Medicine - Programa de Formación Médica Continuada Acreditado最新文献

筛选
英文 中文
Varón de 49 años con lesiones purpúricas en ambas piernas, poliartralgias, parestesias en las extremidades, síndrome constitucional e infección por el virus de la hepatitis C 49岁男性,双腿紫色病变、多关节痛、四肢麻痹、体质综合征和丙型肝炎感染
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.009
M. Ramírez Martín, C. Corral Cuadrado, E. Rico Sánchez-Mateos, J. Muñoz Serrano
{"title":"Varón de 49 años con lesiones purpúricas en ambas piernas, poliartralgias, parestesias en las extremidades, síndrome constitucional e infección por el virus de la hepatitis C","authors":"M. Ramírez Martín, C. Corral Cuadrado, E. Rico Sánchez-Mateos, J. Muñoz Serrano","doi":"10.1016/j.med.2025.06.009","DOIUrl":"10.1016/j.med.2025.06.009","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 34","pages":"Pages 2104.e1-2104.e4"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vasculitis de mediano vaso 中血管炎
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.003
A. Abbasi Pérez , J. Campos Esteban , L. Antúnez Segura , E. Rico Sánchez-Mateos , E. Fernández Fernández
{"title":"Vasculitis de mediano vaso","authors":"A. Abbasi Pérez ,&nbsp;J. Campos Esteban ,&nbsp;L. Antúnez Segura ,&nbsp;E. Rico Sánchez-Mateos ,&nbsp;E. Fernández Fernández","doi":"10.1016/j.med.2025.06.003","DOIUrl":"10.1016/j.med.2025.06.003","url":null,"abstract":"<div><div>Medium-vessel vasculitides are inflammatory diseases that mainly affect medium muscle and visceral arteries, causing necrotizing inflammation. They include polyarteritis nodosa (PAN), Kawasaki disease (KD), and ANCA-associated vasculitis (AAV). PAN is a rare vasculitis that affects medium-sized vessels. It is characterized by systemic symptoms such as fever, weight loss, and involvement of organs such as the skin, kidneys, and nerves. Its diagnosis is based on histology and imaging techniques which show characteristic aneurysms. Treatment includes corticosteroids and immunosuppressants. KD, more common in children, affects coronary arteries and manifests as persistent fever, conjunctivitis, lymphadenopathy, and mucocutaneous lesions. Management includes intravenous immunoglobulins and acetylsalicylic acid to prevent aneurysms. AAVs are necrotizing vasculitides and include granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). These affect small- and medium-sized vessels, with frequent involvement of the kidneys, lungs, and upper respiratory tract. Diagnosis is based on ANCA positivity and confirmed by biopsy. Treatment depends on the severity, considering that it can be life-threatening, and combines immunosuppressants such as rituximab or cyclophosphamide with corticosteroids.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 34","pages":"Pages 2054-2063"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insuficiencia cardíaca crónica con fracción de eyección del ventrículo izquierdo conservada 左心室喷射部分保存的慢性心力衰竭
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.012
J. Serpa Morán , E. García Romo , A. Leandro Barros , A. Ruiz-Saavedra , C. Tejada González , A. García Lledó
{"title":"Insuficiencia cardíaca crónica con fracción de eyección del ventrículo izquierdo conservada","authors":"J. Serpa Morán ,&nbsp;E. García Romo ,&nbsp;A. Leandro Barros ,&nbsp;A. Ruiz-Saavedra ,&nbsp;C. Tejada González ,&nbsp;A. García Lledó","doi":"10.1016/j.med.2025.06.012","DOIUrl":"10.1016/j.med.2025.06.012","url":null,"abstract":"<div><div>Heart failure with preserved ejection fraction (HFpEF) is defined as a clinical syndrome characterized by the presence of symptoms and/or signs arising from a structural and/or functional abnormality of the heart at rest or on exertion. It is accompanied by elevated natriuretic peptide levels or objective evidence of diastolic dysfunction and preserved left ventricular ejection fraction (equal to or greater than 50%). It is a heterogeneous syndrome whose diagnosis requires ruling out diseases that may justify the symptoms (respiratory diseases, coronary artery disease, valvular or hypertensive heart disease, or cardiomyopathies, among others). It is essential to perform an electrocardiogram, NT-proBNP measurement, and echocardiogram in addition to additional tests according to the patient's clinical context (computed tomography coronary angiogram and cardiac magnetic resonance imaging, among others). Current guidelines recommend the use of diuretics and treatment with SGLT2is to reduce congestive symptoms and the risk of hospitalization due to HF. There are currently no pharmacological treatments that have demonstrated a decrease in mortality in this group of patients. Recent studies suggest that glucagon-like peptide-1 receptor agonists (GLP1-ra) may improve quality of life and decrease symptoms in patients with HFpEF and obesity.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 35","pages":"Pages 2126-2136"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tratamiento de la hipertensión pulmonar 肺动脉高压的治疗
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.030
M.A. Sanromán Guerrero, E. Hernández Sánchez, J.L. Zamorano Gómez
{"title":"Tratamiento de la hipertensión pulmonar","authors":"M.A. Sanromán Guerrero,&nbsp;E. Hernández Sánchez,&nbsp;J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.06.030","DOIUrl":"10.1016/j.med.2025.06.030","url":null,"abstract":"<div><div>In the past three decades, the treatment of choice for pulmonary hypertension has been based on three pharmacological groups targeting three distinct therapeutic targets along with a series of hygienic and dietary measures. Patients who do not respond to treatment are candidates for lung transplantation or palliative care if they are deemed ineligible for transplantation. Currently, a new drug class that acts on the activin pathway is showing highly promising results.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 37","pages":"Pages 2236-2245"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enfermedad venosa aguda 急性静脉疾病
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.022
J. Reina Barrera , F. Álvarez Herrero , A. Bartolomé Sánchez , O. Uclés Cabeza , A. Baturone Blanco , A. Martín-Conejero
{"title":"Enfermedad venosa aguda","authors":"J. Reina Barrera ,&nbsp;F. Álvarez Herrero ,&nbsp;A. Bartolomé Sánchez ,&nbsp;O. Uclés Cabeza ,&nbsp;A. Baturone Blanco ,&nbsp;A. Martín-Conejero","doi":"10.1016/j.med.2025.06.022","DOIUrl":"10.1016/j.med.2025.06.022","url":null,"abstract":"<div><div>Acute venous disease includes thrombosis and trauma, with the latter being much less frequent. It mainly consists of venous thromboembolic disease (VTED), which includes deep vein thrombosis (DVT) of the lower limbs. DVT is classified according to anatomical area (proximal or distal), etiology (primary or secondary), and episode (first or subsequent). The pathophysiology of DVT involves Virchow's triad: hypercoagulable states, endothelial damage, and venous stasis. The clinical manifestations vary and include pain, edema, and cutaneous signs. Diagnosis is based on clinical suspicion, clinical prediction (Wells score), D-dimer analysis, and confirmation by Doppler ultrasound. Complications can be early (pulmonary embolism) or late (recurrent DVT and post-thrombotic syndrome). Treatment includes hygienic and dietary measures, anticoagulants, fibrinolytics, and surgery in select cases. Superficial vein thrombosis is a common entity that is diagnosed clinically and confirmed via Doppler ultrasound. Treatment includes general measures, non-steroidal anti-inflammatory drugs, and elastic stockings.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 36","pages":"Pages 2192-2200"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insuficiencia cardíaca aguda 急性心力衰竭
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.013
A. Leandro Barros, D. García Arribas, J. Serpa Morán, C. Tejada González, A. Ruiz-Saavedra, A. García Lledó
{"title":"Insuficiencia cardíaca aguda","authors":"A. Leandro Barros,&nbsp;D. García Arribas,&nbsp;J. Serpa Morán,&nbsp;C. Tejada González,&nbsp;A. Ruiz-Saavedra,&nbsp;A. García Lledó","doi":"10.1016/j.med.2025.06.013","DOIUrl":"10.1016/j.med.2025.06.013","url":null,"abstract":"<div><div>Acute heart failure (AHF) is a severe condition that requires urgent care, with high mortality and readmission rates. It mainly affects older adults and can occur <em>de</em> <em>novo</em> or as decompensation of chronic heart failure. It is a complex clinical syndrome with multiple pathogenic mechanisms that include cardiac and extracardiac factors. It can be triggered by ischemia, hypertension, arrhythmias, or infections. In addition, cardiac function and peripheral vasculature play key roles in its pathophysiology. It mainly presents with signs of congestion or peripheral hypoperfusion with four clinical forms: acute decompensation of heart failure, acute pulmonary edema, isolated right ventricular failure, and cardiogenic shock. Diagnosis is based on physical examination and additional tests such as an electrocardiogram (ECG), echocardiography, and biomarker analysis (BNP, NT-proBNP). Treatment of AHF focuses on relieving congestion and improving peripheral perfusion, identifying and treating triggers and optimizing long-term treatments. It includes diuretics, vasodilators, and vasoconstrictors to improve perfusion and inotropics to improve cardiac function when necessary.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 35","pages":"Pages 2137-2146"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tetralogía de Fallot ¿cómo determinamos el riesgo de muerte súbita? 法洛四联:我们如何确定猝死的风险?
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.037
M.A. Sanromán Guerrero, E. Hernández Sánchez, J.L. Zamorano Gómez
{"title":"Tetralogía de Fallot ¿cómo determinamos el riesgo de muerte súbita?","authors":"M.A. Sanromán Guerrero,&nbsp;E. Hernández Sánchez,&nbsp;J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.06.037","DOIUrl":"10.1016/j.med.2025.06.037","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 37","pages":"Pages 2290.e1-2290.e3"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardio-oncología Cardio-oncología
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.032
E. Hernández Sánchez, M.A. Sanromán Guerrero, J.L. Zamorano Gómez
{"title":"Cardio-oncología","authors":"E. Hernández Sánchez,&nbsp;M.A. Sanromán Guerrero,&nbsp;J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.06.032","DOIUrl":"10.1016/j.med.2025.06.032","url":null,"abstract":"<div><div>Cardio-oncology is a discipline that comprehensively addresses cardiovascular disease in patients with cancer. With the advances in cancer diagnosis and treatment, the survival rate of many malignant neoplasms has considerably increased in recent decades. This has brought the cardiovascular morbidity and mortality associated with various treatment regimens into greater focus. The optimal management of these patients throughout the different stages of the oncologic process is based on proper cardiovascular risk stratification and the development of preventive strategies, followed by close monitoring using imaging techniques and serum cardiac biomarkers. The early introduction of heart failure medications in response to ventricular function deterioration as well as assessing interrupting oncologic treatment or the use of alternative regimens, in addition to cardioprotective agents or less cardiotoxic formulations, must be decided through consensus by multidisciplinary teams. It is also essential to establish a long-term follow-up plan for cancer survivors, whether pediatric or adult, and to ensure a healthy lifestyle along with optimal control of cardiovascular risk factors throughout the entire process.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 37","pages":"Pages 2258-2271"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paciente varón de 87 años con múltiples factores de riesgo vascular y lesión trófica en miembro inferior derecho 87岁男性患者,有多种血管危险因素和右下肢营养损伤
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.028
O. Uclés Cabeza , F. Álvarez Herrero , A. Baturone Blanco , A. Bartolomé Sánchez , J. Reina Barrera , A. Martín-Conejero
{"title":"Paciente varón de 87 años con múltiples factores de riesgo vascular y lesión trófica en miembro inferior derecho","authors":"O. Uclés Cabeza ,&nbsp;F. Álvarez Herrero ,&nbsp;A. Baturone Blanco ,&nbsp;A. Bartolomé Sánchez ,&nbsp;J. Reina Barrera ,&nbsp;A. Martín-Conejero","doi":"10.1016/j.med.2025.06.028","DOIUrl":"10.1016/j.med.2025.06.028","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 36","pages":"Pages 2225.e1-2225.e4"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enfermedad arterial periférica de miembros inferiores 下肢周围动脉疾病
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-06-01 DOI: 10.1016/j.med.2025.06.020
A. Bartolomé Sánchez , O. Uclés Cabeza , J. Reina Barrera , F. Álvarez Herrero , A. Baturone Blanco , A. Martín-Conejero
{"title":"Enfermedad arterial periférica de miembros inferiores","authors":"A. Bartolomé Sánchez ,&nbsp;O. Uclés Cabeza ,&nbsp;J. Reina Barrera ,&nbsp;F. Álvarez Herrero ,&nbsp;A. Baturone Blanco ,&nbsp;A. Martín-Conejero","doi":"10.1016/j.med.2025.06.020","DOIUrl":"10.1016/j.med.2025.06.020","url":null,"abstract":"<div><div>Chronic ischemia of the lower limbs is a clinical condition due to the presence of peripheral arterial disease characterized by obstruction of the arteries that supply the legs. Its risk factors, pathophysiology, and classification are described. It is caused by the accumulation of atheroma plaques in the arteries that reduces blood flow and causes symptoms such as pain when walking (intermittent claudication) or pain at rest. In severe cases, ulcers or gangrene may occur. The diagnosis is based on a physical examination, the ankle-brachial index, and imaging tests such as CT angiography or arteriography. Treatment aims to reduce cardiovascular risk and improve symptoms. It includes non-pharmacological measures such as smoking cessation and doing exercise, drugs such as antiplatelet agents and statins, and, in some cases, surgery to revascularize the leg. This update highlights the importance of early diagnosis and appropriate treatment to prevent serious complications such as amputation.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 36","pages":"Pages 2175-2184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信