Medicine - Programa de Formación Médica Continuada Acreditado最新文献

Protocolo diagnóstico y terapéutico de los síndromes paraneoplásicos del cáncer de pulmón

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.006

G. González, S. Roa, M. García-Pardo, Y. Lage, A. Barril, J.C. Calvo, M.E. Olmedo, V. Alía, P. Garrido, J. Chamorro

引用次数: 0

Mesotelioma pleural maligno

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.003

V. Alía, M.E. Olmedo, G. González, Y. Lage, M. García-Pardo, S. Roa, J.C. Calvo, A. Barrill, P. Garrido, J. Chamorro

{"title":"Mesotelioma pleural maligno","authors":"V. Alía, M.E. Olmedo, G. González, Y. Lage, M. García-Pardo, S. Roa, J.C. Calvo, A. Barrill, P. Garrido, J. Chamorro","doi":"10.1016/j.med.2025.03.003","DOIUrl":"10.1016/j.med.2025.03.003","url":null,"abstract":"<div><div>Malignant pleural mesothelioma is an aggressive and rare neoplasm associated with asbestos exposure. Its incidence is increasing in developing countries. It has a poor prognosis, with a median survival time of about one year. The treatments currently available offer limited benefits. Based on the available evidence, the role of radical surgery is controversial because of the high perioperative morbidity and mortality and the tendency for disease recurrence. Platinum- and pemetrexed-based chemotherapy was the cornerstone of the treatment of unresectable disease in patients with good functional reserve. Immunotherapy with nivolumab and ipilimumab has recently emerged as a new standard option, improving survival figures and with manageable toxicity, especially in the non-epithelioid histologic subtype. Pleural effusion and trapped lung are common complications in this disease, so techniques aimed at controlling symptoms are fundamental. It is necessary to conduct new clinical trials and translational research in order to improve survival and quality of life expectations for patients with pleural mesothelioma.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1595-1602"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591725","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

Manejo de las toxicidades inmunomediadas por fármacos anti-PD-1/PD-L1

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.007

A. Barrill, J.C. Calvo, M.E. Olmedo, V. Alía, S. Roa, G. González, M. García-Pardo, Y. Lage, P. Garrido, J. Chamorro

引用次数: 0

Biomarcadores predictivos en el cáncer de pulmón. Implicaciones terapéuticas

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.005

M.E. Olmedo, Y. Lage, M. García-Pardo, S. Roa, J.C. Calvo, V. Alía, A. Barril, G. González, P. Garrido y J. Chamorro

引用次数: 0

Cáncer de cabeza y cuello

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.004

S. Roa, V. Alía, A. Barrill, Y. Lage, M. García-Pardo, M.E. Olmedo, J.C. Calvo, G. González, P. Garrido y J. Chamorro

引用次数: 0

Carcinoma de pulmón de célula no pequeña

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.002

Y. Lage, M. García-Pardo, M.E. Olmedo, S. Roa, J.C. Calvo, V. Alía, A. Barrill, G. González, P. Garrido, J. Chamorro

{"title":"Carcinoma de pulmón de célula no pequeña","authors":"Y. Lage, M. García-Pardo, M.E. Olmedo, S. Roa, J.C. Calvo, V. Alía, A. Barrill, G. González, P. Garrido, J. Chamorro","doi":"10.1016/j.med.2025.03.002","DOIUrl":"10.1016/j.med.2025.03.002","url":null,"abstract":"<div><div>Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. The main risk factor is tobacco, followed by radon. The main histological subtypes are adenocarcinoma and squamous cell carcinoma. In most cases, patients are diagnosed with NSCLC in advanced stages (III-IV), usually after the onset of respiratory and/or constitutional symptoms. The first diagnostic test is usually a chest X-ray in which a pulmonary nodule is observed, after which staging should be completed with a thoracic-abdominal-pelvic computed tomography (CT) scan (and a positron emission tomography (PET-CT) scan in case of localized or locally advanced disease) and a cranial CT scan. The histological diagnosis should be confirmed by performing a biopsy. Enough tissue should be obtained not only for cytomorphological diagnosis (histological subtype), but also for the biomarker study (molecular diagnosis and PD-L1). In the last decade, significant advances have been made in the treatment of patients with NSCLC with the emergence of targeted therapies and immunotherapy, which have achieved a significant improvement in survival. The treatment of choice will depend on the patient's characteristics (general condition, previous diseases, etc.) and preferences as well as on the tumor characteristics, the histological subtype, and whether targeted therapies exist or not (depending on the biomarker results).</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1580-1594"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591717","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

Dolor pleurítico y astenia en un paciente fumador

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.009

J.C. Calvo, Y. Lage, M. García-Pardo, J. Chamorro Pérez

引用次数: 0

Carcinoma microcítico de pulmón

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.001

J. Chamorro, M.E. Olmedo, J.C. Calvo, V. Alía, A. Barrill, S. Roa, G. González, M. García-Pardo, Y. Lage, P. Garrido

{"title":"Carcinoma microcítico de pulmón","authors":"J. Chamorro, M.E. Olmedo, J.C. Calvo, V. Alía, A. Barrill, S. Roa, G. González, M. García-Pardo, Y. Lage, P. Garrido","doi":"10.1016/j.med.2025.03.001","DOIUrl":"10.1016/j.med.2025.03.001","url":null,"abstract":"<div><div>Small cell lung cancer accounts for about 15% of all lung neoplasms and is closely related to smoking. It displays singularly aggressive behavior; the five-year survival rate is approximately 5%. Small cell lung cancer should be suspected when a lung mass with voluminous lymph node involvement and extensive metastatic involvement is identified in a patient with a high smoking burden. A biopsy should be performed as soon as possible as well as full staging via thoracic-abdominal-pelvic CT scan and PET-CT in case of limitated-stage disease. Likewise, a cranial CT scan should also be performed given the high brain tropism of this neoplasm.</div><div>The treatment of choice in limitated-stage disease is the combination of chemotherapy (cisplatin-based) and radiotherapy administered concurrently. In patients with metastases (extensive disease), the first-line treatment of choice is a combination of chemotherapy (cisplatin or carboplatin and etoposide), together with an immune checkpoint inhibitor (atezolizumab or durvalumab). If progression occurs, administering topotecan or even retreatment with platinum can be considered, although it has low response rates.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1571-1579"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591716","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 manejo multimodal del cáncer de pulmón: cirugía, radioterapia y tratamiento sistémico. Indicaciones terapéuticas y paliativas de la cirugía y la radioterapia

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.008

J. Chamorro, J.C. Calvo, M. García-Pardo, G. González, S. Roa, Y. Lage, A. Barril, M.E. Olmedo, V. Alía, P. Garrido

引用次数: 0

Protocolos de prevención y diagnóstico precoz de los tumores digestivos I: adenocarcinoma de esófago y estómago

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-02-01 DOI: 10.1016/j.med.2025.01.016

M. Sierra Morales, F.M. Salinas Núñez, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez

{"title":"Protocolos de prevención y diagnóstico precoz de los tumores digestivos I: adenocarcinoma de esófago y estómago","authors":"M. Sierra Morales, F.M. Salinas Núñez, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez","doi":"10.1016/j.med.2025.01.016","DOIUrl":"10.1016/j.med.2025.01.016","url":null,"abstract":"<div><div>Barrett's esophagus is considered a preneoplastic entity with low risk of progression to esophageal adenocarcinoma, which should be ruled out in the presence of risk factors. Once detected, maintenance treatment with proton pump inhibitors is recommended, so as to minimize exposure to gastric acid reflux, as well as endoscopic follow-up, the frequency of which will depend on the degree of extension of Barrett's esophagus.</div><div>Gastric adenocarcinoma is the fifth most frequent cancer worldwide. Strategies have been developed to facilitate an early diagnosis and reduce its incidence. However, population screening in areas with a low incidence is not recommended. Chronic atrophic gastritis and intestinal metaplasia are considered preneoplastic lesions because they may possibly progress to the development of dysplasia and adenocarcinoma. The main cause of chronic gastritis is chronic <em>Helicobacter pylori</em> infection. Eradication is recommended if it is detected, as is endoscopic surveillance if follow-up criteria are met. Finally, if dysplasia or early carcinoma is found during screening, endoscopic treatment is recommended if a visible lesion is identified.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 25","pages":"Pages 1506-1510"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143356654","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