Medicina de Familia-SEMERGEN最新文献

{"title":"El papel de la medicina de familia en el diagnóstico de enfermedades minoritarias: a propósito de un caso de neurofibromatosis tipo 1","authors":"D. López Chaves , D. Martín-Enguix , A. Cabrerizo Carvajal","doi":"10.1016/j.semerg.2025.102477","DOIUrl":"10.1016/j.semerg.2025.102477","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 3","pages":"Article 102477"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696955","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":"Abordaje multidisciplinar y grupal de adultos con dolor crónico no oncológico en un centro de atención primaria","authors":"L. Perelló,&nbsp;N. Riera,&nbsp;C. Riera,&nbsp;A.M. Márquez,&nbsp;A.L. Tomé,&nbsp;L. Río,&nbsp;A. Aguado","doi":"10.1016/j.semerg.2025.102475","DOIUrl":"10.1016/j.semerg.2025.102475","url":null,"abstract":"<div><div>Chronic non-oncological pain (CNOP) is a common cause of primary care consultation. It affects physical and mental health, and is frequently associated with disability. The usual treatments are pharmacological, while education and exercise strategies recommended by clinical guidelines are rarely used.</div></div><div><h3>Objective</h3><div>To evaluate a group intervention based on education, psychological intervention and physical exercise to manage CNOP and/or fibromyalgia.</div></div><div><h3>Materials and methods</h3><div>Pilot study, without control group, conducted in Primary Care. We evaluated three groups, with a total of 42 adults with CNOP and/or fibromyalgia. Intervention: neuroscience education (1 session), psycho-educative groups (5 sessions) and physical exercise (5 sessions). We measured the change in perceived pain with the visual analogue scale (VAS), quality of life with the SF-36 version 2 questionnaire and number of chronic analgesics used, and we analyzed the data with the paired sample Student's t test (statistical significance: p<!--> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>Perceived pain decreased on average by 0.59 (SD: 1.59) (p<!--> <!-->=<!--> <!-->0.057), the number of analgesics used by 0.32 (SD: 0.72) (p<!--> <!-->=<!--> <!-->0.008) and the SF-36 score increased 3.83 (SD: 8.89) (p<!--> <!-->=<!--> <!-->0.031). The dimensions of the SF-36 questionnaire that improved were bodily pain, with a mean variation of 7.25 (SD: 13.90) (p<!--> <!-->=<!--> <!-->0.01), social function 7.58 (SD: 16.43) (p<!--> <!-->=<!--> <!-->0.021), mental health 9.46 (16.57) (p<!--> <!-->=<!--> <!-->0.005) and vitality 7.59 (SD: 18.66) (p<!--> <!-->=<!--> <!-->0.041).</div></div><div><h3>Conclusions</h3><div>A group intervention with active strategies based on neurosciences education, psychological intervention, and physical exercise was useful to reduce pain and chronical use of analgesics and improve the quality of life of patients with CNOP.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 5","pages":"Article 102475"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680254","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":"Consenso de expertos sobre la organización de la asistencia al tabaquismo en España","authors":"C. Rábade-Castedo ,&nbsp;G. Estrada Riolobos ,&nbsp;S. Cebrián ,&nbsp;J.L. Díaz-Maroto ,&nbsp;L. Gaztelurrutia Lavesa ,&nbsp;M. González-Béjar ,&nbsp;C.A. Jiménez-Ruiz ,&nbsp;J.A. Riesco-Miranda ,&nbsp;R. de Simón-Gutiérrez","doi":"10.1016/j.semerg.2025.102484","DOIUrl":"10.1016/j.semerg.2025.102484","url":null,"abstract":"<div><h3>Objective</h3><div>To generate a cost-effective healthcare model for the management of smoking in Spain.</div></div><div><h3>Material and methods</h3><div>This was a qualitative study based on nominal group methodology and a literature review. Nine tobacco experts (3 pulmonologists, 3 primary care physicians, and 3 community pharmacists) analysed the current smoking care context and available evidence on interventions. Based on this information, they generated a healthcare model for the management of smoking.</div></div><div><h3>Results</h3><div>A total of 11 general principles were agreed upon, including, for example, the recognition of smoking as a chronic disease, the need for a comprehensive, coordinated approach adjusted to the characteristics and needs of the smokers, or the training of health care professionals on smoking cessation. Two proposed levels of smoking care were established and described (characteristics, competencies, resources, etc.); one is non-specialized (primary care, hospital care and community pharmacy) and another is specialized (smoking units). The objective of the non-specialized level is to identify the smoker, establish the diagnosis, evaluate the patients, and provide at least a brief intervention. The non-specialized level provides highly specialized comprehensive assistance to smokers with special characteristics. The document summarizes the evidence of the main interventions on smoking and has recommendations and care algorithms (actions in the patients’ first and subsequent visits and referral criteria).</div></div><div><h3>Conclusions</h3><div>Smoking in Spain requires a comprehensive, structured, interdisciplinary, coordinated, and efficient approach adapted to the characteristics and needs of the smokers.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 7","pages":"Article 102484"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697356","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":"Seguimiento proactivo por los equipos de Atención Primaria en los pacientes con necesidades paliativas en domicilio: ¿puede condicionar el lugar de fallecimiento?","authors":"C. Angulo García ,&nbsp;T. Díaz Canales ,&nbsp;L. Masiá Borrell ,&nbsp;M. Merlo Loranca ,&nbsp;A. Rodríguez Laso","doi":"10.1016/j.semerg.2025.102476","DOIUrl":"10.1016/j.semerg.2025.102476","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether proactive follow-up by Primary Care teams for patients attended by Home Palliative Care Support Teams influences the place of death for patients with advanced chronic illness. Additionally, to examine whether this association is affected by the patient's complexity.</div></div><div><h3>Material and methods</h3><div>An analytical, observational, retrospective cohort study was conducted involving 422 patients attended by a home palliative care support team in Madrid in 2023. Variables included sociodemographic and clinical data, resource consumption, and preferences regarding the place of death. Bivariate and multivariate logistic regressions were used to identify factors associated with the place of death (home or outside: hospital or palliative care unit).</div></div><div><h3>Results</h3><div>While 63% of patients expressed a preference to die at home, only 32.7% did so. Personal and family preferences emerged as the most decisive factors determining the place of death. Proactive follow-up was associated with a lower likelihood of dying at home after adjusting for family preferences, patient complexity, and functionality (Odds ratio: 0.26; 95% confidence interval: 0.11-0.59). Patients with non-oncological conditions and low scores in functionality indices were more likely to die at home.</div></div><div><h3>Conclusions</h3><div>Joint follow-up between Primary Care and home palliative care support team increases the probability of dying outside the home, contrary to what is reported in the literature. However, this association may reflect the inability to provide adequate home care rather than being the cause of the place of death.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102476"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682495","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":"Influencia de la asignatura Medicina Familiar y Comunitaria del grado de Medicina en la elección de la especialidad","authors":"J.A. Divisón Garrote ,&nbsp;A. Castillo Sandoval ,&nbsp;J.A. Carbayo Herencia ,&nbsp;M. Simarro Rueda ,&nbsp;E. Carrasco Carrasco ,&nbsp;M. Guillén Pérez ,&nbsp;A. Muros Ortega","doi":"10.1016/j.semerg.2025.102473","DOIUrl":"10.1016/j.semerg.2025.102473","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;The presence of the subject of Family and Community Medicine (FCM) is important in the medical degree and should be taught by family doctors. The aim of the study was to assess whether its inclusion as a discipline in the degree influences students and graduates in their choice of specialty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;Descriptive, observational and analytical study of surveys carried out on 422 students of the FCM subject who studied during the 2017-18 to 2023-24 academic years at the Faculty of Medicine of the Catholic University of Murcia and on 96 graduates of this university who, in the process of choosing a specialty, opted for FCM. In a first phase, the students of each course completed 2 surveys, one on the first day of class and another on the last, both in person. In each survey, 5 questions were asked on a 10-point Likert scale and one multiple-choice question. In the final survey, 4 questions were added, also on a 10-point Likert scale. In the second phase, a seven-question survey with dichotomous answers was sent electronically to the graduates in May 2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;74% of the students were women, mean age 23.2 years SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1.6. 290 (68.7%) answered the initial survey and 352 (83.4%) the final one. Most of them thought that FCM is important for the National Health System (NHS) and that it is not well valued by either the NHS or the patients. When asked if they considered the subject important in the degree, 75% of them gave it a score &gt;&lt;!--&gt; &lt;!--&gt;9. The percentage of students who considered FCM as a future option with an average score &gt;&lt;!--&gt; &lt;!--&gt;7 was 42% and after taking the subject this percentage increased to 57% (mean score at the beginning 5,9 SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1,6 and at the end 7,7 SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.6, p&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Regarding the academic and teaching staff evaluation, the average score was: interesting subject 7.9 SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1.8 (44%&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;9), useful subject 8.57 SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1.6 (61%&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;9) and different approach 7.6 SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2 (78.2%&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;7). The average evaluation of the teaching staff was &gt;&lt;!--&gt; &lt;!--&gt;9.&lt;/div&gt;&lt;div&gt;74.2% of the graduates were women, average age 28.4 years SD&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.8. 62 (64%) answered the survey; 66.1% did not know the specialty well before teaching the subject. For 51.6% of them, the subject changed their perception of the specialty, for 48.4% it made them consider the specialty as a future option and for 33.9% it influenced their choice of specialty. 91.9% chose the specialty by their own decision. Almost all of the graduates stated that the subject should be in the medical degree.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The fact that the subject is taught by family doctors and the quality of teaching has positively influenced the choice of medi","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 4","pages":"Article 102473"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681551","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":"Effect of triple inhaled therapy on cardiovascular and all-cause mortality compared with dual inhaled therapy in COPD: A systematic review and meta-analysis","authors":"A. Calderón-Montero ,&nbsp;M. García Fernández ,&nbsp;M.E. García-Velasco ,&nbsp;M. Joshi ,&nbsp;K. Khan ,&nbsp;C. Calderón-Ferrer ,&nbsp;M. Núñez-Núñez","doi":"10.1016/j.semerg.2025.102478","DOIUrl":"10.1016/j.semerg.2025.102478","url":null,"abstract":"<div><h3>Background</h3><div>There is uncertainty about the role of triple inhaled therapy with LAMA/LABA/ICS (long-acting muscarinic antagonist/long-acting β2-agonist/inhaled glucocorticoids) in chronic obstructive pulmonary disease (COPD) on cardiovascular mortality. We estimated the effect of triple inhaled therapy (TT) compared with dual inhaled therapy (DT, including either LAMA/LABA or LABA/ICS) on all-cause and cardiovascular mortality in an evidence synthesis,</div></div><div><h3>Methods</h3><div>Following prospective registration (<span><span>https://osf.io/gtfvm</span><svg><path></path></svg></span>), a comprehensive search strategy of PubMed, Scopus, and Embase was performed, without language or time restrictions until September 30, 2024. All randomized clinical trials (RCTs) evaluating TT vs. DT and reporting cardiovascular or all-cause mortality were included. We assessed risk of bias and conducted a random effect meta-analysis estimating summary relative risk (RR) with 95% confidence intervals (CI), evaluating heterogeneity using <em>I</em>². A network meta-analysis (NMA) was undertaken to hierarchically rank the therapies using P-score.</div></div><div><h3>Results</h3><div>From 781 citations, 5 RCTs were selected. There were 3 three-arm RCTs comparing TT vs. LABA/ICS vs. LAMA/LABA, 1 two-arm RCT comparing TT vs. LABA/ICS, and 1 two-arm RCT comparing TT vs. LAMA/LABA (total of 7855 patients receiving TT, 7003 LABA/ICS and 5059 LAMA/LABA). The risk of bias was moderate in 2 (40%), and low in 3 (60%) RCTs. TT reduced cardiovascular mortality by 48% vs. LAMA/LABA (RR 0.52, 95% CI 0.32–0.86, 3 RCTs, <em>I</em>² <!-->=<!--> <!-->0%) and by a non-significant 11% vs. LABA/ICS (RR 0.89, 95% CI 0.57–1.37, 3 RCTs, <em>I</em>² <!-->=<!--> <!-->0%). TT reduced all-cause mortality by 34% vs. LAMA/LABA (RR 0.66, 95% CI 0.48–0.90, 4 RCTs, <em>I</em>² <!-->=<!--> <!-->23.7%) and by 10% vs. LABA/ICS (RR 0.90, 95% CI 0.71–1.13, 4 RCTs, <em>I</em>² <!-->=<!--> <!-->0%). For both cardiovascular and all-cause mortality, NMA P-score showed that TT ranked first (81%/91%), LABA/ICS ranked second (58%/57%) and LAMA/LABA ranked last (11%/&lt;1%) in effectiveness.</div></div><div><h3>Conclusions</h3><div>In patients with moderate to very severe COPD and previous exacerbations, TT inhaled significantly reduces cardiovascular and all-cause mortality compared to LAMA/LABA dual therapy, but not when compared to LABA/ICS.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 5","pages":"Article 102478"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696870","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":"Multiple eruptive xanthomas","authors":"M. Mansilla-Polo ,&nbsp;S. Becerril-Andrés ,&nbsp;I. Torres-Navarro","doi":"10.1016/j.semerg.2025.102479","DOIUrl":"10.1016/j.semerg.2025.102479","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 7","pages":"Article 102479"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697357","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":"Escorbuto: cómo sospechar una enfermedad olvidada","authors":"C. Ferrín Castro ,&nbsp;A. Martínez Baladrón ,&nbsp;C. Fernández Domato","doi":"10.1016/j.semerg.2025.102474","DOIUrl":"10.1016/j.semerg.2025.102474","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 7","pages":"Article 102474"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687243","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":"El papel indispensable de la atención primaria rural: una llamada a la acción","authors":"A. González Cabrera","doi":"10.1016/j.semerg.2025.102480","DOIUrl":"10.1016/j.semerg.2025.102480","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 5","pages":"Article 102480"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696869","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":"Estrategia de formación para una sociedad científica de médicos de familia: «Un enfoque integral hacia la excelencia»","authors":"V. Pallarés-Carratalá ,&nbsp;C. Cols-Sagarra ,&nbsp;L. Martínez-Berganza Asensio ,&nbsp;A. Segura-Grau ,&nbsp;J. Ibañez ,&nbsp;M. Matosas-Fonolleda ,&nbsp;J. Cohen ,&nbsp;R.M. Micó-Pérez ,&nbsp;J. Polo-García ,&nbsp;en nombre del grupo de trabajo de la Agencia de Formación de SEMERGEN","doi":"10.1016/j.semerg.2025.102481","DOIUrl":"10.1016/j.semerg.2025.102481","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>This work analyzes the importance of a comprehensive training strategy from a scientific society of primary care physicians for continuing medical education. A strategy called “an integral approach towards excellence” is proposed, encompassing various key aspects.</div></div><div><h3>Methods</h3><div>The methodology employed includes a diagnostic phase, based on individual interviews and a survey, and a strategy design phase. The diagnosis focused on 6 dimensions: competencies, knowledge, methodology, satisfaction, evaluation, and organization.</div></div><div><h3>Results</h3><div>As a result, 8 strategic lines were articulated, ranging from positioning the society as a reference to the internationalization of training. The strategy emphasizes the importance of adapting training to the specific needs of physicians, promoting research and innovation, and addressing current challenges such as the incorporation of artificial intelligence in medical practice.</div></div><div><h3>Conclusion</h3><div>An effective training strategy from a scientific society should include competency-based continuing education programs and collaboration with academic and technological institutions, in order to respond to current and future challenges in medicine.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 4","pages":"Article 102481"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696142","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}