Atencion Primaria Practica最新文献_第2页

Doctor, tengo piedras en el pulmón: a propósito de un caso sobre las enfermedades intersticiales pulmonares en atención primaria 医生，我的肺里有结石：基层医疗机构间质性肺病病例报告

Atencion Primaria Practica Pub Date : 2024-07-01 DOI: 10.1016/j.appr.2024.100210

Alba García Jiménez , María Isabel Colomer Martorell

引用次数: 0

Dermatitis anular de gran tamaño y su presunto vector 大面积环状皮炎及其可疑病媒

Atencion Primaria Practica Pub Date : 2024-07-01 DOI: 10.1016/j.appr.2024.100209

Carles Albaladejo Blanco, Mercede Beccia, Silvia Martínez González

引用次数: 0

El sector salud en la agenda climática: ¿hacia una resiliencia integral? 气候议程中的卫生部门：实现全面抗灾能力？

Atencion Primaria Practica Pub Date : 2024-05-28 DOI: 10.1016/j.appr.2024.100201

Mónica Regalado Chamorro , Aldo Medina Gamero

引用次数: 0

Edad e higiene, agentes relevantes en la neumonía adquirida en la comunidad 年龄和卫生，社区获得性肺炎的相关病原体

Atencion Primaria Practica Pub Date : 2024-04-10 DOI: 10.1016/j.appr.2024.100200

David Rivas Sucari , José Luis Rodríguez Eguizabal , Henry César Rivas Sucari

引用次数: 0

Sospecha de la interferencia en la determinación de las hormonas tiroideas en la práctica clínica real 临床实践中甲状腺激素测定的可疑干扰

Atencion Primaria Practica Pub Date : 2024-04-09 DOI: 10.1016/j.appr.2024.100199

Pablo José Ferreira Ocampo , Alicia Torregrossa Benavent , Elena Jaime Lara , Francisca Almodóvar Ruiz

{"title":"Sospecha de la interferencia en la determinación de las hormonas tiroideas en la práctica clínica real","authors":"Pablo José Ferreira Ocampo , Alicia Torregrossa Benavent , Elena Jaime Lara , Francisca Almodóvar Ruiz","doi":"10.1016/j.appr.2024.100199","DOIUrl":"https://doi.org/10.1016/j.appr.2024.100199","url":null,"abstract":"<div><h3>Introduction</h3><p>Analytical methods providing plasma values of thyroid hormones are vulnerable to various interferences that alter the results. An example is the presence of anti-thyroid hormone antibodies (anti-HT), common in patients with autoimmune hypothyroidism, which can disrupt the instrument signal and yield a falsely elevated hormone value in the sample. Only 50% of cases of analytical interferences are reported. These interferences can lead to misdiagnoses and inappropriate therapeutic management, resulting in harm to the patient and increased healthcare expenditure.</p></div><div><h3>Case</h3><p>A 72-year-old woman with autoimmune hypothyroidism on replacement therapy. Routine analysis reveals an elevation in T4 with TSH also above the reference range, when the expected outcome would be TSH suppression. This pattern is confirmed twice with the same analyzer. As the patient is asymptomatic, analytical interference is suspected. Following a protocol established by the Clinical Analysis laboratory, major known interferences are ruled out, leading to the detection of anti-HT as the cause of the false T4 value. Management changes, with medication dosage now monitored solely based on TSH levels.</p></div><div><h3>Conclusions</h3><p>Interferences lead to erroneous interpretations. In this case, considering overdosing of treatment and reducing the LT4 dose would induce hypothyroidism symptoms. Assuming another form of hyperthyroidism, discontinuing treatment, or initiating anti-thyroid drugs would result in similar harm. By detecting the interference, unnecessary iatrogenesis is avoided.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073024000099/pdfft?md5=62328cf263c1721de9fbe114201a9fb5&pid=1-s2.0-S2605073024000099-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140534953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Left temporal epilepsy unmasking tuberculoma in an immunocompetent adolescent: Case report 免疫功能正常的青少年左颞部癫痫掩盖了结核瘤：病例报告

Atencion Primaria Practica Pub Date : 2024-04-01 DOI: 10.1016/j.appr.2024.100198

Abdirahman Ibrahim Said , Mohamoud Abdulahi , Abdirahman Omer Ali , Asma Mohamoud Koshin , Said Ahmed Walhad , Abdisalam Hassan Muse

{"title":"Left temporal epilepsy unmasking tuberculoma in an immunocompetent adolescent: Case report","authors":"Abdirahman Ibrahim Said , Mohamoud Abdulahi , Abdirahman Omer Ali , Asma Mohamoud Koshin , Said Ahmed Walhad , Abdisalam Hassan Muse","doi":"10.1016/j.appr.2024.100198","DOIUrl":"https://doi.org/10.1016/j.appr.2024.100198","url":null,"abstract":"<div><p>Tuberculosis (TB) is a chronic granulomatous disease caused by <em>Mycobacterium tuberculosis</em>, with extrapulmonary manifestations occurring in approximately 1% of cases. Among these, central nervous system involvement, including intracranial tuberculomas, is rare. We present the case of a 13-year-old female from Borama, Somalia, admitted with abnormal lip movements and a complex medical history, including weight loss, recurrent urinary tract infections, and a familial predisposition to TB. Neurological examination revealed left-sided facial deviation and hyperreflexia, prompting investigations that confirmed left temporal epilepsy and a right-sided tuberculoma. Treatment with levetiracetam and anti-TB medication led to significant improvement. This case underscores the importance of considering tuberculomas in the differential diagnosis of neurological presentations, even in non-HIV patients, especially in resource-limited settings like Africa.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073024000087/pdfft?md5=529dbe1c92b1b26aa5b00a0c5600e777&pid=1-s2.0-S2605073024000087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Esophageal carcinoma in second-trimester pregnancy in a resource-limited setting: Case report 在资源有限的环境中，妊娠二期出现食管癌：病例报告

Atencion Primaria Practica Pub Date : 2024-04-01 DOI: 10.1016/j.appr.2024.100197

Abdirahman Ibrahim Said , Ismail Hussein Ismail , Ayanle Mohamed Mohamed , Halimo Barkhad Mohamed , Abdisamad Mohamoud Ali , Don Eliseo III Lucero-Prisno , Hassan Abdirahman Elmi

{"title":"Esophageal carcinoma in second-trimester pregnancy in a resource-limited setting: Case report","authors":"Abdirahman Ibrahim Said , Ismail Hussein Ismail , Ayanle Mohamed Mohamed , Halimo Barkhad Mohamed , Abdisamad Mohamoud Ali , Don Eliseo III Lucero-Prisno , Hassan Abdirahman Elmi","doi":"10.1016/j.appr.2024.100197","DOIUrl":"https://doi.org/10.1016/j.appr.2024.100197","url":null,"abstract":"<div><p>Esophageal carcinoma during pregnancy is an extremely rare condition that presents unique challenges in terms of diagnosis and management. In this case study, we report on a 34-year-old pregnant woman from Somalia/Somaliland who presented with dysphagia and weight loss. She had previously been treated for gastroesophageal reflux disease, but her symptoms worsened over time. Upon examination, the patient exhibited cachexia, palpable cervical nodes, and basal crepitation upon admission. A CT scan of the neck revealed esophageal carcinoma with metastasis, while an ultrasonography confirmed the presence of a 24-week fetus. Due to the limited availability of chemotherapy and cancer treatment facilities, palliative care was initiated, unfortunately resulting in the unfortunate demise of both the patient and the fetus. This case highlights the significant impact of resource scarcity on disease management, as well as the ethical complexities involved in making decisions regarding palliative care for pregnant patients with cancer. It emphasizes the importance of timely diagnosis and the implementation of comprehensive, multidisciplinary approaches in addressing such rare occurrences.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073024000075/pdfft?md5=2edbf9e493eef0a4682977be407c1782&pid=1-s2.0-S2605073024000075-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140347526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiología de la ansiedad y su contexto en atención primaria 初级保健中焦虑症的流行病学及其背景

Atencion Primaria Practica Pub Date : 2024-03-19 DOI: 10.1016/j.appr.2024.100194

José Antonio Domínguez Domínguez , Victor Expósito Duque , Elisa Torres Tejera

引用次数: 0

La ansiedad como pandemia: desafíos y reflexiones 焦虑作为一种流行病：挑战与思考

Atencion Primaria Practica Pub Date : 2024-03-18 DOI: 10.1016/j.appr.2024.100196

Aldo Medina Gamero

引用次数: 0

Crisis tirotóxica: manejo y diagnóstico en el servicio de urgencias. Reporte de un caso 甲亢危象：急诊科的处理和诊断。病例报告

Atencion Primaria Practica Pub Date : 2024-03-18 DOI: 10.1016/j.appr.2024.100195

Ana María Olmedo Montijano , David Reina Escobar , Álvaro Lozano Carnero

引用次数: 0