Medicina de Familia-SEMERGEN最新文献

{"title":"Uso de la Unidad de Rehabilitación del Equilibrio (URE) en disfunciones vestibulares: revisión sistemática sobre su aplicación diagnóstica y terapéutica","authors":"M. Jara ,&nbsp;S.V. Flores ,&nbsp;R. Montaña ,&nbsp;Á. Roco-Videla","doi":"10.1016/j.semerg.2025.102568","DOIUrl":"10.1016/j.semerg.2025.102568","url":null,"abstract":"<div><div>The Balance Rehabilitation Unit (BRU) has emerged as a promising tool for the evaluation and treatment of vestibular dysfunctions. In this context, the present study analyzed scientific evidence regarding its clinical use through a systematic review guided by PRISMA guidelines. In most of the studies (80%), the BRU was used to assess center of pressure (COP) and sway velocity (SV), showing significant improvements after the interventions. Furthermore, when compared to conventional treatments, it demonstrated superior results in these parameters, reinforcing its value in rehabilitation. However, the absence of normative values limits its diagnostic application, highlighting the need for further research to establish clear reference parameters that can guide its clinical use.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102568"},"PeriodicalIF":0.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120827","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":"Redefiniendo la atención primaria: recomendaciones de CARABELA-AP para el manejo de enfermedades crónicas prevalentes","authors":"J. Polo ,&nbsp;P. Rodríguez ,&nbsp;I. Mediavilla ,&nbsp;A. Pérez ,&nbsp;L. Regadera ,&nbsp;E. Fitas ,&nbsp;C. Moreno ,&nbsp;A. Prado ,&nbsp;A. Izarra ,&nbsp;R.M. Micó-Pérez ,&nbsp;el Comité Científico de CARABELA-AP","doi":"10.1016/j.semerg.2025.102586","DOIUrl":"10.1016/j.semerg.2025.102586","url":null,"abstract":"<div><h3>Aim</h3><div>The CARABELA-AP initiative aims to optimize the comprehensive management of prevalent chronic diseases (PCDs), such as asthma, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and heart failure, within the Primary Care (PC) setting in Spain.</div></div><div><h3>Material and methods</h3><div>The CARABELA methodology is structured into four phases: (1) characterization of the care process and development of quality indicators; (2) validation of results in pilot centers and identification of areas for improvement and potential solutions; (3) prioritization of improvement areas/solutions and consensus on indicators in a national meeting using the Delphi methodology; and (4) dissemination of results and implementation in other healthcare centers through the development of a guide to optimize and coordinate PCD management.</div></div><div><h3>Results</h3><div>The analysis conducted in 104 pilot centers allowed for the characterization and standardization of the care process for the five PCDs, from diagnosis to follow-up. Additionally, 21 areas for improvement and 37 key solutions were identified and prioritized based on their impact and ease of implementation. Among the 35 quality indicators developed, 33 were validated.</div></div><div><h3>Discussion</h3><div>CARABELA-AP proposes the groundwork for transforming the PC care model by strengthening multidisciplinary coordination and promoting a more efficient and sustainable management of PCDs. The structured implementation of key solutions and identified areas for improvement supports a comprehensive approach that ensures continuity of care and equitable access to treatment for these conditions. Additionally, the developed framework enables the adaptation of strategies to the local needs of the healthcare centers and facilitates ongoing monitoring of their impact through quality care indicators.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102586"},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093185","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":"Epidemiología, características y gestión de la enfermedad renal crónica asociada a la diabetes en un área sanitaria de Cádiz","authors":"J. Escribano-Serrano ,&nbsp;E. Jiménez-Varo ,&nbsp;M. Escribano-Cobalea ,&nbsp;C. Casto-Jarillo ,&nbsp;A. López-Ceres ,&nbsp;E. Campos-Dávila ,&nbsp;A. Hormigo-Pozo ,&nbsp;C. Nieto-Ordoñez ,&nbsp;M.Á. Rodríguez-Juliá ,&nbsp;A. Michán-Doña","doi":"10.1016/j.semerg.2025.102584","DOIUrl":"10.1016/j.semerg.2025.102584","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic Kidney Disease associated with Diabetes Mellitus (CKD-DM) is a prevalent condition with significant morbidity, mortality, and healthcare burden. Despite its relevance, its specific characteristics within the Spanish context have been scarcely described.</div></div><div><h3>Objective</h3><div>To determine the prevalence, clinical phenotypes, and therapeutic management of CKD-DM according to KDIGO guidelines in a healthcare area in southern Spain.</div></div><div><h3>Methods</h3><div>Observational, cross-sectional, and retrospective study based on SIDICAM records from July 2021 to June 2023 in the Campo de Gibraltar East Health Management Area. Diabetic patients (PDM) were identified and classified according to KDIGO 2024 criteria: estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR).</div></div><div><h3>Results</h3><div>Among the 8,732 PDM analyzed, 32.3% had CKD-DM (95% <span>C</span>I: 31.3%-33.2%), and 6.9% met criteria for nephrology-range CKD-DM. The predominant phenotype was eGFR &lt;<!--> <!-->60<!--> <!-->mL/min/1.73 m² (14.2%), followed by the combined phenotype (9.2%) and isolated albuminuria (8.9%). Prevalence was higher in women and increased with age and diabetes duration. SGLT2 inhibitors were used in 48% of patients with CKD-DM, rising to 60% among the youngest group.</div></div><div><h3>Conclusion</h3><div>CKD-DM shows a high prevalence and phenotypic variability according to age, sex, and diabetes progression. This study highlights the need for personalized preventive and therapeutic strategies, as well as the crucial role that primary care must play in the early detection and management of CKD-DM.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102584"},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093212","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":"Obesidad y osteoartritis: más allá del peso, una sinergia inflamatoria que exige un cambio de paradigma","authors":"A. Alcántara Montero ,&nbsp;P.J. Ibor Vidal","doi":"10.1016/j.semerg.2025.102598","DOIUrl":"10.1016/j.semerg.2025.102598","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 7","pages":"Article 102598"},"PeriodicalIF":0.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082331","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":"¿Se debería hacer seguimiento a las gammapatías monoclonales de significado incierto de tamaño menor de 0,5 g/dl?","authors":"M.T. Carande del Río ,&nbsp;B. Sacristán Enciso ,&nbsp;J. López Gómez","doi":"10.1016/j.semerg.2025.102574","DOIUrl":"10.1016/j.semerg.2025.102574","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102574"},"PeriodicalIF":0.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018697","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":"Aceite y vida: el impacto del aceite de oliva en la salud humana. Revisión de la evidencia de la recomendación del uso del aceite de oliva virgen extra","authors":"J.M. Rubio López","doi":"10.1016/j.semerg.2025.102582","DOIUrl":"10.1016/j.semerg.2025.102582","url":null,"abstract":"<div><div>Extra virgin olive oil (EVOO) is a key functional food in the Mediterranean diet, renowned for its multiple health benefits. Rich in monounsaturated fatty acids, such as oleic acid, and bioactive compounds like polyphenols and tocopherols, EVOO helps reduce LDL cholesterol, increase HDL cholesterol, and protect against oxidative stress. Regular consumption is associated with a lower incidence of cardiovascular, metabolic, and neurodegenerative diseases. Studies such as PREDIMED and the Seven Countries Study have demonstrated its role in preventing cardiovascular events and reducing blood pressure. Additionally, EVOO contributes to cancer prevention, lowering the risk of specific types like breast and colon cancer. It also improves insulin sensitivity and intestinal microbiota health, promoting metabolic and cognitive balance. Recommended for its positive impact on health, EVOO should be a staple in a healthy daily diet, not only as a substitute for saturated fats but as an essential ingredient to enhance quality of life and prevent chronic diseases.</div><div>The information search period covers the years 2000 to April 2025, in accordance with the inclusion criteria defined for the studies. These criteria prioritize relevant and up-to-date publications, while allowing exceptions for earlier works of historical significance.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102582"},"PeriodicalIF":0.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018696","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":"[FibroScan® in Primary Care. Case report].","authors":"N Sánchez-Varela, T Danif-Ferreira, M Portela-Romero","doi":"10.1016/j.semerg.2025.102555","DOIUrl":"10.1016/j.semerg.2025.102555","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"102555"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800908","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":"Antivirales orales en Atención Primaria: cinco años después de la pandemia, ¿cuál es su lugar?","authors":"M. Linares Rufo","doi":"10.1016/j.semerg.2025.102587","DOIUrl":"10.1016/j.semerg.2025.102587","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102587"},"PeriodicalIF":0.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907551","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":"Desarrollo y retos de la teledermatología en España: un estudio de la práctica en atención primaria","authors":"P. Alguacil Martínez ,&nbsp;P. Saavedra Santana","doi":"10.1016/j.semerg.2025.102577","DOIUrl":"10.1016/j.semerg.2025.102577","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the use, problems, and satisfaction with teledermatology among Primary Care physicians in Spain, analyzing the delay in referrals to Dermatology and the differences between autonomous communities.</div></div><div><h3>Material and methods</h3><div>A cross-sectional study was conducted through a pilot survey of 102 Primary Care physicians, members of Spanish Society of Rural and General Medicine (SEMERGEN), from different Autonomous Communities. The survey, agreed upon by SEMERGEN and the Spanish Association of Dermatology and Venereology (AEDV), included open-ended and closed-ended questions and was distributed via newsletter and WhatsApp. Statistical analysis was performed using R version 4.2.1, summarizing categorical variables as frequencies/percentages and numerical variables as medians/interquartile ranges.</div></div><div><h3>Results</h3><div>39,2% of professionals use teledermatology in their daily practice, with asynchronous (store-and-forward, 49%) being the most prevalent, especially in rural areas and nursing homes. 68.6% of professionals rated their satisfaction with teledermatology at 7 or more out of 10. The main problems identified were lack of training (44.1%), delays of more than 60<!--> <!-->days in the in-person consultation (58.8%), and lack of coordination between Primary Care and Dermatology (41.8% in urban areas). Screening and prioritizing patients with suspected skin cancer (72.5%) and shared decision-making with the dermatologist (64.7%), as well as improved access in rural areas, which was significantly higher (48.6%; <em>P</em> <!-->&lt;<!--> <!-->.001), were the most frequently cited objectives. The most common barriers were image quality, the use of personal devices, and legal concerns about data protection.</div></div><div><h3>Conclusions</h3><div>Teledermatology is a well-established and valued tool in Primary Care, especially useful in rural areas and for the management of skin cancer. However, challenges remain, such as the need for ongoing training, improved image quality, and greater coordination between levels of care. Professional satisfaction is high, but the delay in in-person referrals and regional variability require organizational and collaborative interventions with the AEDV and regional health services. SEMERGEN and the AEDV should promote training strategies and legal/technical advice to optimize teledermatology in Spain.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102577"},"PeriodicalIF":0.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893547","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":"Pitiriasis rosada atípica. Más allá del árbol de Navidad","authors":"M. Rodriguez-Troncoso,&nbsp;I. Perez-Lopez,&nbsp;R. Ruiz-Villaverde","doi":"10.1016/j.semerg.2025.102576","DOIUrl":"10.1016/j.semerg.2025.102576","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 8","pages":"Article 102576"},"PeriodicalIF":0.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827613","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}