Atencion Primaria Practica最新文献

{"title":"Crisis tirotóxica: manejo y diagnóstico en el servicio de urgencias. Reporte de un caso","authors":"Ana María Olmedo Montijano ,&nbsp;David Reina Escobar ,&nbsp;Álvaro Lozano Carnero","doi":"10.1016/j.appr.2024.100195","DOIUrl":"https://doi.org/10.1016/j.appr.2024.100195","url":null,"abstract":"<div><p>We present a case report of subacute thyroiditis in a patient who exhibited symptoms indicative of thyroid storm. Initially, our patient visited her primary care physician, presenting dyspnea at rest and orthopnea, along with analytical abnormalities. Considering the epidemiological background, her PCP decided to refer her to the emergency department for optimal management and treatment. Given the high mortality and morbidity rates associated with untreated cases, it was decided to conduct a review of the management at emergency department.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 2","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073024000051/pdfft?md5=f94b832e3215965d398c039ae3c55241&pid=1-s2.0-S2605073024000051-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140145435","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}

{"title":"Epidemiología de la ansiedad y su contexto en atención primaria","authors":"José Antonio Domínguez Domínguez ,&nbsp;Victor Expósito Duque ,&nbsp;Elisa Torres Tejera","doi":"10.1016/j.appr.2024.100194","DOIUrl":"https://doi.org/10.1016/j.appr.2024.100194","url":null,"abstract":"<div><p>Anxiety is an emotion that has accompanied humanity throughout its history; It has been the engine of change and survival, but when it appears disproportionately or in the face of wrong stimuli, it is when we are facing an anxiety disorder.</p><p>Currently, anxiety disorders are a real health problem for all health systems due to their high prevalence in the population and since the start of the COVID pandemic this situation has not improved at all.</p><p>In this article we examine the prevalence data to date, the variability that they present and their impact in the context of primary care.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 2","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S260507302400004X/pdfft?md5=f5008ce11453ff21e68b072b36020373&pid=1-s2.0-S260507302400004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160867","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}

{"title":"Esophageal carcinoma in second-trimester pregnancy in a resource-limited setting: Case report","authors":"Abdirahman Ibrahim Said ,&nbsp;Ismail Hussein Ismail ,&nbsp;Ayanle Mohamed Mohamed ,&nbsp;Halimo Barkhad Mohamed ,&nbsp;Abdisamad Mohamoud Ali ,&nbsp;Don Eliseo III Lucero-Prisno ,&nbsp;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":"6 2","pages":"Article 100197"},"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}

{"title":"Abordaje integral del síndrome de inestabilidad y caídas del anciano en atención primaria","authors":"Jheyson Parra-Saldarriaga ,&nbsp;Margarita M. Benavides-Ruiz ,&nbsp;Jorge A. Sánchez-Duque","doi":"10.1016/j.appr.2023.100187","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100187","url":null,"abstract":"","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 1","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49802235","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}

{"title":"Pancreatitis aguda asociada a infección por el virus Epstein-Barr. Presentación de un caso y revisión de la literatura","authors":"Christian Alberto Vargas Machuca-Carranza ,&nbsp;Luis Ángel Rodríguez-Chávez ,&nbsp;Melissa Ysabel Romero-Diaz ,&nbsp;Víctor Alexander Lozano-Araujo","doi":"10.1016/j.appr.2023.100190","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100190","url":null,"abstract":"<div><p>Acute pancreatitis is an inflammatory pathology involving the exocrine pancreas. Biliary stones and alcohol are its most common etiological factors; it is mentioned that around 10% of acute pancreatitis cases are caused by other factors, such as infections by parasites, bacteria, and viruses. We present the case of a patient who started with a febrile condition for three weeks and, in the last week, developed abdominal symptoms, leading to a diagnosis of acute viral pancreatitis based on clinical and laboratory criteria. A literature review on this topic is also provided.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 1","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S260507302300024X/pdfft?md5=4fd70205c7d6edeb7eb604d4d5dce11e&pid=1-s2.0-S260507302300024X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100901","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}

{"title":"Tratamiento farmacológico de los trastornos de ansiedad","authors":"Antonieta Also Fontanet ,&nbsp;Natalia Echiburu Salinas ,&nbsp;Jessica Pinto Asenjo","doi":"10.1016/j.appr.2023.100189","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100189","url":null,"abstract":"<div><p>The main objective of the treatment for anxiety disorders is to relieve symptoms, prevent relapse and avoid sequels. An integral therapeutic approach most be considered (psychosocial, biologic and pharmacologic). The antidepressants and anxiolytics are the mainstay pharmacological treatment. When the prescription is made, the patient must be informed of therapeutic objectives, duration and possible side effects. Age, previous treatment, tolerance, pregnancy and side effects most be considered. In Spain there is a high rate of prescription and consume of antidepressants and anxiolytics: the data of “Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)” support that the consume of antidepressants in Spain has passed from 26.5 DHD (Daily doses per 1000 habitants/Dose per day per 1000 habitants) in the year 2000 to 79.5 DHD in the year 2013; translating and increment of 200%. Regarding the anxiolytics the DHD has increased from 50.88 in 2012 to 58.09 in 2022.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 1","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073023000238/pdfft?md5=6ba5152fb3bfa88e91697100d163162f&pid=1-s2.0-S2605073023000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839738","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}

{"title":"La bandera sudafricana: un electrocardiograma de alto riesgo","authors":"Pilar Alcantud-Lozano ,&nbsp;Sonia Cebrián-López ,&nbsp;Ángel Sánchez Garrido-Lestache ,&nbsp;Juan J. Portero-Portaz","doi":"10.1016/j.appr.2023.100186","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100186","url":null,"abstract":"","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 1","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49802234","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}

{"title":"Factors affecting cognitive decline among patients with diabetes: A cross-sectional study in Lebanon","authors":"Sandra Mechref ,&nbsp;Georges Hatem ,&nbsp;Hussein Nehme ,&nbsp;Razan Mhanna ,&nbsp;Samah Meouch ,&nbsp;Samar Rachidi","doi":"10.1016/j.appr.2023.100188","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100188","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Patients with diabetes are prone to cognitive decline, including memory loss, decreased attention, and processing speed. This study aims to evaluate cognitive impairment in patients with diabetes and the factors associated with cognitive decline.</p></div><div><h3>Materials and methods</h3><p>A cross-sectional study was conducted over 5 months targeting 318 previously diagnosed patients with diabetes from 2 endocrinology clinics. The Arab version of the Mini-Mental State Examination assessed cognitive function through 11 items exploring 6 cognitive domains. Participants' general characteristics, lifestyle, and medical history were collected. They were also asked about the management of their diabetes (type of and adherence to medication and doing regular laboratory tests or glycemic monitoring at home). Other information, such as glycated hemoglobin A1c, cholesterol, and triglycerides level, was retrieved from the patient's files while noting the patient's systolic and diastolic blood pressures.</p></div><div><h3>Results</h3><p>Patients had a mean age of 59.8 (10.7). Around 68% of patients had a possible cognitive impairment, and 31.8% a normal cognitive function. Significantly lower scores were noted among females (20.0; <em>P</em> &lt; .001), and older patients had lower cognitive functions than others (19.4; <em>P</em> &lt; .001). Illiterate had significantly lower scores (15.0) than those with advanced education (24.9; <em>P</em> &lt; .001). Participants with diabetes for more than 5 years (20.8) and those with uncontrolled glycemia (20.8) had lower cognitive function than patients diagnosed more recently (22.2; <em>P</em> = .021) or those with controlled glycemia (23.1; <em>P</em> &lt; .001). A cognitive decline was found among those with total cholesterol ≥<!--> <!-->200 mg/dL (20.7 vs. 21.9; <em>P</em> = .044), a systolic blood pressure of 140 mmHg or more (20.0 vs. 22.5; <em>P</em> &lt; .001), and hematocrit levels below 40% (20.6 vs. 22.4; <em>P</em> = .002). After adjusting for covariates, a lower cognitive function score was found per increase of 1 year of age (b<!--> <!-->=−0.120, CI (−<!--> <!-->0.13, −<!--> <!-->0.03); <em>P</em> = .038) and among females (−<!--> <!-->0.186 (−<!--> <!-->3.30, −<!--> <!-->0.35); <em>P</em> = .016). An increase of a factor of 0.342 was found between the levels of education (CI (0.71–2.04); <em>P</em> &lt; .001), and patients with uncontrolled glycemia had a significantly lower score than others. Moreover, having a systolic blood pressure ≥<!--> <!-->140 mmHg decreased the cognitive function score by a factor of 0.147 (CI (−<!--> <!-->2.98, −<!--> <!-->0.01); <em>P</em> = .049).</p></div><div><h3>Conclusion</h3><p>The combined effect of these factors should be considered for treatment management and glycemic control to help early referrals of patients at risk.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"6 1","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2605073023000226/pdfft?md5=5809b918572ff8841c2af17214060be7&pid=1-s2.0-S2605073023000226-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134656797","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}

{"title":"La prevención cuaternaria en el uso de benzodiacepinas y cómo deprescribirlas","authors":"Luz de Myotanh Vázquez Canales ,&nbsp;María Frutos Fernández","doi":"10.1016/j.appr.2023.100183","DOIUrl":"https://doi.org/10.1016/j.appr.2023.100183","url":null,"abstract":"<div><p>The consumption of benzodiazepines in our environment has increased in recent years due to the increase in Mental Health disorders caused by the COVID-19 pandemic. However, the data already showed a previous increase not only in Spain but worldwide. The causes detected are the lack of time, the inertia of the doctor and the patient or the lack of knowledge in the management of its withdrawal. Most prescriptions are made in the Primary Care context. For this reason, it should also be the space in which the deprescriptions should be carried out. This article analyzes the causes of the increase, the moment in which they should be withdrawn, the strategies to be able to carry out a correct withdrawal and community strategies carried out in Spain that have contributed to reducing their consumption.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"5 4","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49786815","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}

{"title":"Experiencia con el proyecto ENDMAP, una actividad formativa para médicos de familia en endocrinología y nutrición","authors":"Agustín Ángel Merchante Alfaro ,&nbsp;Concha F. García-Prieto ,&nbsp;Diana Riba Artés ,&nbsp;Diego Bellido Guerrero","doi":"10.1016/j.appr.2023.100181","DOIUrl":"10.1016/j.appr.2023.100181","url":null,"abstract":"<div><p>It is well known that primary care (PC) in Spain is under considerable stress due to the large volume of care it provides. The aging of the population, the increase in chronic pathologies such as diabetes and cardiovascular risk factors (hypertension and hyperlipidemia) and the growing complexity of diagnostic methods and treatments make it necessary for Family Physicians to be constantly updated. For this reason, the ENDMAP project was designed, a practical training program for Family Physicians in Endocrinology. This article presents how the project has evolved over its 5 editions and the results of the evaluation of the project by both attendees and trainers in terms of interest and usefulness.</p></div>","PeriodicalId":52231,"journal":{"name":"Atencion Primaria Practica","volume":"5 4","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49108128","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}