Medicine - Programa de Formación Médica Continuada Acreditado最新文献_第2页

Protocolo diagnóstico del riesgo cardiovascular y del síndrome metabólico 心血管风险和代谢综合征诊断规程

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.015

C. Tejada-González, A.J. Herruzo-León, A. Ruiz-Saavedra, A. Leandro-Barros, J.A. Serpa-Morán

{"title":"Protocolo diagnóstico del riesgo cardiovascular y del síndrome metabólico","authors":"C. Tejada-González, A.J. Herruzo-León, A. Ruiz-Saavedra, A. Leandro-Barros, J.A. Serpa-Morán","doi":"10.1016/j.med.2025.08.015","DOIUrl":"10.1016/j.med.2025.08.015","url":null,"abstract":"<div><div>Atherosclerosis is a chronic disease characterized by the deposition of lipids in the intima layer of medium- and large-caliber arteries that causes the formation of atheromatous plaques. This process starts with endothelial dysfunction and the accumulation of oxidized LDL cholesterol followed by inflammation and cell migration. This generates a vicious cycle that increases the risk of cardiovascular events such as heart attacks and strokes. Plaques can be stable or vulnerable; the latter are at greater risk of rupture, triggering thrombosis and acute arterial obstruction. Risk factors include hypercholesterolemia, diabetes, hypertension, and unhealthy habits. Globally, atherosclerosis is one of the main causes of morbidity and mortality, affecting countries with limited resources more. Inflammation plays a central role in disease progression. It is mediated by macrophages and foam cells that secrete proinflammatory cytokines. In addition, mechanisms such as hypoxia and reverse cholesterol transport influence plaque stability. The clinical manifestations are systemic, notable among which are ischemic heart disease, cerebrovascular disease, peripheral arterial disease, and renal and oncologic complications. The approach includes primary and secondary prevention by controlling risk factors and specific therapies to stabilize plaques and reduce acute events.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 39","pages":"Pages 2405-2407"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989626","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

Valvulopatía tricúspide y pulmonar 三叉肺泡病

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.003

A. González Leal, J.L. Zamorano Gómez

{"title":"Valvulopatía tricúspide y pulmonar","authors":"A. González Leal, J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.08.003","DOIUrl":"10.1016/j.med.2025.08.003","url":null,"abstract":"<div><div>Tricuspid and pulmonary valve diseases are a group of conditions that affect the valves on the right side of the heart. Tricuspid valve disease, which mainly includes tricuspid insufficiency, is usually secondary to valve annulus dilation in the context of pulmonary hypertension or heart failure. Tricuspid stenosis is less common and is generally associated with rheumatic or congenital diseases. These alterations can cause systemic venous congestion, hepatomegaly, ascites, and peripheral edema, with a significant impact on quality of life. On the other hand, pulmonary valve diseases, which include pulmonary stenosis and pulmonary insufficiency, are usually congenital in origin or secondary to severe pulmonary hypertension. The diagnosis of both valve diseases is based on a clinical examination, echocardiography, and, in some cases, magnetic resonance imaging or cardiac catheterization. Treatment includes medical management to reduce congestion in addition to surgical or percutaneous options, such as valvuloplasty or valve replacement. Early detection and appropriate treatment are essential to prevent complications and improve patient prognosis.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 38","pages":"Pages 2317-2323"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926550","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

Endotelio. Función y daño endotelial. Concepto de factores de riesgo de ateroesclerosis. Factores corregibles 内皮。内皮功能和损伤。动脉粥样硬化危险因素的概念。corregibles因素

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.010

A. Ruiz-Saavedra , J. Torán-Martínez , C. Tejada-González , J.A. Serpa-Morán , A. Leandro-Barros , A. García-Lledó

引用次数: 0

Protocolo terapéutico de la dislipidemia: prevención primaria y secundaria 血脂异常治疗方案：一级和二级预防

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.014

C. Tejada-González, V. Bonilla-Jiménez, A. Leandro-Barros, J. Serpa-Morán, C. Tejada-González, A. Ruiz-Saavedra

{"title":"Protocolo terapéutico de la dislipidemia: prevención primaria y secundaria","authors":"C. Tejada-González, V. Bonilla-Jiménez, A. Leandro-Barros, J. Serpa-Morán, C. Tejada-González, A. Ruiz-Saavedra","doi":"10.1016/j.med.2025.08.014","DOIUrl":"10.1016/j.med.2025.08.014","url":null,"abstract":"<div><div>In the treatment of dyslipidemia, a distinction is made between primary and secondary prevention. Treatment always includes a healthy diet, regular exercise, and lifestyle modifications. The lipid control objectives in primary prevention are determined by risk scales, while in secondary prevention, a double therapeutic objective is sought: an LDL level of less than 55mg/dl and a reduction of at least 50% compared to the baseline LDL level. Statins, ezetimibe, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 inhibitors are the different pharmacological treatment options. Hypertriglyceridemia in primary prevention is not a therapeutic objective except in cases of severe hypertriglyceridemia (greater than 500mg/dl) to avoid the development of pancreatitis; in patients with levels of 200–500mg/dl, it depends on the cardiovascular risk. Icosapent ethyl is an option to consider in secondary prevention in patients with triglyceride levels above 150mg/dl and good LDL control.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 39","pages":"Pages 2400-2404"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989785","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

Dislipidemias. Lipoproteínas aterogénicas. Objetivos terapéuticos. Manejo farmacológico en prevención primaria y secundaria Dislipidemias。猴aterogénicas。治疗目标。一级和二级预防中的药物管理

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.011

C. Tejada-González , V. Bonilla-Jiménez , A. Ruiz-Saavedra , J.A. Serpa-Morán , A. Leandro-Barros , A. García-Lledó

引用次数: 0

Valvulopatía aórtica Valvulopatía夹

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.001

A. González Leal, J.L. Zamorano Gómez

{"title":"Valvulopatía aórtica","authors":"A. González Leal, J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.08.001","DOIUrl":"10.1016/j.med.2025.08.001","url":null,"abstract":"<div><div>Aortic valve disease encompasses a group of disorders that affect the aortic valve, which is responsible for regulating blood flow from the left ventricle to the aorta. Aortic stenosis is characterized by inadequate valve opening. The most common cause in older adult patients is degenerative; in younger individuals, the most common cause is congenital malformations such as bicuspid valve. This flow restriction leads to increased ventricular afterload, left ventricular hypertrophy, and, eventually, heart failure. On the other hand, aortic insufficiency may be due to degenerative changes, congenital anomalies, infective endocarditis, or aortic root dilation, among others.</div><div>The diagnosis of aortic valve disease is based on a clinical examination, in which auscultation of heart murmurs can be key. It is confirmed by echocardiographic studies, cardiac magnetic resonance imaging, computed tomography, and, in some cases, catheterization. Treatment depends on severity and may include medical management, valve replacement surgery, or less invasive techniques such as transcatheter aortic valve implantation (TAVI). An early, multidisciplinary approach is essential to optimize clinical outcomes and improve the patient's quality of life.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 38","pages":"Pages 2291-2303"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926552","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 la hipertensión arterial secundaria 继发性动脉高血压诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.016

A. Ruiz-Saavedra, J. García-Pérez-Velasco, F. Vidal-Ostos-De-Lara, J.A. Serpa-Morán, C. Tejada-González, A. Leandro-Barros

引用次数: 0

Protocolo diagnóstico y terapéutico de la valvulopatía mitral en el anciano 老年人二尖瓣病的诊断和治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-09-01 DOI: 10.1016/j.med.2025.08.005

A. González Leal, J.L. Zamorano Gómez

{"title":"Protocolo diagnóstico y terapéutico de la valvulopatía mitral en el anciano","authors":"A. González Leal, J.L. Zamorano Gómez","doi":"10.1016/j.med.2025.08.005","DOIUrl":"10.1016/j.med.2025.08.005","url":null,"abstract":"<div><div>Mitral valve disease in older adults presents diagnostic and therapeutic challenges due to comorbidities and physiological changes associated with age. Mitral stenosis, mostly of rheumatic origin, and degenerative or functional mitral insufficiency are the predominant forms. Typical symptoms include dyspnea, fatigue, and arrhythmias such as atrial fibrillation that are aggravated by decreased cardiac reserve in older patients. The diagnostic protocol entails a detailed anamnesis, clinical examination, and echocardiographic studies, with three-dimensional echocardiography and catheterization being useful in complex cases. Therapeutic strategies depend on disease severity, the patient's functional status, and comorbidities. Medical treatment seeks to alleviate symptoms through diuretics and heart rhythm control. Surgical interventions, such as valve replacement or repair, and percutaneous procedures, such as mitral valvuloplasty, are carefully considered options in this group of patients. A multidisciplinary assessment and individualized management are essential in order to optimize clinical outcomes, improving quality of life and reducing complications in this vulnerable population.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 38","pages":"Pages 2331-2336"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926553","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

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

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 , J. Campos Esteban , L. Antúnez Segura , E. Rico Sánchez-Mateos , 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