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Sarcoidosis
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.022
C. Arévalo-Cañas , G. Starita-Fajardo , L. Salmerón-Godoy , M. Andreo-Galera
{"title":"Sarcoidosis","authors":"C. Arévalo-Cañas ,&nbsp;G. Starita-Fajardo ,&nbsp;L. Salmerón-Godoy ,&nbsp;M. Andreo-Galera","doi":"10.1016/j.med.2025.04.022","DOIUrl":"10.1016/j.med.2025.04.022","url":null,"abstract":"<div><div>Sarcoidosis is a systemic inflammatory disease characterized by the formation of non-caseating granulomas that can affect any organ, with the lung being the most characteristic. Demonstrating non-necrotizing granulomas in a biopsy is essential in order to establish a diagnosis in practically all cases. Other additional tests, such as blood and urine tests, imaging and respiratory function tests, and bronchoalveolar lavage are useful in the diagnosis. The mainstay of treatment is corticosteroids, although immunosuppressive and biologic drugs may be useful.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1883-1894"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834650","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
Protocolo de evaluación de la afectación cardíaca en las enfermedades autoinmunes y autoinflamatorias
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.024
C. Arévalo-Cañas , I. Calatayud-Marín , F. Tornero-Romero , J. Ballano-Rodríguez-Solís
{"title":"Protocolo de evaluación de la afectación cardíaca en las enfermedades autoinmunes y autoinflamatorias","authors":"C. Arévalo-Cañas ,&nbsp;I. Calatayud-Marín ,&nbsp;F. Tornero-Romero ,&nbsp;J. Ballano-Rodríguez-Solís","doi":"10.1016/j.med.2025.04.024","DOIUrl":"10.1016/j.med.2025.04.024","url":null,"abstract":"<div><div>Cardiac involvement in systemic autoimmune diseases (SADs) and autoinflammatory diseases (AIDs) is underdiagnosed and can occur at different levels. This protocol provides a generic diagnostic approach to pericardial, myocardial, and endocardial involvement in SADs and AIDs, with the aim of improving their identification and promoting early diagnosis. Echocardiography, and especially cardiac magnetic resonance imaging, are useful in the diagnosis.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1900-1903"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834651","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
Amiloidosis
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.021
F. Tornero-Romero , F. Lage-Estébanez , L. Cantero del Olmo , A. Albiñana-Pérez , A. Palacio-Tamarit y C. Arévalo-Cañas
{"title":"Amiloidosis","authors":"F. Tornero-Romero ,&nbsp;F. Lage-Estébanez ,&nbsp;L. Cantero del Olmo ,&nbsp;A. Albiñana-Pérez ,&nbsp;A. Palacio-Tamarit y C. Arévalo-Cañas","doi":"10.1016/j.med.2025.04.021","DOIUrl":"10.1016/j.med.2025.04.021","url":null,"abstract":"<div><div>Amyloidoses represent a group of complex diseases that occur as a consequence of extracellular amyloid deposition in different tissues. The three main types of amyloidoses are secondary amyloidosis (AA), as a consequence of chronic inflammation produced in infectious and inflammatory diseases, mainly affecting the kidney; light-chain amyloidosis (AL), secondary to the production of immunoglobulin chains in hematological diseases, mainly affecting the heart and kidney; and transthyretin amyloidosis (ATTR) in its hereditary or wild-type variant, predominantly affecting the heart and peripheral nervous system. The treatment of AA and AL is that of the underlying disease, while in ATTR, stabilizers, gene silencing drugs, and eliminating drugs are under investigation.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1871-1882"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834654","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
Síndrome antifosfolípido
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.012
I. González Fernández , I. González Fernández , C. Moriano Morales, M. Retuerto Guerrero
{"title":"Síndrome antifosfolípido","authors":"I. González Fernández ,&nbsp;I. González Fernández ,&nbsp;C. Moriano Morales,&nbsp;M. Retuerto Guerrero","doi":"10.1016/j.med.2025.04.012","DOIUrl":"10.1016/j.med.2025.04.012","url":null,"abstract":"<div><div>Antiphospholipid syndrome is the main cause of acquired thrombophilia. It is characterized by the presence of venous/arterial thrombosis and obstetric morbidity, although other clinical and/or analytical manifestations not included in the conventional criteria may also be present. Antiphospholipid antibodies are involved in its development, which promotes a prothrombotic state in patients. Recently, new classification criteria have been incorporated (2023) that aim to help in the early and better identification of this disease. The mainstay of managing this condition when clinical manifestations develop is anticoagulation with vitamin K antagonists (in many cases in maintenance). In select refractory cases, the use of other drugs such as corticosteroids, hydroxychloroquine, statin, or even rituximab may be necessary. In cases of antiphospholipid antibody carriers without thrombotic episodes and/or obstetric morbidity, primary thromboprophylaxis with acetylsalicylic acid can be considered on an individual basis based on the antiphospholipid antibody profile, cardiovascular risk, and/or the presence of associated systemic autoimmune diseases.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1808-1815"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834463","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 relacionada con IgG4
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.020
G. Starita Fajardo , D. Lucena López , C. Arévalo-Cañas , A. González García
{"title":"Enfermedad relacionada con IgG4","authors":"G. Starita Fajardo ,&nbsp;D. Lucena López ,&nbsp;C. Arévalo-Cañas ,&nbsp;A. González García","doi":"10.1016/j.med.2025.04.020","DOIUrl":"10.1016/j.med.2025.04.020","url":null,"abstract":"<div><div>IgG4-related disease (IgG4-RD) is an immune-mediated disorder of a fibroinflammatory nature that can affect practically any organ. Some of the most common manifestations are glandular involvement, orbital pseudotumor, pancreatic involvement, and retroperitoneal fibrosis. The 2019 ACR/EULAR classification criteria for IgG4-RD, based on clinical and histologic findings, may be useful for diagnosis. Corticosteroids are the mainstay of treatment, although different immunosuppressive drugs are under investigation with mixed results.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1861-1870"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834653","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
Protocolo diagnóstico de las enfermedades autoinflamatorias
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.025
J. Ballano-Rodríguez-Solís , C. Arévalo-Cañas
{"title":"Protocolo diagnóstico de las enfermedades autoinflamatorias","authors":"J. Ballano-Rodríguez-Solís ,&nbsp;C. Arévalo-Cañas","doi":"10.1016/j.med.2025.04.025","DOIUrl":"10.1016/j.med.2025.04.025","url":null,"abstract":"<div><div>Autoinflammatory diseases are characterized by recurrent episodes of inflammation that are mainly mediated by the innate immune system and due to genetic mutations. Its diagnosis is challenging due to its low prevalence and phenotypic heterogeneity, especially in adults. After ruling out other more frequent diseases as the cause of the inflammatory phenomena, a genetic study is key to confirming the suspicion.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1904-1908"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835345","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
Protocolo terapéutico de las enfermedades autoinflamatorias
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.026
J. Ballano-Rodríguez-Solís , C. Arévalo-Cañas
{"title":"Protocolo terapéutico de las enfermedades autoinflamatorias","authors":"J. Ballano-Rodríguez-Solís ,&nbsp;C. Arévalo-Cañas","doi":"10.1016/j.med.2025.04.026","DOIUrl":"10.1016/j.med.2025.04.026","url":null,"abstract":"<div><div>The repeated episodes of inflammation that characterize autoinflammatory diseases trigger organ damage and occupational disability. Treatment is aimed at reducing the number and intensity of outbreaks as well as avoiding the development of secondary amyloidosis, which is most associated with inflammasomopathies. The most commonly used therapeutic agents include: NSAIDs, corticosteroids, colchicine, and biologic drugs (mainly anti-IL-1 and TNF inhibitors).</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1909-1912"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833110","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
Protocolo diagnóstico diferencial del dolor abdominal en pacientes con enfermedades inmunomediadas autoinmunes sistémicas
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.015
M. Retuerto Guerrero, E. Díez Álvarez, C. Sieiro Santos, I. González Fernández
{"title":"Protocolo diagnóstico diferencial del dolor abdominal en pacientes con enfermedades inmunomediadas autoinmunes sistémicas","authors":"M. Retuerto Guerrero,&nbsp;E. Díez Álvarez,&nbsp;C. Sieiro Santos,&nbsp;I. González Fernández","doi":"10.1016/j.med.2025.04.015","DOIUrl":"10.1016/j.med.2025.04.015","url":null,"abstract":"<div><div>Autoimmune rheumatic diseases are often accompanied by pain and other gastrointestinal symptoms that may affect different areas of the digestive tract. Its differential diagnosis is complex due to the nonspecific and episodic nature of the clinical manifestations. It is essential to perform a comprehensive differential diagnosis that considers specific organ damage and vascular complications associated with the disease, infections, adverse drug effects, and occult neoplasms. The case history should be detailed, including the onset, location, duration, and characteristics of the pain as well as triggering factors, associated symptoms, and treatments received. The physical examination plays a key role in identifying signs of acute abdomen that require surgical intervention as well as oriented clinicians toward a precise etiology. Laboratory studies, in addition to imaging tests according to clinical suspicion, are indispensable. This comprehensive approach makes it possible to distinguish between surgical, inflammatory, metabolic, and infectious causes, ensuring adequate and timely management.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1834-1838"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834468","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
Protocolo diagnóstico de las miositis
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.023
I. Calatayud Marín , N. Abdilla Bonías , M. Calabuig Ballester , C. Arévalo-Cañas
{"title":"Protocolo diagnóstico de las miositis","authors":"I. Calatayud Marín ,&nbsp;N. Abdilla Bonías ,&nbsp;M. Calabuig Ballester ,&nbsp;C. Arévalo-Cañas","doi":"10.1016/j.med.2025.04.023","DOIUrl":"10.1016/j.med.2025.04.023","url":null,"abstract":"<div><div>Idiopathic inflammatory myopathies (IIM) are systemic autoimmune diseases characterized by progressive muscle weakness and variable extramuscular involvement. This diagnostic protocol offers a structured approach that includes a detailed clinical assessment, identification of specific autoantibodies, imaging studies, and muscle biopsy. The integration of these tools improves diagnostic accuracy, facilitates disease classification, and optimizes clinical management.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1895-1899"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835344","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
Episodios de fiebre, dolor abdominal, artritis y lesiones cutáneas en joven adulto
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.027
M. Andreo , F. Lidón , C. Arévalo-Cañas , A. Quiles-Recuenco , F. Gutiérrez
{"title":"Episodios de fiebre, dolor abdominal, artritis y lesiones cutáneas en joven adulto","authors":"M. Andreo ,&nbsp;F. Lidón ,&nbsp;C. Arévalo-Cañas ,&nbsp;A. Quiles-Recuenco ,&nbsp;F. Gutiérrez","doi":"10.1016/j.med.2025.04.027","DOIUrl":"10.1016/j.med.2025.04.027","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 31","pages":"Pages 1913.e1-1913.e3"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833111","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
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