALUD CARDIOVASCULAR DE MÚTUA TERRASSA

 

Villa J, Cano A, Franco D, Monsalve M, Hincapié J, Amariles P. Relevancia clínica de las interacciones medicamentosas entre antiinflamatorios no esteroideos y antihipertensivos. Aten Primaria 2014;46:464-474 [M,I]

24667116             R/C

RELEVANCIA CLÍNICA DE LAS INTERACCIONES MEDICAMENTOSAS ENTRE ANTIINFLAMATORIOS NO ESTEROIDEOS Y ANTIHIPERTENSIVOS

 

Ferrer A, Formiga F, Sanz H, Monserrate E, Verges D; Grupo Octabaix. Envejecimiento satisfactorio e indicadores de fragilidad en los mayores de la comunidad. Estudio Octabaix. Aten Primaria 2014;46:475-482 [T,II]

24792420             R/C

ENVEJECIMIENTO SATISFACTORIO E INDICADORES DE FRAGILIDAD EN LOS MAYORES DE LA COMUNIDAD. ESTUDIO OCTABAIX

 

Ramos-Morcillo AJ, Ruzafa-Martínez M, Fernández-Salazar S, Del-Pino-Casado R, Armero Barranco D. Actitudes de médicos y enfermeras ante las actividades preventivas y de promoción en atención primaria. Aten Primaria 2014;46:483-491 [T,II]

24768655             R/C

ACTITUDES DE MÉDICOS Y ENFERMERAS ANTE LAS ACTIVIDADES PREVENTIVAS Y DE PROMOCIÓN EN ATENCIÓN PRIMARIA

 

Llor C, Cots JM, Hernández S, Ortega J, Arranz J, Monedero MJ, et al; Happy Audit Study Group. Efectividad de dos tipos de intervención en la prescripción antibiótica en las infecciones de las vías respiratorias en atención primaria en España. Estudio Happy Audit. Aten Primaria 2014;46:492-500 [QE,II]

24768657             R/C

EFECTIVIDAD DE DOS TIPOS DE INTERVENCIÓN EN LA PRESCRIPCIÓN ANTIBIÓTICA EN LAS INFECCIONES DE LAS VÍAS RESPIRATORIAS EN ATENCIÓN PRIMARIA EN ESPAÑA

 

Martínez-Castelao A, Górriz JL, Bover J, Segura-de la Morena J, Cebollada J, Escalada J, et al. Documento de consenso para la detección y manejo de la enfermedad renal crónica. Aten Primaria 2014;46:501-519 [M,III]

25288498             R/C

DOCUMENTO DE CONSENSO PARA LA DETECCIÓN Y MANEJO DE LA ENFERMEDAD RENAL CRÓNICA

 

BRITISH JOURNAL OF PSYCHIATRY 

 

Malhi GS, Geddes JR. Carving bipolarity using a lithium sword. Br J Psychiatry 2014;205:337-339 [AO,I]

25368357             R/C

ESCULPIR LA BIPOLARIDAD USANDO UNA ESPADA DE LITIO

 

BRITISH MEDICAL JOURNAL 

 

Leening MJ, Ferket BS, Steyerberg EW, Kavousi M, Deckers JW, Nieboer D, et al. Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study. BMJ 2014;349:g5992 [S,I]

25403476             R/C

DIFERENCIAS DE SEXO EN EL RIESGO A LO LARGO DE LA VIDA Y EN LA PRIMERA MANIFESTACIÓN DE ENFERMEDAD CARDIOVASCULAR: ESTUDIO DE COHORTE POBLACIONAL PROSPECTIVO

 

Roberts MJ, Campbell JL, Abel GA, Davey AF, Elmore NL, Maramba I, et al. Understanding high and low patient experience scores in primary care: analysis of patients' survey data for general practices and individual doctors. BMJ 2014;349:g6034 [T,I]

25389136

COMPRENDER LAS PUNTUACIONES ALTAS Y BAJAS DE LA EXPERIENCIA DEL PACIENTE EN ATENCIÓN PRIMARIA: ANÁLISIS DE LOS DATOS DE LAS ENCUESTAS ENTRE PACIENTES SOBRE CONSULTAS GENERALES Y MÉDICOS INDIVIDUALES

 

Heath I. Role of fear in overdiagnosis and overtreatment—an essay by Iona Heath. BMJ 2014;349:g6123 [R,I]

PAPEL DEL MIEDO EN EL SOBREDIAGNÓSTICO Y SOBRETRATAMIENTO--ENSAYO DE IONA HEATH

 

Kyrgiou M, Mitra A, Arbyn M, Stasinou SM, Martin-Hirsch P, Bennett P, et al. Fertility and early pregnancy outcomes after treatment for cervical intraepithelial neoplasia: systematic review and meta-analysis. BMJ 2014;349:g6192 [M,II]

25352501             R/C

RESULTADOS DE FERTILIDAD Y EMBARAZO TEMPRANO TRAS TRATAMIENTO DE LA NEOPLASIA CERVICAL INTRAEPITELIAL: REVISIÓN SISTEMÁTICA Y METAANÁLISIS

 

Castanon A, Landy R, Brocklehurst P, Evans H, Peebles D, Singh N, et al; PaCT Study Group. Risk of preterm delivery with increasing depth of excision for cervical intraepithelial neoplasia in England: nested case-control study. BMJ 2014;349:g6223 [CC,I]

25378384             R/C

RIESGO DE PARTO PRETÉRMINO CON EL AUMENTO DE LA PROFUNDIDAD DE LA EXCISIÓN EN LA NEOPLASIA CERVICAL INTRAEPITELIAL EN INGLATERRA: ESTUDIO DE CASO CONTROL ANIDADO

 

Afzal S, Brøndum-Jacobsen P, Bojesen SE, Nordestgaard BG. Genetically low vitamin D concentrations and increased mortality: mendelian randomisation analysis in three large cohorts. BMJ 2014;349:g6330 [S,II]

25406188             R/C

CONCENTRACIONES GENÉTICAMENTE BAJAS DE VITAMINA D Y MORTALIDAD AUMENTADA: ANÁLISIS DE ALEATORIZACIÓN MENDELIANA EN TRES GRANDES COHORTES

 

Corbett A, Burns A, Ballard C. Don't use antipsychotics routinely to treat agitation and aggression in people with dementia. BMJ 2014;349:g6420 [R,I]

25368388             R/C

NO USE ANTIPSICÓTICOS DE FORMA RUTINARIA PARA TRATAR LA AGITACIÓN Y LA AGRESIÓN EN PERSONAS CON DEMENCIA

 

Middleton SD, Anakwe RE. Carpal tunnel syndrome. BMJ 2014;349:g6437 [R,I]

25378457

SÍNDROME DEL TÚNEL CARPIANO

 

Guthrie B, Dreischulte T. Quality in primary care. BMJ 2014;349:g6485 [AO,I]

25389154

CALIDAD EN ATENCIÓN PRIMARIA

 

Harcourt J, Barraclough K, Bronstein AM. Meniere's disease. BMJ 2014;349:g6544 [R,I]

25391837

ENFERMEDAD DE MENIERE

 

Welsh P, Sattar N. Vitamin D genes and mortality. BMJ 2014;349:g6599 [AO,I]

25406190

GENES DE VITAMINA D Y MORTALIDAD

 

Ecclestone K, Robinson BL, Wheeler S. Is emotional restraint a healthy response to adversity? BMJ 2014;349:g6607 [AO,I]

25378024

¿ES EL CONTROL EMOCIONAL UNA RESPUESTA SANA CONTRA LA ADVERSIDAD?

 

Stegenga H, Haines A, Jones K, Wilding J; Guideline Development Group. Identification, assessment, and management of overweight and obesity: summary of updated NICE guidance. BMJ 2014;349:g6608 [M,III]

25430558

IDENTIFICACIÓN, VALORACIÓN Y MANEJO DEL SOBREPESO Y LA OBESIDAD: RESUMEN DE LA GUIA NICE ACTUALIZADA

 

Strander B, Adolfsson J. Safety of modern treatment for cervical pre-cancer. BMJ 2014;349:g6611[AO,I]

25378385

SEGURIDAD DEL TRATAMIENTO MODERNO DEL PRECÁNCER CERVICAL

 

Blanker MH, Deventer KR, Bijl D. Measuring symptomatic relief in men with lower urinary tract symptoms. BMJ 2014;349:g6664 [AO,I]

25380756

MEDIDAS DE ALIVIO SINTOMÁTICO EN HOMBRES CON SÍNTOMAS DE VÍAS URINARIAS BAJAS

 

Kalla R, Ventham NT, Satsangi J, Arnott ID. Crohn's disease. BMJ 2014;349:g6670 [R,I]

25409896

ENFERMEDAD DE CROHN

 

Mair FS, May CR. Thinking about the burden of treatment. BMJ 2014;349:g6680 [AO,I]

25385748

PENSAR SOBRE LA CARGA DE TRATAMIENTO

 

Lotery A, MacEwen C. What is stopping the NHS from using bevacizumab for macular degeneration and other retinal disorders? BMJ 2014;349:g6887 [AO,I]

25406142

¿QUÉ ESTÁ DETENIENDO AL NHS PARA USAR EL BEVACIZUMAB PARA LA DEGENERACIÓN MACULAR Y OTROS TRASTORNOS RETINIANOS?

 

Gnjidic D, Le Couteur DG, Hilmer SN. Discontinuing drug treatments. BMJ 2014;349:g7013 [AO,I]

25416561

INTERRUMPIR LOS TRATAMIENTOS FARMACOLÓGICOS

 

CANADIAN MEDICAL ASSOCIATION JOURNAL 

 

Babio N, Toledo E, Estruch R, Ros E, Martínez-González MA, Castañer O, et al; PREDIMED Study Investigators. Mediterranean diets and metabolic syndrome status in the PREDIMED randomized trial. CMAJ 2014;186:E649-E657 [EC,II]

25316904             R/C

DIETAS MEDITERRÁNEAS Y ESTADO DE SÍNDROME METABÓLICO EN EL ENSAYO ALEATORIZADO PREDIMED

 

CIRCULATION 

 

Miller ER 3rd, Appel LJ. High prevalence but uncertain clinical significance of orthostatic hypotension without symptoms. Circulation 2014;130:1772-1774 [AO,I]

25278100

ALTA PREVALENCIA PERO SIGIFICADO CLÍNICO INCIERTO DE LA HIPOTENSIÓN ORTOSTÁTICA SIN SÍNTOMAS

 

Rich JD, Rich S. Clinical diagnosis of pulmonary hypertension. Circulation 2014;130:1820-1830 [R,I]

25385937

DIAGNÓSTICO CLÍNICO DE LA HIPERTENSIÓN PULMONAR

 

Griffiths HR, Lip GY. New biomarkers and risk stratification in atrial fibrillation: simplicity and practicality matter. Circulation 2014;130:1837-1839 [AO,I]

25294785

NUEVOS BIOMARCADORES Y ESTRATIFICACIÓN DEL RIESGO EN LA FIBRILACIÓN AURICULAR: LA SENCILLEZ Y EL SENTIDO PRÁCTICO IMPORTAN

 

Myerburg RJ. Initiatives for improving out-of-hospital cardiac arrest outcomes. Circulation 2014;130:1840-1843 [AO,I]

25274001

INICIATIVAS PARA MEJORAR LOS RESULTADOS DE LA PARADA CARDIACA EXTRAHOSPITALARIA

 

Nichol G, Elrod JA, Becker LB. Treatment for out-of-hospital cardiac arrest: is the glass half empty or half full? Circulation 2014;130:1844-1846 [AO,I]

25399398

TRATAMIENTO DE LA PARADA CARDIACA EXTRAHOSPITALARIA ¿ESTÁ EL VASO MEDIO LLENO O MEDIO VACÍO?

 

Blom MT, Beesems SG, Homma PC, Zijlstra JA, Hulleman M, van Hoeijen DA, et al. Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation 2014;130:1868-1875 [S,II]

25399395             R/C

MEJORA DE LA SUPERVIVENCIA DE LA PARADA CARDIACA EXTRAHOSPITALARIA Y USO DE LOS DESFIBRILADORES EXTERNOS AUTOMATIZADOS

 

Chan PS, McNally B, Tang F, Kellermann A; CARES Surveillance Group. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation 2014;130:1876-1882 [T,II]

25399396             R/C

TENDENCIAS RECIENTES EN LA SUPERVIVENCIA DE LA PARADA CARDIACA EXTRAHOSPITALARIA EN ESTADOS UNIDOS

 

Wong MK, Morrison LJ, Qiu F, Austin PC, Cheskes S, Dorian P, et al. Trends in short- and long-term survival among out-of-hospital cardiac arrest patients alive at hospital arrival. Circulation 2014;130:1883-1890 [S,II]

25399397             R/C

TENDENCIAS EN LA SUPERVIVENCIA A CORTO Y A LARGO PLAZO ENTRE PACIENTES CON PARADA CARDIACA EXTRAHOSPITALARIA QUE LLEGAN VIVOS AL HOSPITAL

 

Stiell IG, Brown SP, Nichol G, Cheskes S, Vaillancourt C, Callaway CW, et al; Resuscitation Outcomes Consortium Investigators. What is the optimal chest compression depth during out-of-hospital cardiac arrest resuscitation of adult patients? Circulation 2014;130:1962-1970 [T,II]

25252721             R/C

¿CUÁL ES LA PROFUNDIDAD DE COMPRESIÓN TORÁCICA ÓPTIMA DURANTE LA REANIMACIÓN DE PACIENTES ADULTOS CON PARADA CARDIACA EXTRAHOSPITALARIA?

 

Wadhera RK, Russell CE, Piazza G. Warfarin versus novel oral anticoagulants: how to choose? Circulation 2014;130:e191-e193 [AO,I]

25421049

WARFARINA FRENTE A NUEVOS ANTICOAGULANTES ORALES ¿CÓMO ELEGIR?

 

DIABETES CARE 

 

Gruden G, Landi A, Bruno G. Natriuretic peptides, heart, and adipose tissue: new findings and future developments for diabetes research. Diabetes Care 2014;37:2899-2908 [R,I]

25342830             R/C

PÉPTIDOS NATRIURÉTICOS, CORAZÓN Y TEJIDO ADIPOSO: NUEVOS HALLAZGOS Y DESARROLLOS FUTUROS PARA LA INVESTIGACIÓN DE LA DIABETES

 

Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, et al. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Diabetes Care 2014;37:2909-2918 [EC,I]

25071075             R/C

DIETA MUY BAJA EN CARBOHIDRATOS Y BAJA EN GRASAS SATURADAS PARA EL MANEJO DE LA DIABETES TIPO 2: ENSAYO ALEATORIZADO

 

Umpierrez GE, Reyes D, Smiley D, Hermayer K, Khan A, Olson DE, et al. Hospital discharge algorithm based on admission HbA1c for the management of patients with type 2 diabetes. Diabetes Care 2014;37:2934-2939 [EC,I]

25168125             R/C

ALGORITMO DE ALTA HOSPITALARIA BASADO EN LA HbA1C AL INGRESO PARA EL MANEJO DE PACIENTES CON DIABETES TIPO 2

 

Hayashino Y, Mashitani T, Tsujii S, Ishii H; Diabetes Distress and Care Registry at Tenri Study Group. Serum high-sensitivity C-reactive protein levels are associated with high risk of development, not progression, of diabetic nephropathy among japanese type 2 diabetic patients: a prospective cohort study (Diabetes Distress and Care Registry at Tenri [DDCRT7]). Diabetes Care 2014;37:2947-2952 [S,I]

25168126             R/C

LOS NIVELES DE PCR DE ALTA SENSIBILIDAD SE ASOCIAN CON UN RIESGO ALTO DE DESARROLLO, NO DE PROGRESIÓN, DE NEFROPATÍA DIABÉTICA ENTRE PACIENTES JAPONESES DIABÉTICOS TIPO 2: ESTUDIO DE COHORTE PROSPECTIVO (DDCRT7)

 

Twig G, Afek A, Derazne E, Tzur D, Cukierman-Yaffe T, Gerstein HC, et al. Diabetes risk among overweight and obese metabolically healthy young adults. Diabetes Care 2014;37:2989-2995 [S,I]

25139886             R/C

RIESGO DE DIABETES ENTRE JÓVENES CON SOBREPESO Y OBESOS METABÓLICAMENTE SANOS

 

Hernández-Alonso P, Salas-Salvadó J, Baldrich-Mora M, Juanola-Falgarona M, Bulló M. Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care 2014;37:3098-3105 [EC,I]

25125505             R/C

EFECTO BENEFICIOSO DEL CONSUMO DE PISTACHOS SOBRE EL METABOLISMO DE LA GLUCOSA, LA RESISTENCIA A LA INSULINA, LA INFLAMACIÓN Y LOS MARCADORES RELACIONADOS CON EL RIESGO METABÓLICO: ENSAYO CLÍNICO ALEATORIZADO

 

Li Y, Hu Y, Ley SH, Rajpathak S, Hu FB. Sulfonylurea use and incident cardiovascular disease among patients with type 2 diabetes: prospective cohort study among women. Diabetes Care 2014;37:3106-3113 [S,I]

25150157             R/C

USO DE SULFONILUREAS E INCIDENCIA DE ENFERMEDAD CARDIOVASCULAR ENTRE PACIENTES CON DIABETES TIPO 2: ESTUDIO PROSPECTIVO DE COHORTE EN MUJERES

 

Pasquel FJ, Umpierrez GE. Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care 2014;37:3124-3131 [R,I]

25342831             R/C

ESTADO HIPERGLUCÉMICO HIPEROSMOLAR: REVISIÓN HISTÓRICA DE SU PRESENTACIÓN CLÍNICA, DIAGNÓSTICO Y TRATAMIENTO

 

DRUGS 

 

Matera MG, Rogliani P, Calzetta L, Cazzola M. Phosphodiesterase inhibitors for chronic obstructive pulmonary disease: what does the future hold? Drugs 2014;74:1983-1992 [R,I]

25300411             R/C

INHIBIDORES DE LA FOSFODIESTERASA Y EPOC ¿QUÉ NOS RESERVA EL FUTURO?

 

Dobesh PP, Fanikos J. New oral anticoagulants for the treatment of venous thromboembolism: understanding differences and similarities. Drugs 2014;74:2015-2032 [R,I]

25300410             R/C

NUEVOS ANTICOAGULANTES ORALES EN EL TRATAMIENTO DEL TROMBOEMBOLISMO VENOSO: COMPRENDER LAS DIFERENCIAS Y LAS SIMILITUDES

 

Kjeldsen S, Feldman RD, Lisheng L, Mourad JJ, Chiang CE, Zhang W, et al. Updated national and international hypertension guidelines: a review of current recommendations. Drugs 2014;74:2033-2051 [R,II]

25315030             R/C

GUÍAS DE HIPERTENSIÓN NACIONALES E INTERNACIONALES ACTUALIZADAS: REVISIÓN DE LAS RECOMENDACIONES ACTUALES

 

ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA 

 

Padilla-España L, Repiso-Jiménez B, Fernández-Sánchez F, Frieyro-Elicegui M, Fernández-Morano T, Pereda T, et al. [Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population.] Enferm Infecc Microbiol Clin 2014 [Epub ahead of print] [S,I]

24908497             R/C

UTILIDAD DE LA PRUEBA DEL VPH EN EL CRIBAJE DE NEOPLASIA ANAL INTRAEPITELIAL EN POBLACIÓN CON COMPORTAMIENTO DE RIESGO

 

EUROPEAN HEART JOURNAL 

 

Konstantinides S, Torbicki A. Management of venous thrombo-embolism: an update. Eur Heart J 2014;35:2855-2863 [R,II]

25179762             R/C

MANEJO DEL TROMBOEMBOLISMO VENOSO: ACTUALIZACIÓN

 

Budoff MJ. Progression of coronary calcium: not as predictable as 1-2-3. Eur Heart J 2014;35:2934-2935 [AO,I]

25246484

PROGRESIÓN DEL CALCIO CORONARIO: NO TAN PREDECIBLE COMO 1-2-3

 

Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. Eur Heart J 2014;35:2950-2959 [R,II]

25139896             R/C

ENFERMEDAD CARDIOVASCULAR EN EUROPA 2014: ACTUALIZACIÓN EPIDEMIOLÓGICA

 

Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al; Authors/Task Force Members. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS). Eur Heart J 2014;35:3033-3073 [M,II]

25173341

GUÍAS 2014 DE LA ESC SOBRE DIAGNÓSTICO Y TRATAMIENTO DEL EMBOLISMO PULMONAR AGUDO: GRUPO DE TRABAJO PARA EL DIAGNÓSTICO Y TRATAMIENTO DEL EMBOLISMO PULMONAR AGUDO DE LA ESC RESPALDADO POR LA ERS

 

FAMILY MEDICINE 

 

Dory V,  Charlin B. Multifaceted assessment in a family medicine clerkship: a pilot study. Fam Med 2014;46:755-760 [S,I]

                               R/C

VALORACIÓN MULTIFACTORIAL DE UN ROTATORIO EN MEDICINA DE FAMILIA: ESTUDIO PILOTO

 

Renshaw SE, Saywell RM, Burba JL, Butler AL, Zollinger TW, Kiovsky RD et al. Trends in patient encounters: implications for family medicine clerkships. Fam Med 2014;46:761-769 [T,I]

                               R/C

TENDENCIAS EN LOS ENCUENTROS CON LOS PACIENTES: IMPLICACIONES PARA LOS ROTATORIOS DE MEDICINA DE FAMILIA

 

Thompson DN, Barrett R, Deonarine A, Williams CD, White-Coleman D, Horton S, et al. Effect of lung cancer screening awareness on smoking cessation behavior. Fam Med 2014;46:770-775 [T,I]

                               R/C

EFECTO DEL CONOCIMIENTO DEL CRIBAJE DE CÁNCER DE PULMÓN SOBRE EL COMPORTAMIENTO DEL ABANDONO TABÁQUICO

 

Benè KL, Bergus G. When learners become teachers: a review of peer teaching in medical student education. Fam Med 2014;46:783-787 [R,I]

                               R/C

CUANDO LOS ALUMNOS  SE CONVIERTEN EN PROFESORES: REVISIÓN DE LA ENSEÑANZA POR PARES EN LA FORMACIÓN DE ESTUDIANTES DE MEDICINA

 

GACETA SANITARIA 

 

Cascón-Pereira R, Valverde M. Los significados atribuidos a la gestión como fuente de las actitudes e identidad profesional de los/las médicos/as gestores/as. Gac Sanit 2014;28:475-479 [C,I]

25234273             R/C

LOS SIGNIFICADOS ATRIBUIDOS A LA GESTIÓN COMO FUENTE DE LAS ACTITUDES E IDENTIDAD PROFESIONAL DE LOS/LAS MÉDICOS/AS GESTORES/AS

 

Escobar-Bravo MÁ, Jürschik P, Botigué T, Nuin C. La fragilidad como predictora de mortalidad en una cohorte de edad avanzada. Gac Sanit 2014;28:489-491 [S,I]

25087116             R/C

LA FRAGILIDAD COMO PREDICTORA DE MORTALIDAD EN UNA COHORTE DE EDAD AVANZADA

 

Morcillo V, de Lorenzo-Cáceres A, Domínguez P, Rodríguez R, Torijano MJ. Desigualdades en la salud autopercibida de la población española mayor de 65 años. Gac Sanit 2014;28:511-521 [M,I]

25189674             R/C

DESIGUALDADES EN LA SALUD AUTOPERCIBIDA DE LA POBLACIÓN ESPAÑOLA MAYOR DE 65 AÑOS

 

JAMA INTERNAL MEDICINE 

 

Doran AE, Shah NL. Polyethylene glycol for hepatic encephalopathy: a new solution to purge an old problem? JAMA Intern Med 2014;174:1734-1735 [AO,I]

25244573

POLIETILENGLICOL EN LA ENCEFALOPATÍA HEPÁTICA ¿ NUEVA SOLUCIÓN PARA ELIMINAR UN VIEJO PROBLEMA?

 

Bogenschutz MP, Donovan DM, Mandler RN, Perl HI, Forcehimes AA, Crandall C, et al. Brief intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial. JAMA Intern Med 2014;174:1736-1745 [EC,I]

25179753             R/C

INTERVENCIÓN BREVE EN PACIENTES QUE SE PRESENTAN EN URGENCIAS CON USO PROBLEMÁTICO DE DROGAS: ENSAYO CLÍNICO ALEATORIZADO

 

Tjia J, Briesacher BA, Peterson D, Liu Q, Andrade SE, Mitchell SL. Use of medications of questionable benefit in advanced dementia. JAMA Intern Med 2014;174:1763-1771 [T,I]

25201279             R/C

USO DE MEDICACIÓN DE DUDOSO BENEFICIO EN LA DEMENCIA AVANZADA

 

JAMA PSYCHIATRY 

 

Vyssoki B, Kapusta ND, Praschak-Rieder N, Dorffner G, Willeit M. Direct effect of sunshine on suicide. JAMA Psychiatry 2014;71:1231-1237 [S,I]

25208208             R/C

EFECTO DIRECTO DE LA LUZ SOLAR SOBRE EL SUICIDIO

 

MEDICINA CLINICA 

 

Corbella X. Gestión clínica: pacientes, profesionales, gestores y políticos ante el reto de ponerse, comprensivamente, uno en el lugar del otro. Med Clin (Barc) 2014;143:395-397 [AO,I]

25066501

GESTIÓN CLÍNICA: PACIENTES, PROFESIONALES, GESTORES Y POLÍTICOS ANTE EL RETO DE PONERSE, COMPRENSIVAMENTE, UNO EN EL LUGAR DEL OTRO

 

Mur A, Ortigosa S ¿Es posible una nueva epidemia de consumo de heroína en España? Med Clin (Barc) 2014;143:398-400 [AO,I]

25110182

¿ES POSIBLE UNA NUEVA EPIDEMIA DE CONSUMO DE HEROÍNA EN ESPAÑA?

 

Tavío E, Cano A. Sensibilidad al gluten no celíaca: ¿una verdadera entidad o solo una quimera? Med Clin (Barc) 2014;143:446-447 [AO,I]

25190586

SENSIBILIDAD AL GLUTEN NO CELÍACA: ¿UNA VERDADERA ENTIDAD O SOLO UNA QUIMERA?

 

REUMATOLOGIA CLINICA 

 

Aso J, Martínez JV, Aso A, Arregui R, Bernal M, Alcázar A. Simulación en patología espinal. Reumatol Clin 2014;10:396-405 [R,I]

24913963             R/C

SIMULACIÓN EN PATOLOGÍA ESPINAL

 

THE LANCET 

 

Sibbing D, Massberg S. Dual antiplatelet treatment after stenting: is longer better? Lancet 2014;384:1553-1555 [AO,I]

25037991

TRATAMIENTO ANTIPLAQUETARIO DOBLE TRAS IMPLANTACIÓN DE STENT ¿CUANTO MÁS TIEMPO MEJOR?

 

Koes BW, Enthoven WT. Do patients with acute low-back pain need paracetamol? Lancet 2014;384:1556-1557 [AO,I]

25064595

¿NECESITAN PARACETAMOL LOS PACIENTES CON DOLOR LUMBAR AGUDO?

 

Williams CM, Maher CG, Latimer J, McLachlan AJ, Hancock MJ, Day RO, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. Lancet 2014;384:1586-1596 [EC,I]

25064594             R/C

EFICACIA DEL PARACETAMOL EN EL DOLOR LUMBAR AGUDO: ENSAYO CONTROLADO ALEATORIZADO DOBLE CIEGO

 

The medium and the message of Ebola. Lancet 2014;384:1641 [AO,I]

25441179

EL MEDIO Y EL MENSAJE DEL ÉBOLA

 

Laptook AR. Neonatal and infant death: the Apgar score reassessed. Lancet 2014;384:1727-1728 [AO,I]

25236410

MUERTE INFANTIL Y NEONATAL: LA PRUEBA DE APGAR REEVALUADA

 

Pawlotsky JM. Hepatitis E screening for blood donations: an urgent need? Lancet 2014;384:1729-1730 [AO,I]

25078305

CRIBAJE DE HEPATITIS E EN LAS DONACIONES DE SANGRE ¿NECESIDAD URGENTE?

 

Iliodromiti S, Mackay DF, Smith GC, Pell JP, Nelson SM. Apgar score and the risk of cause-specific infant mortality: a population-based cohort study. Lancet 2014;384:1749-1755 [S,I]

25236409             R/C

PRUEBA DE APGAR Y MORTALIDAD INFANTIL ESPECÍFICA POR CAUSAS: ESTUDIO DE COHORTE POBLACIONAL

 

Lawitz E, Sulkowski MS, Ghalib R, Rodriguez-Torres M, Younossi ZM, Corregidor A, et al. Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet 2014;384:1756-1765 [EC,II]

25078309             R/C

SIMEPREVIR MÁS SOFOSBUVIR, CON O SIN RIBAVIRINA, PARA TRATAR LA INFECCIÓN CRÓNICA POR VIRUS DE LA HEPATITIS C GENOTIPO 1 EN PACIENTES QUE NO RESPONDEN AL INTERFERÓN PEGILADO Y RIBAVIRINA Y EN PACIENTES SIN TRATAMIENTO PREVIO: ESTUDIO ALEATORIZADO COSMOS

 

Howard LM, Molyneaux E, Dennis CL, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet 2014;384:1775-1788 [R,I]

25455248             R/C

TRASTORNOS MENTALES NO PSICÓTICOS EN EL PERIODO PERINATAL

 

Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet 2014;384:1789-1799 [R,I]

25455249             R/C

TRASTORNO BIPOLAR, PSICOSIS AFECTIVA Y ESQUIZOFRENIA EN EMBARAZO Y POSTPARTO

 

Principles to guide type 2 diabetes care in the USA. Lancet 2014;384:1822 [AO,I]

25457905

PRINCIPIOS PARA GUIAR LA ATENCIÓN A LA DIABETES TIPO 2 EN EE UU

 

Drowning: a largely preventable cause of death. Lancet 2014;384:1822 [AO,I]

25457904

AHOGAMIENTO: UNA CAUSA DE MUERTE AMPLIAMENTE PREVENIBLE

 

Osborn J, Thompson M. Management of same-day appointments in primary care. Lancet 2014;384:1828-1829 [AO,I]

25098488

GESTIÓN DE LAS CITAS PARA EL MISMO DÍA EN ATENCIÓN PRIMARIA

 

Campbell JL, Fletcher E, Britten N, Green C, Holt TA, Lattimer V, et al. Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster-randomised controlled trial and cost-consequence analysis. Lancet 2014;384:1859-1868 [EC,II]

25098487             R/C

TRIAJE TELEFÓNICO PARA GESTIONAR LAS SOLICITUDES DE CONSULTA PARA EL MISMO DÍA EN ATENCIÓN PRIMARIA (ENSAYO ESTEEM): ENSAYO CONTROLADO ALEATORIZADO POR GRUPOS Y ANÁLISIS DE COSTO E IMPORTANCIA

 

THE NEW ENGLAND JOURNAL OF MEDICINE 

 

Black WC, Gareen IF, Soneji SS, Sicks JD, Keeler EB, Aberle DR, et al; National Lung Screening Trial Research Team. Cost-effectiveness of CT screening in the National Lung Screening Trial. N Engl J Med 2014;371:1793-1802 [CE,I]

25372087             R/C

RENTABILIDAD DEL CRIBAJE MEDIANTE TAC EN EL NATIONAL LUNG SCREENING TRIAL

 

Gould MK. Clinical practice. Lung-cancer screening with low-dose computed tomography. N Engl J Med 2014;371:1813-1820 [R,I]

25372089

CRIBAJE DEL CÁNCER DE PULMÓN CON TC DE  BAJA DOSIS

 

Manz C, Ross JS, Grande D. Marketing to physicians in a digital world. N Engl J Med 2014;371:1857-1859 [AO,I]

25390738

MARKETING PARA MÉDICOS EN UN MUNDO DIGITAL

 

Alpern JD, Stauffer WM, Kesselheim AS. High-cost generic drugs--implications for patients and policymakers. N Engl J Med 2014;371:1859-1862 [AO,I]

25390739             R/C

FÁRMACOS GENÉRICOS DE COSTE ALTO--IMPLICACIONES PARA LOS PACIENTES Y PARA LOS LEGISLADORES

 

Drazen JM, Kanapathipillai R, Campion EW, Rubin EJ, Hammer SM, Morrissey S, et al. Ebola and quarantine. N Engl J Med 2014;371:2029-2030 [AO,I]

25347231

ÉBOLA Y CUARENTENA

 

Swerdloff R, Anawalt BD. Clinical decisions. Testosterone-replacement therapy. N Engl J Med 2014;371:2032-2034 [AO,I]

25409377

DECISIONES CLÍNICAS: TERAPIA SUSTITUTIVA DE TESTOSTERONA

 

Kent KC. Clinical practice. Abdominal aortic aneurysms. N Engl J Med 2014;371:2101-2108 [R,I]

25427112

ANEURISMAS AÓRTICOS ABDOMINALES

 

 

ANNALS OF INTERNAL MEDICINE

 

S25402511  

Three of 10 adults with diabetes remain undiagnosed, which may be related to less access to care. Compared with diagnosed adults, undiagnosed adults have less elevated hemoglobin A1c levels, less lipid treatment and worse control, and similarly poor BP and combined ABC control regardless of smoking status. Addressing these care gaps in both groups would prevent long-term complications.

S25199883  

Good-quality evidence supports that several medications for bone density in osteoporotic range and/or preexisting hip or vertebral fracture reduce fracture risk. Side effects vary among drugs, and the comparative effectiveness of the drugs is unclear.

S25402512  

Use of NSAIDs was associated with an independent risk for serious bleeding and thromboembolism in patients with AF. Short-term NSAID exposure was associated with increased bleeding risk. Physicians should exercise caution with NSAIDs in patients with AF.

 

ARCHIVOS DE BRONCONEUMOLOGIA

 

BUCHELLI 

Un porcentaje relevante de individuos de una muestra no seleccionada tiene valores elevados de COHb. Posiblemente las principales fuentes de exposición estén en el domicilio particular, por lo que debe explorarse esta posibilidad, alertar sobre los riesgos y estimular la toma de medidas preventivas.

 

ATENCION PRIMARIA

 

S24768658  

Se demuestra la efectividad de esta experiencia para mejorar conocimientos sobre salud cardiovascular y algunos hábitos de vida saludable.

S25288498  

La enfermedad renal crónica (ERC) es un importante problema de salud pública que puede afectar en sus diferentes estadios a cerca del 10% de la población española y que supone una elevada morbimortalidad, así como un importante consumo de recursos al Sistema Nacional de Salud. Diez sociedades científicas involucradas en el manejo del paciente renal nos hemos puesto de acuerdo para hacer una puesta al día del anterior documento de consenso sobre ERC de 2007. El presente es la edición abreviada del documento general extenso, que puede ser consultado en las páginas Web de cada una de las sociedades firmantes. Contiene los siguientes aspectos: definición, epidemiología y factores de riesgo de la ERC; criterios de diagnóstico, evaluación y estadificación de la ERC, albuminuria y estimación del filtrado glomerular; concepto y factores de progresión; criterios de derivación a nefrología; seguimiento del paciente, actitudes y objetivos por especialidad; prevención de la nefrotoxicidad; detección del daño cardiovascular; actitudes, estilo de vida y tratamiento: manejo de la hipertensión arterial, dislipidemia, hiperglucemia, tabaquismo, obesidad, hiperuricemia, anemia, alteraciones del metabolismo mineral y óseo; seguimiento coordinado por atención primaria-otras especialidades-nefrología; manejo del paciente en tratamiento renal sustitutivo, hemodiálisis, diálisis peritoneal y trasplante renal; tratamiento paliativo de la uremia terminal. Esperamos que sirva de gran ayuda en el manejo multidisciplinar del paciente con ERC, a la vista de las recomendaciones más actualizadas.

S24768655  

Las actitudes de los profesionales ante las actividades de PPS son aceptables y se debe trabajar en su mantenimiento. Las organizaciones sanitarias deberían implementar intervenciones adaptadas a distintos perfiles profesionales así como intervenciones que pongan en valor dichas actividades y mejoren la pericia y la seguridad en su realización.

S24792420  

La prevalencia de envejecimiento satisfactorio es elevada en personas de 86 años en la comunidad. La escasa actividad física multiplica por 7 la asociación a envejecimiento no satisfactorio, y la debilidad muscular por 6. Por ello, incorporar el cribado dirigido a detectar estos 2 factores podría mejorar intervenciones posteriores hacia un envejecimiento más óptimo, si estos resultados se confirman en futuros estudios.

S24768657  

La participación activa de los médicos con uso de pruebas rápidas en la consulta se acompaña de una reducción importante de antibióticos en las ITR, sobre todo en las infecciones mayoritariamente virales.

S24667116  

Algunos AINE pueden disminuir la efectividad del tratamiento antihipertensivo cuando se utilizan simultáneamente con antihipertensivos, en especial con inhibidores de la enzima conversora de angiotensina, diuréticos, bloqueadores beta y antagonistas de los receptores de angiotensina. No se encontró evidencia de la modificación del efecto de los antagonistas de los canales de calcio, especialmente dihidropiridínicos, por el uso simultáneo con AINE.

 

BRITISH JOURNAL OF PSYCHIATRY

 

S25368357 

The classification of mood disorders lacks precision and consequently there has been no recent meaningful advance in their treatment. By virtue of its therapeutic specificity, lithium responsivity offers an opportunity to diagnose a definitive subtype of mood disorders that may provide a platform for the development of targeted therapy.

 

BRITISH MEDICAL JOURNAL

 

S25352501  

There is no evidence suggesting that treatment for cervical intraepithelial neoplasia adversely affects fertility, although treatment was associated with a significantly increased risk of miscarriages in the second trimester. Research should explore mechanisms that may explain this increase in risk and stratify the impact that treatment may have on fertility and early pregnancy outcomes by the size of excision and treatment method used.

S25406188  

Genetically low 25-hydroxyvitamin D concentrations were associated with increased all cause mortality, cancer mortality, and other mortality but not with increased cardiovascular mortality. These findings are compatible with the notion that genetically low 25-hydroxyvitamin D concentrations may be causally associated with cancer and other mortality but also suggest that the observational association with cardiovascular mortality could be the result of confounding.

S25378384  

The risk of preterm birth is at most minimally affected by a small excision. Larger excisions, particularly over 15 mm or 2.66 cm(3), are associated with a doubling of the risk of both preterm and very preterm births. The risk does not decrease with increasing time from excision to conception. Efforts should be made to excise the entire lesion while preserving as much healthy cervical tissue as possible. Close obstetric monitoring is warranted for women who have large excisions of the cervical transformation zone.

S25403476  

At age 55, though men and women have similar lifetime risks of cardiovascular disease, there are considerable differences in the first manifestation. Men are more likely to develop coronary heart disease as a first event, while women are more likely to have cerebrovascular disease or heart failure as their first event, although these manifestations appear most often at older ages.

S25389136  

Aggregating patients' ratings of doctors' communication skills at practice level can mask considerable variation in the performance of individual doctors, particularly in lower performing practices. Practice level surveys may be better used to "screen" for concerns about performance that require an individual level survey. Higher scoring practices are unlikely to include lower scoring doctors. However, lower scoring practices require further investigation at the level of the individual doctor to distinguish higher and lower scoring general practitioners.

S25368388  

Genetically low vitamin D concentrations and increased mortality: mendelian randomisation analysis in three large cohorts

 

CANADIAN MEDICAL ASSOCIATION JOURNAL

 

S25316904 

A Mediterranean diet supplemented with either extra virgin olive oil or nuts is not associated with the onset of metabolic syndrome, but such diets are more likely to cause reversion of the condition. An energy-unrestricted Mediterranean diet may be useful in reducing the risks of central obesity and hyperglycemia in people at high risk of cardiovascular disease.

 

CIRCULATION

 

S25399395 

Increased AED use is associated with increased survival in patients with a shockable initial rhythm. We recommend continuous efforts to introduce or extend AED programs.

S25399396 

Data drawn from a large subset of U.S communities suggest that rates of survival from out-of-hospital cardiac arrest have improved among sites participating in a performance improvement registry.

S25399397 

OHCA patients who were transported alive are increasingly likely to have cardiovascular risk factors but less likely to have previous cardiovascular conditions. The overall incidence of OHCA patients transported to hospital alive did not change over the past decade. Short- and longer-term survival after OHCA has substantially improved, with younger patients experiencing the greatest improvement.

S25252721 

This large study of out-of-hospital cardiac arrest patients demonstrated that increased cardiopulmonary resuscitation compression depth is strongly associated with better survival. Our adjusted analyses, however, found that maximum survival was in the depth interval of 40.3 to 55.3 mm (peak, 45.6 mm), suggesting that the 2010 American Heart Association cardiopulmonary resuscitation guideline target may be too high.

 

DIABETES CARE

 

S25071075 

Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC. This suggests an LC diet with low saturated fat may be an effective dietary approach for T2DM management if effects are sustained beyond 24 weeks.

S25125505 

Chronic pistachio consumption is emerging as a useful nutritional strategy for the prediabetic state. Data suggest that pistachios have a glucose- and insulin-lowering effect, promote a healthier metabolic profile, and reverse certain metabolic deleterious consequences of prediabetes.

S25168125 

Measurement of HbA1c on admission is beneficial in tailoring treatment regimens at discharge in general medicine and surgery patients with type 2 diabetes.

S25139886 

Healthy metabolic profile and the absence of diabetes risk factors do not protect young adults from incident diabetes associated with overweight and obesity.

S25342830 

Natriuretic peptides (NPs) play a key role in cardiovascular homeostasis, counteracting the deleterious effects of volume and pressure overload and activating antibrotic and antihypertrophic pathways in the heart. N-terminal B-type NP (NT-proBNP) also is a promising biomarker of global cardiovascular risk in the general population, and there is increasing interest on its potential use in diabetic patients for screening of silent cardiovascular abnormalities, cardiovascular risk stratification, and guided intervention. Recently, both atrial NP (ANP) and B-type NP (BNP) have emerged as key mediators in the control of metabolic processes including the heart in the network of organs that regulate energy usage and metabolism. Epidemiological studies have shown that ANP and BNP are reduced in people with obesity, insulin resistance, and diabetes, and this deficiency may contribute to enhance their global cardiovascular risk. Moreover, ANP and BNP have receptors in the adipose tissue, enhance lipolysis and energy expenditure, and modulate adipokine release and food intake. Therefore, low ANP and BNP levels may be not only a consequence but also a cause of obesity, and recent prospective studies have shown that low levels of NT-proBNP and midregional proANP (MR-proANP) are a strong predictor of type 2 diabetes onset. Whether ANP and BNP supplementation may result in either cardiovascular or metabolic benefits in humans remains, however, to be established.

S25342831 

The hyperosmolar hyperglycemic state (HHS) is the most serious acute hyperglycemic emergency in patients with type 2 diabetes. von Frerichs and Dreschfeld described the first cases of HHS in the 1880s in patients with an "unusual diabetic coma" characterized by severe hyperglycemia and glycosuria in the absence of Kussmaul breathing, with a fruity breath odor or positive acetone test in the urine. Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be <1% of hospital admissions of patients with diabetes. The reported mortality is between 10 and 20%, which is about 10 times higher than the mortality rate in patients with diabetic ketoacidosis (DKA). Despite the severity of this condition, no prospective, randomized studies have determined best treatment strategies in patients with HHS, and its management has largely been extrapolated from studies of patients with DKA. There are many unresolved questions that need to be addressed in prospective clinical trials regarding the pathogenesis and treatment of pediatric and adult patients with HHS.

S25150157 

Long-term use of sulfonylureas was associated with a significantly higher risk of developing CHD among women with diabetes.

S25168126 

Serum hs-CRP levels, independent of possible confounders, were associated with a subsequent risk of developing, not progressing, diabetic nephropathy in type 2 diabetic patients. Serum hs-CRP may be useful for predicting the future risk of developing diabetic nephropathy.

 

DRUGS

 

S25300411 

Phosphodiesterase-4 (PDE4) inhibitors have broad anti-inflammatory activity, inhibiting the airway inflammation associated with chronic obstructive pulmonary disease (COPD), especially by reducing airway neutrophils that are key cells in COPD. A careful evaluation of the results of several meta-analyses allows us to consider the use of PDE4 inhibitors as very important in those patients with COPD who are particularly susceptible to exacerbations, the so-called 'frequent exacerbators'. Consequently, PDE4 inhibitors should be used earlier and more frequently than is the case today, but they are prescribed sporadically because of side effects. Several strategies are conceivable to avoid side effects, but, unfortunately, many of these approaches are yet to be successfully translated into clinical effectiveness after several decades of research. A novel alternative approach is to administer multiple drugs simultaneously or drugs capable of two distinct primary pharmacological actions based on distinct pharmacophores (bifunctional drugs) in order to produce additive or synergistic effects and, consequently, to dispense these drugs at lower doses, inducing fewer side effects. The fact that we have realized that there is a need to target simultaneously more PDEs unquestionably represents an advance in the possible use of PDE inhibitors. Actually, the possibility that multivalent (multifunctional) ligands, which feature two or more pharmacophores, may deliver superior efficacy is an approach that is being explored. Recognizing the role of specific targeted therapy aimed at subcellular domains has changed our understanding of the use of PDE inhibitors, and offers an opportunity to improve both the therapeutic tolerability and efficacy of these drugs.

S25300410  

Venous thromboembolism (VTE) is a major cause of morbidity, mortality, and healthcare expenditure. In the United States, approximately 0.1 % of the population experiences an initial VTE event each year. Anticoagulation therapy is the cornerstone of acute VTE treatment and for prevention of recurrent VTE events. Conventional anticoagulants, including heparin, low-molecular-weight heparins, fondaparinux, and vitamin K antagonists are widely used but have limitations. Newer oral anticoagulant agents, including direct thrombin inhibitors (e.g., dabigatran etexilate) and direct factor Xa inhibitors (e.g., rivaroxaban, apixaban, and edoxaban) have been developed to attempt to overcome some of the limitations of conventional anticoagulant therapy. These new oral agents have been evaluated for safety and efficacy in large, randomized clinical trials in the treatment and secondary prevention of VTE with results that are comparable to conventional therapy. Dabigatran, rivaroxaban, apixaban, and edoxaban are important new treatment options for patients with VTE. In this review, we compare these new agents and their associated clinical trials in VTE treatment.

S25315030  

Despite the availability of effective pharmacological treatments to aid the control of blood pressure, the global rate of uncontrolled blood pressure remains high. As such, further measures are required to improve blood pressure control. Recently, several national and international guidelines for the management of hypertension have been published. These aim to provide easily accessible information for healthcare professionals and patients to aid the diagnosis and treatment of hypertension. In this review, we have compared new and current guidelines from the American and International Societies of Hypertension; the American Heart Association, American College of Cardiology and the US Center for Disease Control and Prevention; the panel appointed to the Eighth Joint National Committee; the European Societies of Hypertension and Cardiology; the French Society of Hypertension; the Canadian Hypertension Education Program; the National Institute for Health and Clinical Excellence (UK); the Taiwan Society of Cardiology and the Chinese Hypertension League. We have identified consensus opinion regarding best practises for the management of hypertension and have highlighted any discrepancies between the recommendations. In general there is good agreement between the guidelines, however, in some areas, such as target blood pressure ranges for the elderly, further trials are required to provide sufficient high-quality evidence to form the basis of recommendations.

 

ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA

 

S24908497 

Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia.

 

EUROPEAN HEART JOURNAL

 

S25139896 

This paper provides an update for 2014 on the burden of cardiovascular disease (CVD), and in particular coronary heart disease (CHD) and stroke, across the countries of Europe. Cardiovascular disease causes more deaths among Europeans than any other condition, and in many countries still causes more than twice as many deaths as cancer. There is clear evidence in most countries with available data that mortality and case-fatality rates from CHD and stroke have decreased substantially over the last 5-10 years but at differing rates. The differing recent trends have therefore led to increasing inequalities in the burden of CVD between countries. For some Eastern European countries, including Russia and Ukraine, the mortality rate for CHD for 55-60 year olds is greater than the equivalent rate in France for people 20 years older.

S25179762  

Venous thrombo-embolism is the third most frequent acute cardiovascular syndrome after myocardial infarction and stroke. Recently published landmark trials paved the way for significant progress in the management of the disease and provided the evidence for the ESC Pulmonary Embolism (PE) Guidelines 2014 update. Risk stratification strategies for non-high-risk PE continue to evolve, with an increasing emphasis on clinical prediction rules and right ventricular (RV) assessment on computed tomographic pulmonary angiography. In the field of anticoagulation treatment, pharmacogenetic testing for vitamin K antagonists on top of clinical parameters was not found to offer a significant benefit during the initiation phase; on the other hand, dosing based on the patient's clinical data seems superior to fixed loading regimens. The phase 3 trial programme of new oral anticoagulants in the treatment of venous thrombo-embolism has been completed, and the results indicate that these agents are at least as effective and probably cause less major bleeding than currently standard treatment. A multicentre prospective phase 4 trial will determine whether early discharge and out-of-hospital treatment of low-risk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. For intermediate-risk PE defined on the basis of imaging tests and laboratory biomarkers, the bleeding risks of full-dose thrombolytic treatment appear too high to justify its use, unless clinical signs of haemodynamic decompensation appear. Patients in whom PE has resulted in chronic thrombo-embolic pulmonary hypertension and who are not suitable for pulmonary endarterectomy, may be expected to benefit from emerging pharmaceutical and interventional treatment options.

 

FAMILY MEDICINE

 

DORY 

Conclusions: Written tests of clinical reasoning could provide relevant additional information to the evaluation of students’ competence over the course of a family medicine clerkship. Further research is needed to determine the potential educational consequences of such programs of assessment.

THOMPSON 

Conclusions: Smoking cessation should be recommended for all current smokers, and those with a history of smoking should be informed about lung cancer screening with CT scan.

RENSHAW 

Conclusions: As medical care services and settings change, documenting comprehensive clinical experiences will be valuable to respond to changes in patient presentations in family physician offices, both locally and nationally. Patient encounter data evaluations should be used to ensure students’ clinical experiences are adequate, equivalent, and reflective of community practice. Continuous assessment of student experiences is essential due to shifts in prevalence, practice characteristics, and changes in patient preferences.

BENE  

Conclusions: We find evidence from several different educational settings that peer teaching benefits both the peer teachers and the learners. This suggests that peer teaching is a valuable methodology for medical schools to engage learners as teachers.

 

GACETA SANITARIA

 

S25087116 

En una cohorte prospectiva de mayores de 75 años que viven en su propio domicilio en la ciudad de Lleida, el mayor nivel de fragilidad está asociado con un mayor riesgo de muerte a los 2 años.

S25189674  

Esta revisión muestra que entre las personas mayores persiste la desigualdad de género y de nivel socioeconómico con respecto a la salud autopercibida. Son necesarios futuros estudios para aclarar los factores que hacen que persistan las desigualdades en los mayores, y así poder diseñar políticas de salud específicas para este sector de la población.

S25234273 

La contribución de este trabajo consiste en comprender por qué los/las médicos/as gestores/as desarrollan actitudes adversas a la gestión y por qué se definen como médicos/as y no como gestores/as. La explicación recae en los significados que otorgan a la gestión, como base sobre la cual construyen sus actitudes hacia ésta y su identidad profesional. De esta comprensión se derivan algunas implicaciones para la gestión sanitaria.

 

JAMA INTERNAL MEDICINE

 

S25179753  

In this sample of drug users seeking emergency medical treatment, a relatively robust brief intervention did not improve substance use outcomes. More work is needed to determine how drug use disorders may be addressed effectively in the ED.

S25201279  

Most nursing home residents with advanced dementia receive medications with questionable benefit that incur substantial associated costs.

 

JAMA PSYCHIATRY

 

S25208208  

Duration of daily sunshine was significantly correlated with suicide frequency independent of season, but effect sizes were low. Our data support the hypothesis that sunshine on the day of suicide and up to 10 days prior to suicide may facilitate suicide. More daily sunshine 14 to 60 days previously is associated with low rates of suicide. Our study also suggests that sunshine during this period may protect against suicide.

 

REUMATOLOGIA CLINICA

 

S24913963 

La columna es terreno abonado para la simulación, involucrando a diferentes Especialistas (traumatólogos, neurocirujanos, rehabilitadores, médicos de familia, etc.). La simulación requiere la producción intencional de síntomas exagerados o falsos respondiendo a un incentivo externo. Sin embargo, en la práctica, hay dificultades en la demostración de dichos requisitos. Esto origina que algunos simuladores no resulten identificados y que pacientes no simuladores con actitud incongruente sean etiquetados de rentistas, originando distrés iatrógeno y exposición a litigación.

Se analiza la simulación en el raquis, proponiendo una modificación terminológica, así como una nueva estrategia de diagnóstico, para evitar errores y reducir tanto el distrés iatrógeno como la ligitabilidad.

Basándonos en la experiencia clínico-forense de los autores, se analiza la bibliografía y se propone una semiología uniforme. El abordaje es multidimensional y la estrategia de diagnóstico basada en: anamnesis, exploración y pruebas complementarias, adaptando sus resultados a una terminología uniforme con significado preciso de signos y síntomas.

 

THE LANCET

 

S25455249  

The perinatal period is associated with an increased risk of severe mental disorders. We summarise the evidence regarding the epidemiology, risk factors, and treatment of severe mental illness in relation to childbirth, focusing on bipolar disorder, affective psychosis, and schizophrenia. We discuss women with ongoing chronic conditions and those with the onset of new episodes of post-partum psychosis. Despite the importance of perinatal episodes, with suicide a leading cause of maternal death, few studies are available to guide the management of women with severe mental disorders in pregnancy and the post-partum period. However, general principles of management are discussed, including the need for an individual risk-benefit analysis for each woman.

S25236409  

Low Apgar score at 5 min was strongly associated with the risk of neonatal and infant death. Our findings support its continued usefulness in contemporary practice.

S25064594  

Our findings suggest that regular or as-needed dosing with paracetamol does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of paracetamol in this patient group.

S25455248  

Mental disorders are among the most common morbidities of pregnancy and the postnatal period, and can have adverse effects on the mother, her child, and family. This Series paper summarises the evidence about epidemiology, risk factors, identification, and interventions for non-psychotic mental disorders. Although the phenomenology and risk factors for perinatal mental disorders are largely similar to those for the disorders at other times, treatment considerations differ during pregnancy and breastfeeding. Most randomised controlled trials have examined psychosocial and psychological interventions for postnatal depression, with evidence for effectiveness in treating and preventing the disorder. Few high-quality studies exist on the effectiveness or safety of pharmacological treatments in the perinatal period, despite quite high prescription rates. General principles of prescribing of drugs in the perinatal period are provided, but individual risk-benefit analyses are needed for decisions about treatment.

S25078309  

Combined simeprevir and sofosbuvir was efficacious and well tolerated.

S25098487  

Introduction of telephone triage delivered by a GP or nurse was associated with an increase in the number of primary care contacts in the 28 days after a patient's request for a same-day GP consultation, with similar costs to those of usual care. Telephone triage might be useful in aiding the delivery of primary care. The whole-system implications should be assessed when introduction of such a system is considered.

 

THE NEW ENGLAND JOURNAL OF MEDICINE

 

S25372087  

We estimated that screening for lung cancer with low-dose CT would cost $81,000 per QALY gained, but we also determined that modest changes in our assumptions would greatly alter this figure. The determination of whether screening outside the trial will be cost-effective will depend on how screening is implemented. (Funded by the National Cancer Institute; NLST ClinicalTrials.gov number, NCT00047385.).

S25390739 

Some older generic drugs have become very expensive, owing to factors including drug shortages, supply disruptions, and consolidations in the generic-drug industry. But generics manufacturers that legally obtain a market monopoly can also unilaterally raise prices.

 

 

 

                      

XXVIII Congreso de Comunicación y Salud

 

 

semFYC - JRT 2017

 

Cáceres, 10 y 11 de Noviembre 2017


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