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Alteraciones adquiridas de la coagulación
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.012
A.C. Leal Ferrero, A. Mendoza Martínez, C.I. Morellón Peña, V. Jiménez Yuste
{"title":"Alteraciones adquiridas de la coagulación","authors":"A.C. Leal Ferrero,&nbsp;A. Mendoza Martínez,&nbsp;C.I. Morellón Peña,&nbsp;V. Jiménez Yuste","doi":"10.1016/j.med.2024.11.012","DOIUrl":"10.1016/j.med.2024.11.012","url":null,"abstract":"<div><div>Acquired coagulation disorders are those that occur alongside and develop as a part of hematological, neoplastic, autoimmune, cardiovascular, or hepatic diseases; though they can also originate spontaneously. They usually manifest as a deficit of a coagulation factor or as global hemostasis impairment. Given its variable pathophysiology, the clinical phenotype ranges from mild hemorrhagic symptoms to potentially lethal hemorrhagic manifestations. In most situations, treatment involves addressing the underlying medical condition and includes supportive care to prevent or treat hemorrhagic manifestations.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 22","pages":"Pages 1299-1308"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141396","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 microangiopatías trombóticas
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.014
P. González-Marugán, A. Mendoza Martínez, S.C. Galván Platas, V. Jiménez Yuste
{"title":"Protocolo diagnóstico de las microangiopatías trombóticas","authors":"P. González-Marugán,&nbsp;A. Mendoza Martínez,&nbsp;S.C. Galván Platas,&nbsp;V. Jiménez Yuste","doi":"10.1016/j.med.2024.11.014","DOIUrl":"10.1016/j.med.2024.11.014","url":null,"abstract":"<div><div>Thrombotic microangiopathies (TMA) are a group of conditions characterized by the onset of microangiopathic hemolytic anemia, thrombocytopenia, and variable organ damage. The most important forms of TMA are thrombotic thrombocytopenic purpura (TTP), Shiga toxin-mediated TMA or typical hemolytic-uremic syndrome (HUS), and complement-mediated TMA or atypical HUS (aHUS). Due to its high morbidity and mortality, it is essential to establish an initial suspicion that allows for an early diagnosis and starting appropriate therapeutic measures</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 22","pages":"Pages 1319-1322"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141398","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 de anticoagulación en situaciones especiales
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.016
G. Maortua Langdon, A. Mendoza Martínez, J.M. Martín de Bustamante González-Iglesias, V. Jiménez Yuste
{"title":"Protocolo de anticoagulación en situaciones especiales","authors":"G. Maortua Langdon,&nbsp;A. Mendoza Martínez,&nbsp;J.M. Martín de Bustamante González-Iglesias,&nbsp;V. Jiménez Yuste","doi":"10.1016/j.med.2024.11.016","DOIUrl":"10.1016/j.med.2024.11.016","url":null,"abstract":"<div><div>Anticoagulant treatment of venous thromboembolism is a major challenge for practitioners. However, there are times when the challenge is even greater, as in the case of some special situations in which anticoagulation requires individualized management due to the potential adverse effects of anticoagulation. These situations include comorbidities that increase the risk of toxicity, such as renal insufficiency, older adult patients, or patients with cancer. In recent years, new anticoagulant therapies have been developed that are more effective and safer for patients. These are of particular interest in these special situations due to their improved safety profile, although they also require specific considerations in these patient subgroups.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 22","pages":"Pages 1327-1330"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141400","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
Gestante de 26 semanas con diátesis hemorrágica a estudio
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.018
A. Mendoza Martínez, J.M. Martín de Bustamante González-Iglesias, V. Jiménez Yuste
{"title":"Gestante de 26 semanas con diátesis hemorrágica a estudio","authors":"A. Mendoza Martínez,&nbsp;J.M. Martín de Bustamante González-Iglesias,&nbsp;V. Jiménez Yuste","doi":"10.1016/j.med.2024.11.018","DOIUrl":"10.1016/j.med.2024.11.018","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 22","pages":"Pages 1335.e1-1335.e4"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141402","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 poliglobulias 多发性球状红细胞症诊断方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.007
L. Medina de Alba, R. Mas Babío, J. Martínez-López, G. Carreño Gómez-Tarragona
{"title":"Protocolo diagnóstico de las poliglobulias","authors":"L. Medina de Alba,&nbsp;R. Mas Babío,&nbsp;J. Martínez-López,&nbsp;G. Carreño Gómez-Tarragona","doi":"10.1016/j.med.2024.11.007","DOIUrl":"10.1016/j.med.2024.11.007","url":null,"abstract":"<div><div>Polycythemia, or erythrocytosis, is an increase in hemoglobin or erythrocyte mass. An increase is considered present when there is more than 16.5<!--> <!-->g/dL of hemoglobin in males and more than 16<!--> <!-->g/dL in females. Erythropoietin produced in the kidneys is responsible for regulating erythropoiesis. Polycythemia vera is the most prominent primary or erythropoietin-independent erythrocytosis; secondary or erythropoietin-dependent erythrocytosis is due to multiple causes. The etiological diagnosis of polycythemia is essential for the treatment and follow-up of these patients.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 21","pages":"Pages 1266-1269"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706620","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 hemolíticas adquiridas y congénitas 获得性和先天性溶血性贫血
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.004
A. García Sánchez, A. Tamayo Soto, J. Martínez-López, M.T. Cedena Romero
{"title":"Anemias hemolíticas adquiridas y congénitas","authors":"A. García Sánchez,&nbsp;A. Tamayo Soto,&nbsp;J. Martínez-López,&nbsp;M.T. Cedena Romero","doi":"10.1016/j.med.2024.11.004","DOIUrl":"10.1016/j.med.2024.11.004","url":null,"abstract":"<div><div>Hemolytic anemias are a heterogeneous group of diseases characterized by a decrease in red blood cell survival (hemolysis). They are regenerative anemias (reticulocytosis) not justified by bleeding or recent correction of maturation factors deficits and which show signs of accelerated erythrocyte destruction, such as increased indirect bilirubin and lactate dehydrogenase (LDH) and decreased haptoglobin as well as morphological abnormalities on a peripheral blood smear. There are multiple causes of hemolytic anemia, including both acute and chronic congenital and acquired diseases. They are of varying potential severity. The intensity of the clinical signs and symptoms depends on the degree and speed of anemia onset. A good etiological diagnosis is fundamental in order to establish the proper treatment, given that each requires specific management.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 21","pages":"Pages 1243-1254"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706623","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
Enfermedades de la hemostasia primaria
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.011
S.C. Galván Platas, A. Mendoza Martínez, P.G. González Marugán, V. Jiménez Yuste
{"title":"Enfermedades de la hemostasia primaria","authors":"S.C. Galván Platas,&nbsp;A. Mendoza Martínez,&nbsp;P.G. González Marugán,&nbsp;V. Jiménez Yuste","doi":"10.1016/j.med.2024.11.011","DOIUrl":"10.1016/j.med.2024.11.011","url":null,"abstract":"<div><div>This update focuses on disorders that affect the vascular endothelium and platelets, key components in primary hemostasis. These are classified into purpura, which involves vascular abnormalities, and quantitative or qualitative platelet abnormalities, both of which can be congenital or acquired. The most common hemorrhagic symptoms include cutaneous and mucosal bleeding following trauma or surgery. Some congenital coagulation disorders are part of more complex syndromes that go beyond hemorrhagic symptoms and require a multidisciplinary approach. It is crucial to take a detailed medical history and perform a thorough physical examination when faced with any coagulation disorder. Platelet function tests and molecular diagnostic techniques are important additional tools. Regarding treatment, bleeding complications are treated in many cases according to their severity with desmopressin, antifibrinolytic agents, platelet transfusion, recombinant activated factor VII, and thrombopoietin receptor agonists. In some cases of congenital origin, allogeneic transplantation of hematopoietic progenitors is the only curative option. In acquired forms, treatment will generally be for the underlying disease itself.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 22","pages":"Pages 1288-1298"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141395","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 71 años pluripatológico que consulta por bicitopenia 71 岁男性，患有多种疾病，因双血细胞减少症就诊。
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.027
M. Callejas Charavía, P. García Ramírez
{"title":"Varón de 71 años pluripatológico que consulta por bicitopenia","authors":"M. Callejas Charavía,&nbsp;P. García Ramírez","doi":"10.1016/j.med.2024.10.027","DOIUrl":"10.1016/j.med.2024.10.027","url":null,"abstract":"","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 20","pages":"Pages 1214.e1-1214.e3"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663701","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 anemia en el paciente anciano 老年患者贫血诊断方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.10.023
D. Conde-Royo , J. Aspa-Cilleruelo
{"title":"Protocolo diagnóstico de la anemia en el paciente anciano","authors":"D. Conde-Royo ,&nbsp;J. Aspa-Cilleruelo","doi":"10.1016/j.med.2024.10.023","DOIUrl":"10.1016/j.med.2024.10.023","url":null,"abstract":"<div><div>Anemia in older adult patients is not only a disease with a high incidence that directly affects patients’ health, but it also behaves as a catalyst of other cardiovascular, functional, and cognitive comorbidities. It can also be a determining factor in these patients’ quality of life. The initial focus is mainly based on the study of iron metabolism and other basic analytical components according to the degree of anemia and mean corpuscular volume. The vast majority of cases can be controlled by replenishing potential deficits or treating underlying diseases, although this protocol also addresses purely hematological causes.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 20","pages":"Pages 1193-1197"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663671","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 anemias hemolíticas 溶血性贫血诊断方案
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2024-11-01 DOI: 10.1016/j.med.2024.11.005
A. Tamayo Soto, A. García Sánchez, J. Martínez-López, M.T. Cedena Romero
{"title":"Protocolo diagnóstico de las anemias hemolíticas","authors":"A. Tamayo Soto,&nbsp;A. García Sánchez,&nbsp;J. Martínez-López,&nbsp;M.T. Cedena Romero","doi":"10.1016/j.med.2024.11.005","DOIUrl":"10.1016/j.med.2024.11.005","url":null,"abstract":"<div><div>Hemolytic anemias are defined by the premature destruction of circulating red blood cells. They can be classified as congenital or acquired and most are of immune origin. Diagnosis requires a comprehensive medical history, including a personal and family history; use of drugs or toxins; and a series of laboratory tests. Test findings predominantly show a marked decrease in hemoglobin; an increase in reticulocytes, bilirubin (indirect fraction), and lactate dehydrogenase; and a decrease in haptoglobin. Finally, a direct antiglobulin test (direct Coombs test) and a peripheral blood smear can be very useful in indicating the possible cause of hemolytic anemia.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 21","pages":"Pages 1255-1259"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706622","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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