Medicine - Programa de Formación Médica Continuada Acreditado最新文献_第3页

Episodios de fiebre, dolor abdominal, artritis y lesiones cutáneas en joven adulto 青年中发热、腹痛、关节炎和皮肤损伤的发作

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

引用次数: 0

Espondiloartritis, espondilitis anquilopoyética y síndrome SAPHO 脊柱炎、强直性脊柱炎和SAPHO综合征

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.001

J. Campos Esteban, E. Rabadán Rubio, E. Fernández Fernández, A. Abbasi Pérez, A. Movasat Hajkhan

{"title":"Espondiloartritis, espondilitis anquilopoyética y síndrome SAPHO","authors":"J. Campos Esteban, E. Rabadán Rubio, E. Fernández Fernández, A. Abbasi Pérez, A. Movasat Hajkhan","doi":"10.1016/j.med.2025.05.001","DOIUrl":"10.1016/j.med.2025.05.001","url":null,"abstract":"<div><div>Spondyloarthritis is a heterogeneous group of chronic rheumatic diseases characterized by autoimmune/autoinflammatory involvement of different structures of the axial skeleton; entheses; peripheral joints; and extra-articular tissues such as the eyes, skin, and intestine. These conditions share a genetic basis, with HLA-B27 as a predisposing factor, in addition to immunological and environmental factors that contribute to their development. The clinical manifestations, which usually occur in flares, include inflammatory lumbar pain, peripheral arthritis, enthesitis, and extra-articular symptoms (uveitis, psoriasis, and inflammatory bowel disease). Its natural progression leads to the onset of tissue damage and characteristic osteogenesis. The diagnosis is based on a detailed clinical assessment supported by laboratory tests and imaging studies, notable among which is the use of magnetic resonance imaging for early detection, mainly in axial forms. Therapeutic strategies seek to reduce inflammation, alleviate symptoms, and prevent progression of structural damage, combining pharmacological treatments (NSAIDs, DMARDs, and biologics) with non-pharmacological interventions, including regular exercise. Delayed diagnosis and insufficient management represent significant challenges, underscoring the need for a multidisciplinary approach in the event of the onset of extra-musculoskeletal manifestations in order to improve patient health outcomes.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 32","pages":"Pages 1915-1922"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083764","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

Artritis reactiva Artritis reactiva

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.003

E. Rabadán Rubio, E. Rico Sánchez-Mateos, P. Pretel Ruiz, C. Bohórquez Heras, L. Ruiz Gutiérrez

{"title":"Artritis reactiva","authors":"E. Rabadán Rubio, E. Rico Sánchez-Mateos, P. Pretel Ruiz, C. Bohórquez Heras, L. Ruiz Gutiérrez","doi":"10.1016/j.med.2025.05.003","DOIUrl":"10.1016/j.med.2025.05.003","url":null,"abstract":"<div><div>Reactive arthritis (RA) is a form of aseptic arthritis that usually occurs one to six weeks after a primary infection that did not initially affect the joints. The microorganisms usually involved in its onset tend to have a genitourinary or enteric origin. It usually appears in young patients, with a peak incidence in individuals between 30 and 40 years of age. The natural history of this disease classifies the clinical manifestations according to chronology in an acute phase, in which the symptoms of the primary infection manifest and followed a few days later by joint manifestations, and a chronic phase of disease, if the symptoms persist for more than six months. Symptoms include musculoskeletal manifestations (peripheral and axial arthritis, dactylitis, and enthesitis) and extra-articular manifestations, including mucocutaneous manifestations such as balanitis circinata and keratoderma blennorrhagicum, and ocular manifestations, with conjunctivitis being the most common. The diagnosis should be made by attempting to identify the causative bacteria via culture when possible, serology, or molecular tests such as RCP. Antibiotic therapy should be used to treat the active infection. For joint manifestations, NSAIDs and corticosteroids are the first line of treatment, followed by disease-modifying drugs and anti-TNF-alpha for refractory or chronic cases.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 32","pages":"Pages 1932-1941"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083766","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 uveítis anteriores 早期卵泡炎诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.006

C. Corral Cuadrado, J. Muñoz Serrano, M. Ramírez Martín, E. Fernández Fernández

引用次数: 0

Protocolo diagnóstico de las entesitis 肠炎诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.008

C. Bohórquez Heras, A. Movasat Hajkhan, A. Abbasi Pérez, M. Ramírez Martín

引用次数: 0

Protocolo de tratamiento de los antilinfocitos B en las enfermedades inmunomediadas 免疫介导疾病中的B型抗淋巴细胞治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.017

M. Retuerto Guerrero, C. Moriano Morales, I. González Fernández , I. González Fernández

{"title":"Protocolo de tratamiento de los antilinfocitos B en las enfermedades inmunomediadas","authors":"M. Retuerto Guerrero, C. Moriano Morales, I. González Fernández , I. González Fernández","doi":"10.1016/j.med.2025.04.017","DOIUrl":"10.1016/j.med.2025.04.017","url":null,"abstract":"<div><div>B lymphocytes play a key role in the pathophysiology of systemic autoimmune diseases (SAD), as they not only transform into autoantibody-producing plasma cells, but also secrete proinflammatory cytokines that amplify the immune response. In addition, these lymphocytes act as antigen-presenting cells, which promotes the activation of T lymphocytes and perpetuates the autoimmune process. Aberrant B-cell activation contributes to the formation of immune complexes that, when deposited in different organs and tissues, cause tissue damage, as observed in diseases such as systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis. Due to their central role in the pathogenesis of SAD, B-cells have become a key therapeutic target. Therapies targeting these lymphocytes, such as rituximab, have shown efficacy in improving clinical outcomes and reducing systemic inflammation. However, their use entails risks, such as an increase in serious infections due to its immunosuppressive effect and the possible induction of hypogammaglobulinemia, lymphopenia, and neutropenia, which compromises the patient's immune defense. Close monitoring of immunoglobulin levels and the administration of antimicrobial prophylaxis according to the patient's needs is essential.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1842-1846"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834465","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 oligoartritis

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.005

J. Muñoz Serrano, M. Ramírez Martín, C. Corral Cuadrado, J. Campos Esteban

引用次数: 0

Mujer de 56 años con fiebre, síndrome general, desnutrición y agitación 患有发热、一般综合症、营养不良和躁动的56岁妇女

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.018

C. Díez Morrondo, M. Retuerto Guerrero, C. Sieiro Santos, I. González Fernández

引用次数: 0

Protocolo diagnóstico de la fiebre en las enfermedades reumáticas autoinmunes sistémicas 全身性自身免疫性风湿病发热诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.016

M. Retuerto Guerrero, C. Moriano Morales, I. González Fernández , I. González Fernández

{"title":"Protocolo diagnóstico de la fiebre en las enfermedades reumáticas autoinmunes sistémicas","authors":"M. Retuerto Guerrero, C. Moriano Morales, I. González Fernández , I. González Fernández","doi":"10.1016/j.med.2025.04.016","DOIUrl":"10.1016/j.med.2025.04.016","url":null,"abstract":"<div><div>Fever is a common symptom in patients with systemic autoimmune rheumatic diseases (SARD) such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and vasculitis. Its emergence can be attributed to multiple causes, including the inflammatory activity of the underlying disease, opportunistic infections related to immunosuppression, and, in more infrequent cases, underlying neoplasms. It is crucial to consider that some infections, such as bacterial, viral, or fungal infections, can simulate a flare-up of immune-mediated disease, leading to diagnostic confusion and a potential delay in appropriate treatment. In addition, certain drugs used in the management of SARDs, such as immunosuppressants or biologics, may predispose to these infections, further complicating the differential diagnosis. A systematic approach that includes a detailed case history, thorough physical examination, and appropriate selection of laboratory and imaging tests is essential to identify the underlying cause. This protocol aims to optimize early diagnosis and treatment, reducing complications and improving patient prognosis.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1839-1841"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834469","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 sacroilitis y la discitis 骶骨炎和椎间盘炎的诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.007

M. Ramírez Martín, C. Corral Cuadrado, E. Rico Sánchez-Mateos, J. Muñoz Serrano

引用次数: 0