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Protocolo diagnóstico y terapéutico de las parasitosis y afectación genitourinaria 寄生虫病和泌尿生殖系统疾病的诊断和治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-07 DOI: 10.1016/j.med.2026.06.035
N. Jaén-Sánchez, L. Suárez-Hormiga, M. Hernández-Cabrera, H.S. Rosario-Mendoza, L. López-Delgado, J.L. Pérez-Arellano
{"title":"Protocolo diagnóstico y terapéutico de las parasitosis y afectación genitourinaria","authors":"N. Jaén-Sánchez,&nbsp;L. Suárez-Hormiga,&nbsp;M. Hernández-Cabrera,&nbsp;H.S. Rosario-Mendoza,&nbsp;L. López-Delgado,&nbsp;J.L. Pérez-Arellano","doi":"10.1016/j.med.2026.06.035","DOIUrl":"10.1016/j.med.2026.06.035","url":null,"abstract":"<div><div>Unlike other organ systems, the genitourinary system is affected by a limited number of parasitic infections. The main conditions include protozoan infections, such as malaria, visceral leishmaniasis (<em>kala-azar</em>), Chagas disease, and trichomoniasis; and helminth infections such as schistosomiasis and filariasis, in addition to isolated cases of other conditions. Diffuse lesions are predominant, although focal forms have been described, such as in hydatid disease or infection by <em>Dioctophyma renale</em>. With the exception of cases such as urinary schistosomiasis or trichomoniasis, the abnormalities are usually nonspecific and do not form part of the typical clinical picture. A single parasitic infection can cause genitourinary damage through various pathogenic mechanisms. The clinical and biological manifestations are highly variable and may coexist or occur sequentially over time. These range from asymptomatic forms with isolated urinary abnormalities to more complex presentations such as nephrotic syndrome, nephritic syndrome, gross hematuria, chyluria, urinary syndrome, and the two forms of renal failure: acute kidney injury and chronic kidney disease.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 59","pages":"Pages 3683-3687"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148574656","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
Osteoporosis secundarias
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-15 DOI: 10.1016/j.med.2026.07.004
R. Lana Soto, J.A. Blázquez Cabrera
{"title":"Osteoporosis secundarias","authors":"R. Lana Soto,&nbsp;J.A. Blázquez Cabrera","doi":"10.1016/j.med.2026.07.004","DOIUrl":"10.1016/j.med.2026.07.004","url":null,"abstract":"<div><div>Secondary osteoporosis is the loss of bone mass resulting from certain diseases and medications. Its clinical presentation differs from that of primary osteoporosis, as it occurs in younger patients of both sexes, may be more severe, and is associated with a higher prevalence of fragility fractures. Early diagnosis of the associated disease is essential for etiological treatment, to assess individual fracture risk, and to tailor anti-osteoporotic therapy.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 60","pages":"Pages 3723-3731"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148575487","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 de las parasitosis y eosinofilia 寄生虫病和嗜酸性粒细胞病的诊断和治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-07 DOI: 10.1016/j.med.2026.06.036
E. Pisos-Álamo, C. Carranza-Rodríguez, M. Briega-Molina, C.J. Ramírez-Blanco, N. Jaén-Sánchez, J.L. Pérez-Arellano
{"title":"Protocolo diagnóstico y terapéutico de las parasitosis y eosinofilia","authors":"E. Pisos-Álamo,&nbsp;C. Carranza-Rodríguez,&nbsp;M. Briega-Molina,&nbsp;C.J. Ramírez-Blanco,&nbsp;N. Jaén-Sánchez,&nbsp;J.L. Pérez-Arellano","doi":"10.1016/j.med.2026.06.036","DOIUrl":"10.1016/j.med.2026.06.036","url":null,"abstract":"<div><div>Eosinophilia is a sign that occurs relatively frequently in clinical practice. This protocol outlines the definition of the different types of eosinophilia based on their location (peripheral or tissue), the measure used (absolute or relative), and intensity (mild, moderate, or severe). The concept, types, and causes of hypereosinophilic syndromes are reviewed. Subsequently, an initial assessment protocol is outlined for cases of eosinophilia that allows for classifying it into several groups: widespread forms (associated or not with HIV infection) and imported forms. Next, several relevant aspects of eosinophilia related to helminthiasis are detailed, particularly in regard to epidemiology, disease progression patterns, and direct and serological methods for etiological diagnosis. Finally, the importance of treating and managing this condition is highlighted, including a brief discussion of forms not related to parasitic causes and situations in which a specific etiological diagnosis cannot be reached.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 59","pages":"Pages 3688-3693"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148574657","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
Prevención primaria y secundaria de fracturas osteoporóticas. Estrategias con enfoque multidisciplinar: Unidades FLS 骨质疏松性骨折的一、二级预防。多学科战略：FLS单位
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-15 DOI: 10.1016/j.med.2026.07.005
M.J. Moro-Álvarez, M.M. Femenias-Sureda
{"title":"Prevención primaria y secundaria de fracturas osteoporóticas. Estrategias con enfoque multidisciplinar: Unidades FLS","authors":"M.J. Moro-Álvarez,&nbsp;M.M. Femenias-Sureda","doi":"10.1016/j.med.2026.07.005","DOIUrl":"10.1016/j.med.2026.07.005","url":null,"abstract":"<div><div>Bone fragility is the primary sign of osteoporosis. It implies loss of bone mass and damage to bone structure. This leads to osteoporotic fractures with minimal trauma in individuals over 45 years of age, increasing the risk of new fractures, mortality, and a reduced quality of life. The most common fractures occur in the vertebrae, hip, distal forearm, and proximal humerus. Hip fractures have a high mortality rate and cause significant functional impairment. Identifying these fractures requires a medical history and imaging tests, but few patients receive evaluation or treatment following a fracture. Fracture prevention units improve diagnosis and treatment and are cost-effective. In Spain, there is a gap in care that must be addressed, especially given the growing older adult population.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 60","pages":"Pages 3732-3739"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148575488","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 tratamiento de la enfermedad ósea de Paget 佩吉特骨病的诊断和治疗方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-15 DOI: 10.1016/j.med.2026.07.006
C. Rebollo Nájera, L. Corral Gudino
{"title":"Protocolo diagnóstico y tratamiento de la enfermedad ósea de Paget","authors":"C. Rebollo Nájera,&nbsp;L. Corral Gudino","doi":"10.1016/j.med.2026.07.006","DOIUrl":"10.1016/j.med.2026.07.006","url":null,"abstract":"<div><div>Paget's disease of bone (PDB) is the second most common metabolic bone disease. Its diagnosis is incidental in many cases, based on the presence of characteristic lesions observed on imaging studies ordered for other reasons or an isolated elevation of alkaline phosphatase levels on laboratory tests. Pain in the affected area is the primary clinical manifestation in symptomatic cases. Plain x-ray —primarily of the skull, spine, pelvis, and tibias— and bone scintigraphy are the most common diagnostic techniques, with computed tomography and magnetic resonance imaging reserved for uncertain cases. Treatment is primarily indicated when there is bone pain, although it is also considered if the affected bones are at risk of deformity. Treatment for the sole purpose of normalizing bone formation markers is not advised. Intravenous zoledronate is the treatment of choice and orthopedic surgery is necessary in cases of marked deformity and osteoarthritis.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 60","pages":"Pages 3740-3746"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148575489","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 del síndrome febril con afectación cutánea en áreas geográficas con infecciones tropicales endémicas 有地方性热带感染的地理区域的发热性皮肤疾病诊断规程
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-01 DOI: 10.1016/j.med.2026.06.025
C. Lozano Durán, G. Hernández García, J. Balsa Vázquez, L. Porcel Salud, C. Paz Romero
{"title":"Protocolo diagnóstico del síndrome febril con afectación cutánea en áreas geográficas con infecciones tropicales endémicas","authors":"C. Lozano Durán,&nbsp;G. Hernández García,&nbsp;J. Balsa Vázquez,&nbsp;L. Porcel Salud,&nbsp;C. Paz Romero","doi":"10.1016/j.med.2026.06.025","DOIUrl":"10.1016/j.med.2026.06.025","url":null,"abstract":"<div><div>More than 50% of international travel will be to or from tropical areas in Africa, Asia, or the Middle East, and it is precisely this flow that is expected to see the greatest increase in the coming years. The appearance of skin lesions is one of the main reasons for seeking medical care upon returning from a trip, as well as for care in migrant patients. The change in environmental conditions as well as exposure to multiple risk factors during travel (various microorganisms, participation in adventure or leisure activities, etc.), sometimes contribute to the onset of fever and such skin lesions. The etiological spectrum is very broad; therefore, its study must follow established protocols, taking into account the epidemiology and distribution of these diseases as well as the recognition of basic dermatological lesions to be able to make an appropriate differential diagnosis. In cases of imported exanthematous fever, arboviruses and rickettsioses should be considered as a priority.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 58","pages":"Pages 13595-13599"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148380107","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 del síndrome febril agudo con focalidad respiratoria en áreas geográficas de riesgo endémico de infecciones tropicales 热带感染地方病高危地区急性发热性呼吸道综合征诊断规程
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-01 DOI: 10.1016/j.med.2026.06.024
L.M. Gete García, I.M. Corral Bueno, M. Novella Mena, A.M. Culebras López, S. Alonso Valdez
{"title":"Protocolo diagnóstico del síndrome febril agudo con focalidad respiratoria en áreas geográficas de riesgo endémico de infecciones tropicales","authors":"L.M. Gete García,&nbsp;I.M. Corral Bueno,&nbsp;M. Novella Mena,&nbsp;A.M. Culebras López,&nbsp;S. Alonso Valdez","doi":"10.1016/j.med.2026.06.024","DOIUrl":"10.1016/j.med.2026.06.024","url":null,"abstract":"<div><div>Acute fever with respiratory symptoms in patients residing in or coming from tropical areas requires broadening the diagnostic approach beyond the usual causes. It is a significant dilemma for clinicians due to its frequency and potential severity. One must consider the coexistence of common respiratory diseases with specific tropical infections such as malaria, helminthiasis, or leptospirosis. This necessitates a systematic, syndromic approach adapted to the epidemiological context, without overlooking the possibility of coinfection. The presence of coinfection, especially in patients with HIV infection or other states of immunosuppression, adds complexity to the diagnosis and prognosis. The objective of this protocol is to provide practical guidance for systematizing the diagnostic and management process for this syndrome and its specific characteristics using clinical and epidemiological data as well as targeted ancillary tests.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 58","pages":"Pages 13589-13594"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148380106","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 48 años con dolor abdominal 男性，48岁，腹痛
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-07 DOI: 10.1016/j.med.2026.06.037
L. López-Delgado, H.S. Rosario-Mendoza, M. Hernández-Cabrera, J.L. Pérez-Arellano
{"title":"Varón de 48 años con dolor abdominal","authors":"L. López-Delgado,&nbsp;H.S. Rosario-Mendoza,&nbsp;M. Hernández-Cabrera,&nbsp;J.L. Pérez-Arellano","doi":"10.1016/j.med.2026.06.037","DOIUrl":"10.1016/j.med.2026.06.037","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 59","pages":"Pages 3695.e1-3695.e3"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148574658","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
Parasitosis y tubo digestivo 寄生虫病和消化道
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-07 DOI: 10.1016/j.med.2026.06.030
C.J. Ramírez-Blanco, L. López-Delgado, L. Suárez-Hormiga, C. Carranza-Rodríguez, E. Pisos-Álamo, J.L. Pérez-Arellano
{"title":"Parasitosis y tubo digestivo","authors":"C.J. Ramírez-Blanco,&nbsp;L. López-Delgado,&nbsp;L. Suárez-Hormiga,&nbsp;C. Carranza-Rodríguez,&nbsp;E. Pisos-Álamo,&nbsp;J.L. Pérez-Arellano","doi":"10.1016/j.med.2026.06.030","DOIUrl":"10.1016/j.med.2026.06.030","url":null,"abstract":"<div><div>A wide variety of parasitic infections affect the human gastrointestinal tract, compromising different segments from the oral cavity to the anus. This review will first analyze Chagas disease, or American trypanosomiasis, which is the most important parasitic infection capable of affecting both the esophagus and the large intestine. Next, anisakiasis will be examined, a disease that can cause direct lesions in the stomach and intestine, as well as allergic manifestations mediated by hypersensitivity to the parasite.</div><div>Subsequently, three highly important intestinal protozoan infections will be described in detail: giardiasis, cryptosporidiosis, and amebiasis. A brief description of less frequent protozoan infections will also be included, along with the pathogenic role of two microorganisms commonly detected in feces: <em>Dientamoeba fragilis</em> and <em>Blastocystis hominis</em>.</div><div>A large section will be dedicated to the study of the main intestinal helminth infections caused by <em>Ascaris lumbricoides</em>, <em>Trichuris trichiura</em>, hookworms (<em>Ancylostoma duodenale</em> and <em>Necator americanus</em>), and <em>Strongyloides spp</em>. Enterobiasis will also be described, a highly prevalent helminth infection that can cause everything from anal pruritus to complications such as appendicitis. Finally, mention will be made of other less frequent helminth infections caused by nematodes (e.g., <em>Trichostrongylus spp</em>), trematodes (e.g., <em>Dicrocoelium dendriticum</em>), and cestodes (e.g., <em>Taenia spp</em>), which can compromise the human digestive system.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 59","pages":"Pages 3625-3640"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148574659","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
Paciente mujer de 68 años hipertensa, celíaca y con fractura de Colles 68岁女性患者，患有高血压、乳糜泻和锁骨骨折
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2026-06-01 Epub Date: 2026-07-15 DOI: 10.1016/j.med.2026.07.010
A. Capdevila Reniu, R. Arboiro Pinel
{"title":"Paciente mujer de 68 años hipertensa, celíaca y con fractura de Colles","authors":"A. Capdevila Reniu,&nbsp;R. Arboiro Pinel","doi":"10.1016/j.med.2026.07.010","DOIUrl":"10.1016/j.med.2026.07.010","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 60","pages":"Pages 3761.e1-3761.e4"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148559889","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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