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Protocolo de intervención para la prevención de las caídas y la fragilidad en el adulto mayor 预防老年人跌倒和身体虚弱的干预议定书
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-30 DOI: 10.1016/j.med.2026.09.005
I. Nieto Fernández, C.A. Colato López, T. Pareja Sierra, L.M. Boscán Guevara, L.D. Pascual Bojorque, M.C. de Aguilar Caro
{"title":"Protocolo de intervención para la prevención de las caídas y la fragilidad en el adulto mayor","authors":"I. Nieto Fernández,&nbsp;C.A. Colato López,&nbsp;T. Pareja Sierra,&nbsp;L.M. Boscán Guevara,&nbsp;L.D. Pascual Bojorque,&nbsp;M.C. de Aguilar Caro","doi":"10.1016/j.med.2026.09.005","DOIUrl":"10.1016/j.med.2026.09.005","url":null,"abstract":"<div><div>Falls and frailty are closely related geriatric syndromes and are associated with an increased risk of functional decline, institutionalization, and mortality which justifies an integrated, evidence-based preventive approach. This protocol, designed for geriatric clinical practice to facilitate the early detection, prevention, and management of falls and frailty in older adults, is based on international guidelines and consensus statements and incorporates an interdisciplinary approach.</div><div>Personalized, multidomain interventions are proposed, with special emphasis on multicomponent physical exercise as the most effective strategy along with medication optimization, nutritional intervention, and adaptation of the environment. The systematic implementation of this protocol helps reduce adverse events, preserve independence, and improve the quality of life of older adults, constituting a reproducible model applicable in various care settings.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 62","pages":"Pages 3856-3861"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072236","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 de las discrepancias de longitud de los miembros inferiores en la adolescencia 处理青少年下肢长度差异的议定书
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.008
J. Cabello, M. Cuesta, P. Crespo, A. Losa, L. Calvo
{"title":"Protocolo de manejo de las discrepancias de longitud de los miembros inferiores en la adolescencia","authors":"J. Cabello,&nbsp;M. Cuesta,&nbsp;P. Crespo,&nbsp;A. Losa,&nbsp;L. Calvo","doi":"10.1016/j.med.2026.08.008","DOIUrl":"10.1016/j.med.2026.08.008","url":null,"abstract":"<div><div>While subclinical limb length discrepancy is common during adolescence, significant discrepancies are less so. Lower limb length discrepancy leads to biomechanical compensations associated with joint degeneration in the hip, knee, and spine. Discrepancies of two centimeters or more at final height are considered significant. Tables predicting the progression of the discrepancy and bone age are used. Management will involve techniques to slow growth of the longer limb or to to lengthen the shorter limb.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3813-3815"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924846","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
Importancia de la medicina de la adolescencia. Entrevista y abordaje del paciente adolescente 青少年医学的重要性。青少年患者访谈与治疗
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.001
J.L. Iglesias Diz
{"title":"Importancia de la medicina de la adolescencia. Entrevista y abordaje del paciente adolescente","authors":"J.L. Iglesias Diz","doi":"10.1016/j.med.2026.08.001","DOIUrl":"10.1016/j.med.2026.08.001","url":null,"abstract":"<div><div>The importance of Medicine in Adolescence: Interviewing and treating adolescent patients In the context of a rapidly changing society, adolescent care should be deepened and expanded to address new conditions arising from the many factors affecting them: social media, an increase in psychiatric disorders, eating disorders (ED), and others. One of the central pillars of adolescent care is the clinical interview: it may be the physician's only and last opportunity to guide, correct, diagnose, advise, interpret, or help the individual during this period of growth and development before they become an adult.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3763-3768"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917345","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
La autonomía del menor en el contexto sanitario. Conflictos éticos y búsqueda de soluciones 儿童在卫生方面的自主权。道德冲突与解决之道
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.004
M.Á. Donoso Sanz
{"title":"La autonomía del menor en el contexto sanitario. Conflictos éticos y búsqueda de soluciones","authors":"M.Á. Donoso Sanz","doi":"10.1016/j.med.2026.08.004","DOIUrl":"10.1016/j.med.2026.08.004","url":null,"abstract":"<div><div>Adolescence is a period marked by biological, cognitive, emotional, and social changes that entail specific ethical challenges, as it is a period of transition to adulthood with limited freedoms for exercising autonomy. Legal issues arise not only as a result of violations of rights and laws protecting children and adolescents, but also due to the judicialization of medicine.</div><div>The common goal of legal professionals, pediatricians, and parents should be the minor's best interests. This is determined judiciously, on a case-by-case basis, because each adolescent is unique and requires an individualized response. Bioethics serves as a bridge not only between science and human values, but also, through dialogue and deliberation, allows for mediation to curb the tendency to litigate conflicts. This article reviews the historical context that has made it possible to involve minors in healthcare decision-making, the evolution of the legislation that serves as the legal grounds for this involvement, situations in clinical practice in which conflicts may arise in this decision-making process, and an ethical perspective for finding solutions.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3789-3796"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917348","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
Valoración geriátrica integral y modelos predictivos de salud en el anciano 老年综合评估和老年人健康预测模型
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-30 DOI: 10.1016/j.med.2026.09.004
I. Rodríguez-Miñón, C. A. Colato López, D. L. Sepúlveda Moya, L.M. Boscán Guevara, M.C. de Aguilar Caro
{"title":"Valoración geriátrica integral y modelos predictivos de salud en el anciano","authors":"I. Rodríguez-Miñón,&nbsp;C. A. Colato López,&nbsp;D. L. Sepúlveda Moya,&nbsp;L.M. Boscán Guevara,&nbsp;M.C. de Aguilar Caro","doi":"10.1016/j.med.2026.09.004","DOIUrl":"10.1016/j.med.2026.09.004","url":null,"abstract":"<div><div>Population aging is one of the major health challenges of the 21st century. It is associated with an increase in multimorbidity, frailty, and disability. In this context, a comprehensive geriatric assessment (CGA) is the fundamental tool for the multidimensional evaluation of older adults, integrating the functional, mental, social, and nutritional domains. Its use allows for the early identification of deficits and potential strengths, guides individualized interventions, and improves relevant clinical outcomes, such as reducing dependence, institutionalization, and mortality.</div><div>This review updates the essential components of the CGA with a special emphasis on functional assessment and the detection of frailty, as well as the use of standardized scales in various clinical settings, including emergency departments and geriatric oncology. It also analyzes recent advances in predictive health models in geriatrics, ranging from classic indices based on the accumulation of deficits to new approaches supported by biological biomarkers, epigenetic clocks, digital technologies, big data, and artificial intelligence.</div><div>The integration of the CGA with validated predictive models offers an innovative framework for preventive, personalized, and person-centered geriatrics, facilitating clinical decision-making, advance care planning, and the optimization of healthcare resources in an increasingly aging population.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 62","pages":"Pages 3846-3855"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072235","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 abordaje de la osteoporosis en el adulto mayor 老年人骨质疏松症治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-30 DOI: 10.1016/j.med.2026.09.008
T. Pareja Sierra, E. Martín Alcalde, D.L. Sepúlveda Moya, V.E Landaeta Ribera, H.D. Villa Alvarado, P. Duluc Escobar
{"title":"Protocolo de abordaje de la osteoporosis en el adulto mayor","authors":"T. Pareja Sierra,&nbsp;E. Martín Alcalde,&nbsp;D.L. Sepúlveda Moya,&nbsp;V.E Landaeta Ribera,&nbsp;H.D. Villa Alvarado,&nbsp;P. Duluc Escobar","doi":"10.1016/j.med.2026.09.008","DOIUrl":"10.1016/j.med.2026.09.008","url":null,"abstract":"<div><div>Osteoporosis and osteoporotic fractures are highly prevalent and disabling conditions. Specific, individualized treatment is essential to reduce associated morbidity, mortality, and secondary disability. This article describes the most useful medications for treating osteoporosis in older adults as well as the individualized considerations necessary to optimize treatment outcomes in older adult patients. Bone-building drugs are particularly suitable for robust patients without limiting comorbidities, while parenteral antiresorptive agents are the treatment of choice in cases where the former are not indicated. Conversely, patients with irreversible frailty, immobility, and advanced cognitive impairment may not be candidates for this type of treatment. Follow-up on progress and assessment of treatment adherence are key elements for the effective prevention of fractures.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 62","pages":"Pages 3873-3879"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072239","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
Hemorragia uterina anormal en adolescentes: protocolo de actividad asistencial 青少年异常子宫出血：治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.006
A. Vegas Carrillo de Albornoz, F. Martínez Hernández, E. Carrillo de Albornoz Riaza
{"title":"Hemorragia uterina anormal en adolescentes: protocolo de actividad asistencial","authors":"A. Vegas Carrillo de Albornoz,&nbsp;F. Martínez Hernández,&nbsp;E. Carrillo de Albornoz Riaza","doi":"10.1016/j.med.2026.08.006","DOIUrl":"10.1016/j.med.2026.08.006","url":null,"abstract":"<div><div>Abnormal uterine bleeding (AUB) is the most common reason for gynecological consultation among adolescents. The most frequent causes are anovulatory cycles due to immaturity of the hypothalamic-pituitary-ovarian axis and coagulation disorders. It is always recommended to rule out pregnancy, infection, and coagulation disorders when AUB is present. Management should be tailored to the severity of the bleeding and hemodynamic status, prioritizing medical treatment with combined oral contraceptives (COCs), progestins, or antifibrinolytics. Multidisciplinary coordination with gynecology, hematology, pediatrics, and endocrinology, as well as follow-up care, are essential in order to prevent recurrences and complications.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3803-3807"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924848","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 y terapéutico del asma en el adolescente 青少年哮喘的诊断和治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.007
S. Valderrama Arnay
{"title":"Protocolo diagnóstico y terapéutico del asma en el adolescente","authors":"S. Valderrama Arnay","doi":"10.1016/j.med.2026.08.007","DOIUrl":"10.1016/j.med.2026.08.007","url":null,"abstract":"<div><div>Asthma is classically defined as a chronic inflammatory disease of the airways in which various inflammatory cells and mediators play a role. It is influenced in part by genetic factors and is characterized by bronchial hyperresponsiveness and variable airflow obstruction that is fully or partially reversible either through medication or spontaneously. Asthma, along with obesity, is one of the most prevalent chronic diseases among adolescents.</div><div>A thorough medical history and physical examination are essential for diagnosing asthma in adolescents. In this age group, it is necessary to perform pulmonary function tests (forced spirometry) as well as allergy testing in cases where, based on the medical history, it is suspected that exacerbations may be triggered by a respiratory allergen. Before initiating any maintenance treatment, a correct and early diagnosis must be established. The severity must be classified before starting a specific treatment regimen and the inhalation technique must be taught, explained, practiced, demonstrated, and verified.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3808-3812"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148924849","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
La piel en el adolescente 青少年的皮肤
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-07 DOI: 10.1016/j.med.2026.08.003
M. Feito Rodríguez
{"title":"La piel en el adolescente","authors":"M. Feito Rodríguez","doi":"10.1016/j.med.2026.08.003","DOIUrl":"10.1016/j.med.2026.08.003","url":null,"abstract":"<div><div>Adolescence is an important stage of development marked by hormonal changes that alter the skin and its function. These changes can cause various skin conditions, many of which are common and can have a long-term impact on health. During this time, it is common to encounter conditions such as atopic dermatitis, psoriasis, or alopecia <em>areata</em>. These ailments have a variety of symptoms and affect adolescents’ social and emotional lives, in addition to requiring long-term treatment. Problems related to the sebaceous and sudoriparous glands are also frequent and significantly impact quality of life. Although melanoma is rare at this age, consultations regarding pigmented lesions are common. A comprehensive approach should be taken when treating the skin diseases of adolescence, considering not only the severity of the disease but also how it affects the individual's social life, and education about skin care. New treatments have expanded options and improved the quality of life for these young people. Clinical and therapeutic aspects of these common diseases will be discussed in this update.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 61","pages":"Pages 3779-3788"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917347","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
Situaciones clínicas de alta complejidad en el adulto mayor. Apoyo a la toma de decisiones 老年人高度复杂的临床情况。决策支持
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-09-01 Epub Date: 2026-09-30 DOI: 10.1016/j.med.2026.09.001
A. Ferrantelli Blanco, G. Yela, L.D. Mujica Chumbes, C. Rodríguez Román, A. Alises García-Morato, J. Castillejo Núñez
{"title":"Situaciones clínicas de alta complejidad en el adulto mayor. Apoyo a la toma de decisiones","authors":"A. Ferrantelli Blanco,&nbsp;G. Yela,&nbsp;L.D. Mujica Chumbes,&nbsp;C. Rodríguez Román,&nbsp;A. Alises García-Morato,&nbsp;J. Castillejo Núñez","doi":"10.1016/j.med.2026.09.001","DOIUrl":"10.1016/j.med.2026.09.001","url":null,"abstract":"<div><div>Population aging has increased the prevalence of chronic diseases in older adults. This leads to significant clinical complexity and is associated with a greater risk of adverse effects, functional decline, hospitalizations, and mortality. Treatment objectives must be based on the patient's functional, cognitive, and social status as well as their preferences, prioritizing quality of life and the preservation of autonomy over long-term preventive goals of uncertain benefit. Polypharmacy is a key risk factor, making it essential to systematically review medication using validated tools such as the STOPP/START, Beers, and STOPP-Frail criteria.</div><div>Highly complex clinical situations common in geriatrics are reviewed, through a comprehensive geriatric assessment. Current evidence supports the idea that these strategies reduce adverse events, hospitalizations, and treatment toxicity without compromising survival and improve functional outcomes and quality of life. Care for older patients with chronic diseases must be based on multidisciplinary coordination; advance planning regarding decisions; and the integration of geriatric, palliative, and social care. This is a fundamental pillar of healthcare systems facing the challenge of an aging population.</div><div>.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 62","pages":"Pages 3817-3825"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072232","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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