{"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}
V. Pallarés-Carratalá , C. Cols-Sagarra , L. Martínez-Berganza Asensio , A. Segura-Grau , J. Ibañez , M. Matosas-Fonolleda , J. Cohen , R.M. Micó-Pérez , J. Polo-García , en nombre del grupo de trabajo de la Agencia de Formación de SEMERGEN
{"title":"Estrategia de formación para una sociedad científica de médicos de familia: «Un enfoque integral hacia la excelencia»","authors":"V. Pallarés-Carratalá , C. Cols-Sagarra , L. Martínez-Berganza Asensio , A. Segura-Grau , J. Ibañez , M. Matosas-Fonolleda , J. Cohen , R.M. Micó-Pérez , J. Polo-García , 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}
I. de Frutos-Galindo , D. Catalina-Palomares , P. Yubero-García , L. Botella-Juan , D. Vargas-Caraballo-Lockwood , A. Marcos-Delgado , T. Fernández-Villa
{"title":"Effects of sleep on sarcopenia in individuals with metabolic syndrome: A systematic review","authors":"I. de Frutos-Galindo , D. Catalina-Palomares , P. Yubero-García , L. Botella-Juan , D. Vargas-Caraballo-Lockwood , A. Marcos-Delgado , T. Fernández-Villa","doi":"10.1016/j.semerg.2025.102483","DOIUrl":"10.1016/j.semerg.2025.102483","url":null,"abstract":"<div><div>Sarcopenia and metabolic syndrome are present in a large percentage of the elderly population throughout the world. Much of its management is focused on primary prevention, and considering that sleep disturbances also accompany the same aging process associated with these two pathologies, we propose a relationship between sleep impairment and the development of sarcopenia in individuals with metabolic syndrome. A search was carried out in databases following he PRISMA scheme, obtaining fifteen studies. As for the main results: four of eight studies referring to sleep duration relate more than nine hours of sleep with an increased risk of sarcopenia, three of the five studies relate poorer sleep quality with worse body composition data or increased risk of sarcopenia and two studies related late chronotype with a higher risk of sarcopenia and metabolic syndrome. After analyzing the disparity of outcomes, it is necessary to homogenize methodologies to compare the different results.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 4","pages":"Article 102483"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696143","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}
S. Cinza-Sanjurjo , V. Pallarés-Carratalá , A. Díaz Rodríguez , D. Fierro-González , M. Turégano-Yedro , J. Polo-García
{"title":"Aproximación práctica del paciente con hipercolesterolemia en España. Documento de posicionamiento de SEMERGEN","authors":"S. Cinza-Sanjurjo , V. Pallarés-Carratalá , A. Díaz Rodríguez , D. Fierro-González , M. Turégano-Yedro , J. Polo-García","doi":"10.1016/j.semerg.2025.102460","DOIUrl":"10.1016/j.semerg.2025.102460","url":null,"abstract":"<div><div>Hypercholesterolemia, specifically the increase in the set of lipoproteins containing apolipoprotein<!--> <!-->B and, in particular, low-density lipoprotein cholesterol (LDL-C), together with the decrease in high-density lipoprotein cholesterol (HDL-C) constitute the etiopathogenic basis of atherosclerotic vascular disease. Multiple clinical trials have shown that lowering LDL-C by lipid-lowering therapy is associated with a significant decrease in the risk of vascular complications. Thus, LDL-C is the main therapeutic target in patients with dyslipidemia. Unfortunately, current LDL-C control figures are still very low, partly due to insufficient intensification of lipid-lowering therapy, but also due to the need for new tools to achieve these goals. This paper reviews the different lipid-lowering treatment options, including the latest available therapies, and provides a practical approach to achieving LDL-C control goals in patients with hypercholesterolemia, as well as in different patient subgroups.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 4","pages":"Article 102460"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680931","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}
H.R. Vargas-Sánchez , J.C. Tomás-López , E. Guzmán-Medina , A. Alarcón-López , E. Krug-Llamas , E. Arizmendi-Uribe , H. Domínguez-Zárate , J.E. Fernández-Gárate , I.J. Ascencio-Montiel
{"title":"Nirmatrelvir/ritonavir prescription and the risk of hospitalization and death in COVID-19 outpatients","authors":"H.R. Vargas-Sánchez , J.C. Tomás-López , E. Guzmán-Medina , A. Alarcón-López , E. Krug-Llamas , E. Arizmendi-Uribe , H. Domínguez-Zárate , J.E. Fernández-Gárate , I.J. Ascencio-Montiel","doi":"10.1016/j.semerg.2025.102461","DOIUrl":"10.1016/j.semerg.2025.102461","url":null,"abstract":"<div><h3>Objective</h3><div>The nirmatrelvir/ritonavir is an oral combination of antiviral drugs used to treat the COVID-19. In this study we evaluated the risk of hospitalization and death, comparing COVID-19 patients who received and did not receive ambulatory nirmatrelvir/ritonavir prescription.</div></div><div><h3>Material and methods</h3><div>A two-group comparative study was carried out using data from the Mexican Institute of Social Security medical information systems. We analyzed of 83,348 ambulatory patients aged 18 years old and over and with laboratory confirmed SARS-CoV-2 infection during the period from September 12th, 2022, to September 30th, 2023. Of them, 27,437 received nirmatrelvir/ritonavir prescription (32.9%) and 55,911 did not (67.1%). We compared the 60-day COVID-19 related hospitalization and all-cause death risk among groups using a multivariate Poisson regression model.</div></div><div><h3>Results</h3><div>The 60-day COVID-19 related hospitalization and all-cause death combined incidence was 0.13% in the patients who received nirmatrelvir/ritonavir and 0.26% among the cases who did not receive the prescription. In the multivariate model, after adjusting for age, sex, and previous medical conditions such as chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease, the nirmatrelvir/ritonavir prescription was associated with a decrease in 60-day hospitalization and death, with an adjusted risk ratio of 0.52 (95% confidence interval from 0.36 to 0.75).</div></div><div><h3>Conclusions</h3><div>Our data supports that nirmatrelvir/ritonavir prescription is associated with a risk reduction of 60-day COVID-19 related hospitalization and death, in outpatients with COVID-19.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102461"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696956","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":"Una mirada optimista hacia el presente futurista: la IA al servicio de la Atención Primaria","authors":"Albert Bellvert Rios","doi":"10.1016/j.semerg.2025.102450","DOIUrl":"10.1016/j.semerg.2025.102450","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102450"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509203","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}
R. García Risco, P. Buck Espel, A. Arnaiz Camacho, P. García Valentín, M.A. Zapata Victori
{"title":"Conjuntivitis hemorrágica aguda como manifestación ocular en un caso de infección por sarampión pese a vacunación adecuada","authors":"R. García Risco, P. Buck Espel, A. Arnaiz Camacho, P. García Valentín, M.A. Zapata Victori","doi":"10.1016/j.semerg.2025.102472","DOIUrl":"10.1016/j.semerg.2025.102472","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102472"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519612","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}
I. Iniesta Hernández , H. Madrona Rodríguez , O. Redondo González , M. Torralba González de Suso
{"title":"Modelo de predicción clínica validado para mortalidad por COVID-19 en pacientes hospitalizados. ¿Qué es lo verdaderamente importante?","authors":"I. Iniesta Hernández , H. Madrona Rodríguez , O. Redondo González , M. Torralba González de Suso","doi":"10.1016/j.semerg.2025.102471","DOIUrl":"10.1016/j.semerg.2025.102471","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and validate a clinical prediction model aimed at improving resource management and determining the prognosis of patients hospitalized with COVID-19.</div></div><div><h3>Materials and methods</h3><div>A retrospective, single-center cohort study conducted at the University Hospital of Guadalajara, including 1,043 patients hospitalized with COVID-19 between March and May 2020. Data were extracted from hospital records and anonymized. Demographic, clinical, laboratory, radiological, and therapeutic variables were collected, and statistical analysis was performed to identify factors associated with mortality. Logistic regression and Cox models were employed to evaluate mortality predictors. Validation was conducted by comparing ROC curves.</div></div><div><h3>Results</h3><div>The median age of the patients was 70.4<!--> <!-->years (P25-P75: 59-84), with 59.2% being male, and a mortality rate of 23.2%. The most common comorbidities were hypertension (54.8%), dyslipidemia (36.3%), and diabetes (27.1%). Independent predictors of mortality included age over 80<!--> <!-->years (OR: 6.18), chronic obstructive pulmonary disease (OR: 2.35), oxygen saturation <<!--> <!-->90% (OR: 1.7), multilobar pneumonia (OR: 2.4), and elevated LDH levels (OR: 1.2). The area under the curve (AUC) for the derivation model was 0.805 (<em>P</em> <!--><<!--> <!-->.001), and for the validation model, the AUC was 0.78 (<em>P</em> <!--><<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>Advanced age, chronic obstructive pulmonary disease, low oxygen saturation, multilobar pneumonia, and elevated LDH levels are significantly associated with increased mortality risk. The validated predictive model enables classification of patients into high- or low-risk groups, thereby facilitating improved clinical decision-making and resource management.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 2","pages":"Article 102471"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519611","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}
V.M. González-Rodríguez , M.J. Hernández-Arroyo , C. Rodríguez-Barrueco , S. Corredera-Blanco , M. Romero-Sanabria , A. García-Ortiz
{"title":"Efectividad y seguridad de nirmatrelvir + ritonavir en la Covid-19. Estudio NiRCoV","authors":"V.M. González-Rodríguez , M.J. Hernández-Arroyo , C. Rodríguez-Barrueco , S. Corredera-Blanco , M. Romero-Sanabria , A. García-Ortiz","doi":"10.1016/j.semerg.2025.102462","DOIUrl":"10.1016/j.semerg.2025.102462","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the effectiveness and potential safety concerns of Nirmatrelvir + ritonavir (NMV-r) (Paxlovid®) in adults with mild-moderate COVID-19 disease at high risk of progression.</div></div><div><h3>Design</h3><div>Descriptive cross-sectional observational study.</div></div><div><h3>Setting</h3><div>Castilla y León, Spain.</div></div><div><h3>Participants</h3><div>134 patients ≥18 years old with COVID-19 at high risk of progression to severe disease, who were treated between June and September 2022 with NMV-r.</div></div><div><h3>Main measurements</h3><div>The most relevant drug interactions with concomitant medication were obtained from pharmaceutical validation records. From the monitoring of hospital admissions and deaths in the 28 days following the start of treatment, information regarding the effectiveness of the treatment was obtained.</div></div><div><h3>Results</h3><div>57.5% were women, the average age<!--> <!-->±<!--> <!-->SD was 69.7<!--> <!-->±<!--> <!-->17.1, 68.0% received NMV-r in the first two days of the start of symptoms, 74.6% were at home, and 95.7% were vaccinated. The main risk condition for disease progression was being immunocompromised (74.5%), followed by being >65 years old, vaccinated, but with risk factors (21.2%). A total of 62.9% had relevant interactions, with an average<!--> <!-->±<!--> <!-->SD of 1.7<!--> <!-->±<!--> <!-->1.0 per patient. 2.2% required hospital admission and 3.0% died.</div></div><div><h3>Conclusions</h3><div>NMV-r has been effective in preventing severe forms of COVID-19 and hospital admissions in at-risk populations with a high vaccination rate. The prevalence of potential interactions is high, however, collaboration between family physicians and pharmacists allows NMV-r to be used safely.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102462"},"PeriodicalIF":0.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474060","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}