I. Roibás Veiga , P. Méndez Brea , T. González Vidal , C. Vidal Pan
{"title":"Protocolo diagnóstico y terapéutico de la anafilaxia","authors":"I. Roibás Veiga , P. Méndez Brea , T. González Vidal , C. Vidal Pan","doi":"10.1016/j.med.2025.04.007","DOIUrl":"10.1016/j.med.2025.04.007","url":null,"abstract":"<div><div>Anaphylaxis is the most severe allergic reaction. Early diagnosis and urgent administration of the treatment of choice are crucial in order to save the lives of affected patients. The anaphylaxis code implemented by the Galician Health Service is the best approach to the diagnosis and treatment of this disease. It ensures a rapid care pathway for patients with an anaphylactic reaction.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1769-1774"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817298","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}
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}
J.C. Calvo, Y. Lage, M. García-Pardo, J. Chamorro Pérez
{"title":"Dolor pleurítico y astenia en un paciente fumador","authors":"J.C. Calvo, Y. Lage, M. García-Pardo, J. Chamorro Pérez","doi":"10.1016/j.med.2025.03.009","DOIUrl":"10.1016/j.med.2025.03.009","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1627.e1-1627.e3"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591719","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}
P. Méndez Brea , I. Roibás Veiga , T. González Vidal , C. Vidal Pan
{"title":"Asma bronquial","authors":"P. Méndez Brea , I. Roibás Veiga , T. González Vidal , C. Vidal Pan","doi":"10.1016/j.med.2025.04.002","DOIUrl":"10.1016/j.med.2025.04.002","url":null,"abstract":"<div><div>This update addresses asthma from a comprehensive perspective, highlighting its pathophysiology, diagnosis, and treatment. It is a chronic inflammatory disease of the airways characterized by episodes of wheezing, dyspnea, and cough. The importance of an accurate diagnosis that includes an evaluation of symptoms, medical history, and pulmonary function tests is emphasized. It is classified according to severity and control, which helps to personalize treatment. To this end, it is important to identify and avoid triggers as well as to promote the use of long-term control medications, such as inhaled corticosteroids and short-acting bronchodilators for symptom relief. A stepwise approach is recommended, adjusting treatment according to the degree of asthma control. In addition, long-term management strategies and patient education to improve quality of life and reduce exacerbations are described. Management and treatment of severe asthma that is difficult to control is also discussed.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1726-1735"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817294","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}
Á. Domínguez-Soto , Á.L. Corbí , A. Miranda , R. Sánchez Martín , M. Álvarez-Mon , J. Monserrat Sanz
{"title":"Monocitos, macrófagos y células dendríticas en homeostasis y patología","authors":"Á. Domínguez-Soto , Á.L. Corbí , A. Miranda , R. Sánchez Martín , M. Álvarez-Mon , J. Monserrat Sanz","doi":"10.1016/j.med.2025.03.010","DOIUrl":"10.1016/j.med.2025.03.010","url":null,"abstract":"<div><div>Monocytes, macrophages, and dendritic cells are immune cells that play essential roles in the body's defense against pathogens. They are commonly characterized as professional antigen-presenting cells (APCs). Additionally, macrophages initiate inflammation, destroy pathogens, and are responsible for maintaining tissue homeostasis, adapting dynamically to various signals from the microenvironment. On the other hand, dendritic cells represent the nexus between innate and adaptive immunity.</div><div>In this brief review, monocytes, macrophages, and dendritic cells belonging to the immune system will be studied in regard to their origin and homeostasis, nomenclature and classification, physiology, mechanisms by which they perform their functions, and their contribution to the pathogenesis of various diseases.</div><div>Advances in the basic characterization of monocytes, macrophages, and dendritic cells have allowed for understanding them better as major factors in immunity and the progression of inflammatory diseases, cancer, obesity, fibrosis, or autoimmune diseases. Strategies to modify their polarization or modulate their activity offer new therapeutic opportunities for the treatment of these diseases.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 28","pages":"Pages 1629-1642"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739988","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}
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}
J. Chamorro, J.C. Calvo, M. García-Pardo, G. González, S. Roa, Y. Lage, A. Barril, M.E. Olmedo, V. Alía, P. Garrido
{"title":"Protocolo de manejo multimodal del cáncer de pulmón: cirugía, radioterapia y tratamiento sistémico. Indicaciones terapéuticas y paliativas de la cirugía y la radioterapia","authors":"J. Chamorro, J.C. Calvo, M. García-Pardo, G. González, S. Roa, Y. Lage, A. Barril, M.E. Olmedo, V. Alía, P. Garrido","doi":"10.1016/j.med.2025.03.008","DOIUrl":"10.1016/j.med.2025.03.008","url":null,"abstract":"<div><div>Lung cancer requires accurate staging for the best therapeutic approach. Surgery, radiotherapy, and systemic therapies are the mainstays of treatment. The first two are more relevant in early and potentially curative stages. Given the complexity of the cases and the multimodality of the treatments, joint decision making by a multidisciplinary tumor committee is essential in order to choose the best alternative.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1622-1626"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591720","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}
J. Monserrat Sanz , R. Sánchez Martín , E. Castillo Ruiz , A. Prieto Martín , M. Álvarez-Mon
{"title":"Factores solubles del sistema inmune: clasificación y mecanismos de acción","authors":"J. Monserrat Sanz , R. Sánchez Martín , E. Castillo Ruiz , A. Prieto Martín , M. Álvarez-Mon","doi":"10.1016/j.med.2025.03.013","DOIUrl":"10.1016/j.med.2025.03.013","url":null,"abstract":"<div><div>Cytokines and growth factors are key molecules that act on immune system cells and other cell types, intervening in a wide variety of functions such as differentiation, proliferation, activation, suppression, survival, or apoptosis. The manner in which they are regulated has repercussions on cellular responses and, as a consequence, on the appropriate or inappropriate behavior of the immune system. Therefore, they have the potential to cause serious pathological abnormalities. This brief review will analyze in a simple way the classification and description of the basic behavioral mechanisms of some of the most relevant cytokines and soluble factors involved in the communication and response of the cells that form the immune system. The use of biologic drugs such as immunotherapy to regulate the behavior of cytokines and growth factors in different inflammatory diseases, infections, autoimmunity, or cancer is growing every day. Knowledge of the complex, distinct mechanisms that underlie the behavior of cytokines helps in understanding their involvement in these diseases, why they are therapeutic targets, and how new biologic therapies work.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 28","pages":"Pages 1673-1687"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739991","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}
{"title":"Varón de 52 años con erupción cutánea durante un tratamiento farmacológico","authors":"D. Monserrate Tello Montúfar, C. Vidal Pan","doi":"10.1016/j.med.2025.04.009","DOIUrl":"10.1016/j.med.2025.04.009","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1781.e1-1781.e4"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817300","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}
I. Roibás Veiga , P. Méndez Brea , T. González Vidal , C. Vidal Pan
{"title":"Rinoconjuntivitis alérgica","authors":"I. Roibás Veiga , P. Méndez Brea , T. González Vidal , C. Vidal Pan","doi":"10.1016/j.med.2025.04.001","DOIUrl":"10.1016/j.med.2025.04.001","url":null,"abstract":"<div><div>Allergic rhinitis and allergic conjunctivitis are two diseases that frequently coexist in individuals with allergies. Allergic rhinitis (AR) is characterized by sneezing, itching, rhinorrhea, and nasal obstruction. Allergic conjunctivitis (AC) manifests as itching, tearing, photophobia, or blurred vision. Both diseases are caused by IgE-mediated inflammation of the nasal mucosa, eyelid, conjunctiva, or cornea after exposure to an allergen. They are an underestimated cause of morbidity that can entail very significant costs for those who have it. They are also an important risk factor for the development of other atopic disorders such as bronchial asthma.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1713-1725"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817293","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}