Medicina de Familia-SEMERGEN最新文献

{"title":"Dermatosis palmoplantares: aproximación diagnóstica en atención primaria","authors":"I. Alarcón ,&nbsp;J. Arellano","doi":"10.1016/j.semerg.2024.102285","DOIUrl":"10.1016/j.semerg.2024.102285","url":null,"abstract":"<div><p>This article addresses the diagnostic challenges of palmoplantar dermatoses (PPD) within the scope of Primary Health Care (PHC). These common skin conditions, encountered in daily practice, exhibit a diverse range of symptoms and morphologies, complicating their diagnosis. They are etiologically classified into infectious inflammatory, non-infectious inflammatory, and hereditary keratodermas. While various dermatoses may affect the palms and soles, few are specific to this area. Notable examples include palmoplantar pustulosis, dyshidrosis, erythema pernio, and Bazex syndrome. Given the high prevalence of dermatological consultations in PHC, this article underscores the significance of PHC professionals’ knowledge regarding these conditions. It proposes a diagnostic algorithm to facilitate their management and timely referral.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472567","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":"Valoración fisiológica y manejo de pacientes post-COVID con pruebas funcionales cardiopulmonares y de imagen normales","authors":"J. Montoliu Nebot ,&nbsp;A. Iradi Casal ,&nbsp;S. Cepeda Madrigal ,&nbsp;G. Rissi ,&nbsp;S. Sanz Saz ,&nbsp;J.D. Molés Gimeno ,&nbsp;L.M. Miravet Sorribes","doi":"10.1016/j.semerg.2024.102282","DOIUrl":"10.1016/j.semerg.2024.102282","url":null,"abstract":"<div><h3>Objective</h3><p>Contributing to elucidate the pathophysiology of dyspnoea and exertion intolerance in post-COVID syndrome patients with normal cardiopulmonary imaging and functional tests at rest, while determining their fitness and level of endurance in order to individualize working parameters for physical rehabilitation.</p></div><div><h3>Material and methods</h3><p>After an anamnesis and clinical examination at rest, 27 subjects (50<!--> <!-->±<!--> <!-->11.9 years) (14 women) with post-COVID syndrome of more than 6 months of evolution performed a continuous maximal-incremental graded cardiopulmonary exercise test (CPET) with breath-by-breath gas-exchange monitoring and continuous ECG registration, on an electromagnetically braked cycle ergometer. The values obtained were compared with those of reference, gender or controls, using the Chi-square, t-Student or ANOVA test.</p></div><div><h3>Results</h3><p>The clinical examination at rest and the CPET were clinically normal and without adverse events. Reasons for stopping exercise were leg discomfort. It is only worth noting a BMI<!--> <!-->=<!--> <!-->29.9<!--> <!-->±<!--> <!-->5.8<!--> <!-->kg/m² and a basal lactate concentration of 2.1<!--> <!-->±<!--> <!-->0.7<!--> <!-->mmol/L. The physiological assessment of endurance showed the following results relative to predicted VO_2máx: 1)<!--> <!-->peakVO₂ <!-->=<!--> <!-->80.5<!--> <!-->±<!--> <!-->18.6%; 2)<!--> <!-->VO₂ at ventilatory threshold<!--> <!-->1 (VO₂VT1): 46.0<!--> <!-->±<!--> <!-->12.9%; 3)<!--> <!-->VO₂VT2: 57.2<!--> <!-->±<!--> <!-->16.4%; 4)<!--> <!-->working time in acidosis: 5.6<!--> <!-->±<!--> <!-->3,0<!--> <!-->minutes; and 5)<!--> <!-->maximum lactate concentration: 5.1<!--> <!-->±<!--> <!-->2.2<!--> <!-->mmol/L.</p></div><div><h3>Conclusions</h3><p>The CPET identified limited aerobic metabolism and early increase in glycolytic metabolism as causes of dyspnoea and exercise intolerance, determined fitness for physical rehabilitation, and individualized it based on the level of endurance.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472569","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":"Profilaxis vacunal para prevenir infecciones respiratorias agudas en el entorno sanitario","authors":"M. López-Gobernado ,&nbsp;A. Pérez-Rubio ,&nbsp;D. Villalba Gil ,&nbsp;J. Hernández Bartolomé ,&nbsp;J.M. Eiros","doi":"10.1016/j.semerg.2024.102288","DOIUrl":"10.1016/j.semerg.2024.102288","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472572","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":"Modelo predictivo y análisis discriminante del desarrollo de demencia en pacientes con delirium en urgencias","authors":"P. Lupiáñez Seoane ,&nbsp;J.E. Muñoz Negro ,&nbsp;U. Torres Parejo ,&nbsp;F.J. Gómez Jiménez","doi":"10.1016/j.semerg.2024.102283","DOIUrl":"10.1016/j.semerg.2024.102283","url":null,"abstract":"<div><h3>Objective</h3><p>The main aim of our study is to know the sociodemographic, clinical, analytical, and functional variables that predict the probability of developing dementia in patients with delirium who attend the emergency room.</p></div><div><h3>Method</h3><p>All patients with delirium (n<!--> <!-->=<!--> <!-->45) from the emergency room who were admitted to the Geriatrics service of the General University Hospital of Ciudad Real (HGUCR) in 2016-2018 and met the inclusion and exclusion criteria were included. Subsequently, we ran a bivariate and multivariate analysis of the variables that predicted a diagnosis of dementia at six months and a discriminant analysis.</p></div><div><h3>Results</h3><p>15.6% of patients presented dementia at six months of follow-up, 22.2% had developed cognitive impairment. We conducted a multivariate model (R2 Nagelkerke 0.459) for the probability of developing dementia, with elevated heart rate being the most crucial variable (OR<!--> <!-->=<!--> <!-->11.5). The model could excluded dementia with 100% accuracy. Finally, we achieved a discriminant function capable of correctly classifying 95.6% of the cases. It included the following variables of influence: pH, Lawton Brody index, calcium, urea, and heart rate.</p></div><div><h3>Conclusions</h3><p>A few clinical and analytical variables that are easily detectable in the emergency room, especially tachycardia, could help us better identify those patients with delirium at higher risk of developing dementia, as well as formulate hypotheses about the variables involved in the development of dementia in patients with delirium.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472570","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":"Sexsomnia en atención primaria y su gestión: a propósito de un caso clínico","authors":"G.J. Teixeira ,&nbsp;R. Pedrosa ,&nbsp;J.M. Freitas ,&nbsp;M. Mozes","doi":"10.1016/j.semerg.2024.102286","DOIUrl":"10.1016/j.semerg.2024.102286","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472571","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":"Revisión narrativa de la terapia inhalatoria en la EPOC","authors":"M. Villar Martínez ,&nbsp;E. Calvo Manuel ,&nbsp;A.L. Aguilar-Shea","doi":"10.1016/j.semerg.2024.102284","DOIUrl":"10.1016/j.semerg.2024.102284","url":null,"abstract":"<div><p>The basis of COPD maintenance treatment is the long-acting bronchodilators and the inhaled corticosteroids. Faced with the recent modifications in the clinical practice guidelines, we have carried out a review of studies that contrast the various therapeutic alternatives and pharmacological agents within each category, with the fundamental purpose of shedding light on which of these options prove to be more effective.</p><p>Triple therapy stands out as essential in poorly controlled patients or with an eosinophilic phenotype, surpassing dual therapy. However, among the combinations of LAMA/LABA or LAMA/LABA/IC, no drug is observed to be superior in the reviewed evidence. Although triple therapies include corticosteroids, there does not appear to be a significant increase in side effects or pneumonia. Regarding monotherapy with LAMA, no significant differences are seen between the drugs, but in dual therapy with LABA/IC, the budesonide/formoterol combination seems to offer better control than fluticasone/salmeterol.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460618","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":"Ecoansiedad: impacto del cambio climático en la salud mental","authors":"M. Regalado Chamorro ,&nbsp;A. Medina Gamero","doi":"10.1016/j.semerg.2024.102279","DOIUrl":"10.1016/j.semerg.2024.102279","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460619","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":"Tirbanibulin ointment: A new effective and safe treatment of recalcitrant viral warts","authors":"M. Mansilla-Polo ,&nbsp;C. Abril-Pérez ,&nbsp;D. Martín-Torregrosa","doi":"10.1016/j.semerg.2024.102278","DOIUrl":"10.1016/j.semerg.2024.102278","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460621","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":"Síndrome de Hadju-Cheney. A propósito de un nuevo caso y revisión de la literatura","authors":"O. Villarreal ,&nbsp;A. Comerma Méndez ,&nbsp;E. Armengol Pérez ,&nbsp;X. González Giménez ,&nbsp;L. Farran Ortega","doi":"10.1016/j.semerg.2024.102287","DOIUrl":"10.1016/j.semerg.2024.102287","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460620","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":"Mantenimiento de la habilidad de las compresiones torácicas en reanimación cardiopulmonar en profesionales de la atención primaria de salud: estudio cuasiexperimental","authors":"S. Moreno Escribá ,&nbsp;M.A. Sarlat Ribas ,&nbsp;I. Herrera Solsona ,&nbsp;A. Sisó-Almirall ,&nbsp;L. González de Paz ,&nbsp;B. Coll-Vinent Puig","doi":"10.1016/j.semerg.2024.102277","DOIUrl":"https://doi.org/10.1016/j.semerg.2024.102277","url":null,"abstract":"<div><h3>Objective</h3><p>To validate the efficacy of brief CPR training with dual feedback to maintain the ability to perform quality chest compressions.</p></div><div><h3>Materials and methods</h3><p>Quasi-experimental study with two groups to evaluate a brief theoretical training followed by a practice with manikin with feedback; <em>Participants:</em> 155 health and non-health professionals from 5 primary care health centers of urban area (43 losses); <em>Main measurements:</em> Characteristics of compressions that were measured before and after the brief training and their maintenance at 3 and 6 months according to the study group. The effect of training and maintenance of skills were analyzed using multiple linear regression models.</p></div><div><h3>Results</h3><p>155 participants were included, mean age 39.7 years (SD<!--> <!-->=<!--> <!-->12.0) with 82.7% female. The training effect had an improvement in mean compression depth (pre-post difference: 3.5, <em>P</em>&lt;.001), total compressions with adequate depth (pre-post difference: 0.2, <em>P</em>&lt;.001) and Total Compressions with Adequate Rhythm (pre-post difference: 0.4, <em>P</em>&lt;.001). The second phase was completed by 112 participants (72.2%). Compression skills declined at 3 months and were lower at 6 months, although the loss of skills was not statistically significant between the two groups.</p></div><div><h3>Conclusions</h3><p>An individualized, brief training action with feedback immediately improves the quality of compressions. The progressive loss of skills from 3 to 6 months is not relevant.</p></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141438047","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}