Medicine - Programa de Formación Médica Continuada Acreditado最新文献_第6页

Protocolo diagnóstico de las enfermedades autoinflamatorias 自发性疾病诊断规程

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.025

J. Ballano-Rodríguez-Solís , C. Arévalo-Cañas

引用次数: 0

Síndrome antifosfolípido antifosfolípido综合症

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.012

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

{"title":"Síndrome antifosfolípido","authors":"I. González Fernández , I. González Fernández , C. Moriano Morales, M. Retuerto Guerrero","doi":"10.1016/j.med.2025.04.012","DOIUrl":"10.1016/j.med.2025.04.012","url":null,"abstract":"<div><div>Antiphospholipid syndrome is the main cause of acquired thrombophilia. It is characterized by the presence of venous/arterial thrombosis and obstetric morbidity, although other clinical and/or analytical manifestations not included in the conventional criteria may also be present. Antiphospholipid antibodies are involved in its development, which promotes a prothrombotic state in patients. Recently, new classification criteria have been incorporated (2023) that aim to help in the early and better identification of this disease. The mainstay of managing this condition when clinical manifestations develop is anticoagulation with vitamin K antagonists (in many cases in maintenance). In select refractory cases, the use of other drugs such as corticosteroids, hydroxychloroquine, statin, or even rituximab may be necessary. In cases of antiphospholipid antibody carriers without thrombotic episodes and/or obstetric morbidity, primary thromboprophylaxis with acetylsalicylic acid can be considered on an individual basis based on the antiphospholipid antibody profile, cardiovascular risk, and/or the presence of associated systemic autoimmune diseases.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1808-1815"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834463","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

Enfermedad relacionada con IgG4 IgG4相关疾病

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.020

G. Starita Fajardo , D. Lucena López , C. Arévalo-Cañas , A. González García

引用次数: 0

Protocolo diagnóstico diferencial del dolor abdominal en pacientes con enfermedades inmunomediadas autoinmunes sistémicas 免疫介导的全身性自身免疫性疾病患者腹痛的鉴别诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.015

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

{"title":"Protocolo diagnóstico diferencial del dolor abdominal en pacientes con enfermedades inmunomediadas autoinmunes sistémicas","authors":"M. Retuerto Guerrero, E. Díez Álvarez, C. Sieiro Santos, I. González Fernández","doi":"10.1016/j.med.2025.04.015","DOIUrl":"10.1016/j.med.2025.04.015","url":null,"abstract":"<div><div>Autoimmune rheumatic diseases are often accompanied by pain and other gastrointestinal symptoms that may affect different areas of the digestive tract. Its differential diagnosis is complex due to the nonspecific and episodic nature of the clinical manifestations. It is essential to perform a comprehensive differential diagnosis that considers specific organ damage and vascular complications associated with the disease, infections, adverse drug effects, and occult neoplasms. The case history should be detailed, including the onset, location, duration, and characteristics of the pain as well as triggering factors, associated symptoms, and treatments received. The physical examination plays a key role in identifying signs of acute abdomen that require surgical intervention as well as oriented clinicians toward a precise etiology. Laboratory studies, in addition to imaging tests according to clinical suspicion, are indispensable. This comprehensive approach makes it possible to distinguish between surgical, inflammatory, metabolic, and infectious causes, ensuring adequate and timely management.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 30","pages":"Pages 1834-1838"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834468","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 miositis 肌炎诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.023

I. Calatayud Marín , N. Abdilla Bonías , M. Calabuig Ballester , C. Arévalo-Cañas

引用次数: 0

Protocolo terapéutico de las enfermedades autoinflamatorias 自发性疾病治疗规程

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.04.026

J. Ballano-Rodríguez-Solís , C. Arévalo-Cañas

引用次数: 0

Varón de 28 años con dolor lumbar crónico 男性，28岁，慢性下腰痛

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-04-01 DOI: 10.1016/j.med.2025.05.009

J. Campos Esteban, M. Ramírez Martín, E. Rico Sánchez-Mateos

引用次数: 0

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