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

Alteraciones del sistema hemostático

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.010

C.I. Morellón Peña, A. Mendoza Martínez, A.C. Leal Ferrero, V. Jiménez Yuste

引用次数: 0

Síndromes mielodisplásicos y leucemia mielomonocítica crónica 骨髓增生异常综合征和慢性粒细胞白血病

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.021

M. Callejas Charavía, G. López de Hontanar Torres, G. Motornaya Morozova, M. Menor Gómez

引用次数: 0

Protocolo diagnóstico de las leucocitosis afebriles 发热性白细胞增多症诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.024

A. Puchol, P. Villafuerte

{"title":"Protocolo diagnóstico de las leucocitosis afebriles","authors":"A. Puchol, P. Villafuerte","doi":"10.1016/j.med.2024.10.024","DOIUrl":"10.1016/j.med.2024.10.024","url":null,"abstract":"<div><div>Leukocytosis, defined as an increase in the white blood cell count, can occur in a multitude of clinical situations. This protocol will focus on afebrile leukocytosis. To assess leukocytosis, the type of cell with increased values, the degree of leukocytosis, and the patient's symptoms must be evaluated and the morphology of cells observed under the microscope must be taken into account.</div><div>Neutrophilia refers to an increase of at least two standard deviations above the mean in the number of neutrophils in peripheral blood. The most frequent causes of neutrophilia are reactive forms (secondary to another condition) and the other group are those of primary origin when there is autonomous medullary hyperproduction.</div><div>Lymphocytosis is defined as an absolute lymphocyte count greater than 4000/μl, although up to 8000/μl may be normal in newborns and children. Reactive causes are more common in children or young adults, notable among which are mononucleosis syndromes. Other important causes are those secondary to clonal disorders; therefore, a blood smear study for cell morphology and flow cytometry study are required.</div><div>Monocytosis is defined as an increase in the number of monocytes in peripheral blood above 1000/μl. The most frequent causes are infections. Other important causes to consider, especially if monocytosis is sustained and secondary causes have been ruled out, are primary hematologic malignancies, especially in older adults or in patients with unexplained cytopenias.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 20","pages":"Pages 1198-1203"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663699","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 trombocitopenia

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.017

A. Mendoza Martínez, M. Velasco Troyano, M. Hernández Arriaza, V. Jiménez Yuste

引用次数: 0

Protocolo diagnóstico y terapéutico de la neutropenia 中性粒细胞减少症的诊断和治疗方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.026

L. Castilla García , M. Argüello Marina

{"title":"Protocolo diagnóstico y terapéutico de la neutropenia","authors":"L. Castilla García , M. Argüello Marina","doi":"10.1016/j.med.2024.10.026","DOIUrl":"10.1016/j.med.2024.10.026","url":null,"abstract":"<div><div>Neutropenia consists of a decrease in the absolute neutrophil count. It is a common and potentially serious complication in patients with hematologic and oncologic diseases. Its origin may be linked to underlying diseases, myelosuppressive chemotherapy, or hematopoietic stem cell transplantation. It greatly increases the risk of serious bacterial and fungal infections. Effective management of neutropenia is crucial in order to prevent infectious complications and improve clinical outcomes. It can have various causes, including autoimmune disorders, nutritional deficiencies, viral infections, infectious pathogens, and myelosuppressive drugs. The diagnosis is based on assessing the absolute neutrophil count and classifying it according to severity. Infections can be ruled out by means of a detailed clinical history and, in certain situations, by performing imaging tests. The possibility of underlying hematologic disorders should be assessed through specific tests, such as a bone marrow biopsy, flow cytometry, and next-generation sequencing. Managing neutropenia entails the identification and treatment of the underlying cause as well as the prevention and management of infectious complications. Treatment measures range from suspending myelosuppressive drugs to using colony-stimulating factors, empirical antibiotic therapy in cases of febrile neutropenia, and antifungal prophylaxis in high-risk patients. Multidisciplinary care is required for comprehensive, optimal management of neutropenia.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 20","pages":"Pages 1209-1213"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663700","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

Anemias carenciales y anemia megaloblástica 缺失性贫血和巨幼红细胞性贫血

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.003

M. Sánchez Tabernero, A. Blanco Sánchez, J. Martínez-López, I. Zamanillo Herreros

{"title":"Anemias carenciales y anemia megaloblástica","authors":"M. Sánchez Tabernero, A. Blanco Sánchez, J. Martínez-López, I. Zamanillo Herreros","doi":"10.1016/j.med.2024.11.003","DOIUrl":"10.1016/j.med.2024.11.003","url":null,"abstract":"<div><div>Deficiency anemia, defined as a deficiency of essential factors for red blood cell formation and maturation, is a global health problem. The main cause is iron deficiency, followed by megaloblastic anemia, which is mainly due to a deficiency of folic acid or vitamin B12, both essential coenzymes for DNA synthesis. Vitamin B12 requires complex absorption in the gastrointestinal system that involves different phases, as does folic acid, whose main absorption occurs in the duodenum and jejunum. The clinical manifestations of megaloblastic anemia include the typical symptoms of anemia, which is common regardless of the cause, and neurological symptoms that are specific to vitamin B12, or cobalamin, deficiency. The diagnosis is made via blood tests which reveal macrocytic anemia with low reticulocytes. The definitive diagnosis is made when decreased levels of vitamin B12 or folic acid, respectively, are observed. Treatment involves replenishment of the deficient nutrients either orally or parenterally, depending on severity and etiology. Approved formulations available in Spain are included in the text.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 21","pages":"Pages 1227-1233"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706529","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

Anemia ferropénica. Enfermedades por depósito de hierro 缺铁性贫血。铁沉积引起的疾病

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.001

A. Blanco Sánchez, E. Parra Virto, J. Martínez-López, I. Zamanillo Herreros

{"title":"Anemia ferropénica. Enfermedades por depósito de hierro","authors":"A. Blanco Sánchez, E. Parra Virto, J. Martínez-López, I. Zamanillo Herreros","doi":"10.1016/j.med.2024.11.001","DOIUrl":"10.1016/j.med.2024.11.001","url":null,"abstract":"<div><div>Iron deficiency is the most common cause of anemia worldwide, especially in women of childbearing age, due to gynecological losses or during pregnancy, and in older adult patients, in whom it is often the first sign of a digestive tract disease. Clinical suspicion begins with the detection of abnormalities in the blood count, such as microcytosis, and is confirmed by determining analytical parameters related to iron metabolism, such as serum ferritin. A diagnosis of iron-deficiency anemia requires an investigation into its causes, as it may be the first sign of a major underlying disease such as a neoplasm. Treatment consists of managing the underlying disease and daily fasting oral iron supplementation. This may pose problems of tolerance and adherence. In such cases, or if there is malabsorption, the intravenous route may be used. On the other hand, excess iron can have equally deleterious effects due to deposits in various organs such as the heart or liver. Its main causes are hemochromatosis and hematologic diseases with ineffective hematopoiesis. Treatment consists of phlebotomy or iron chelation.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 21","pages":"Pages 1234-1242"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706531","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

Trombofilia y trombosis

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.013

M. Hernández Arriaza, M. Velasco Troyano, A. Mendoza Martínez, V. Jiménez Yuste

引用次数: 0

Protocolo diagnóstico de la trombocitosis 血小板增多症诊断方案

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.025

V. Cardos Gómez , C. Vázquez Martínez

引用次数: 0

Neoplasias mieloproliferativas crónicas Filadelfia negativas 费城阴性慢性骨髓增生性肿瘤

Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.020

N. Curto-García , P. Gili Herreros , C. Portocarrero de las Heras Pérez , E. Magro Mazo

引用次数: 0