Medicina de Familia-SEMERGEN最新文献_第9页

Mujer con hiperamilasemia, prurito y eccema generalizado 患有高血友病、瘙痒和广泛性湿疹的妇女

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-03-01 DOI: 10.1016/j.semerg.2025.102456

S. Labrador-Descalzo , S. Cué Herreria , M. Valle-Coca

引用次数: 0

Modelo de predicción clínica validado para mortalidad por COVID-19 en pacientes hospitalizados. ¿Qué es lo verdaderamente importante? 住院患者COVID-19死亡率的有效临床预测模型。真正重要的是什么？

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-03-01 DOI: 10.1016/j.semerg.2025.102471

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 70.4years (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 80years (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).</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}

引用次数: 0

Efectividad y seguridad de nirmatrelvir + ritonavir en la Covid-19. Estudio NiRCoV nirmatrelvir +利托那韦在COVID -19中的有效性和安全性。研究NiRCoV

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-24 DOI: 10.1016/j.semerg.2025.102462

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}

引用次数: 0

Dificultades percibidas en atención primaria en el abordaje de los cuidados paliativos 初级保健在姑息治疗方面的困难

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-11 DOI: 10.1016/j.semerg.2025.102457

P. Dopico , C. Cervera , P. Ramallal , A. Balayo , P. Gil , L. Arce , L. Arias-Fernández

{"title":"Dificultades percibidas en atención primaria en el abordaje de los cuidados paliativos","authors":"P. Dopico , C. Cervera , P. Ramallal , A. Balayo , P. Gil , L. Arce , L. Arias-Fernández","doi":"10.1016/j.semerg.2025.102457","DOIUrl":"10.1016/j.semerg.2025.102457","url":null,"abstract":"<div><h3>Objective</h3><div>Describe the difficulties perceived by Primary Care health professionals in approaching Palliative Care and their association with sociodemographic and work characteristics.</div></div><div><h3>Materials and methods</h3><div>Cross-sectional study was conducted over a sample of 224 primary care workers (doctors and nurses). Perceived difficulties were assessed by means of Palliative Care Difficulties Scale (PCDS), a validated scale that includes five items: team communication, patient and family communication, Palliative Care team support, relief of symptoms and coordination with the community. Sociodemographic and employment characteristics were collected with self-administered questionnaires. To explore the differences in PCDS scale scores according to socio-occupational characteristics, Student's T-test was performed.</div></div><div><h3>Results</h3><div>Perceived difficulty was moderate (mean score [standard deviation]: 41.7 [8.61]). Specifically, communication with the team, symptom relief and coordination between care levels reported greater perceived difficulty (8.10 [2.46]; 9.90 [2.67] and 10.1 [2.71], respectively). Being over 40years old, a nursing degree, work experience <15years and poor perception of the approach and knowledge of Palliative Care were associated with greater perceived difficulty (<em>P</em>  <!-->.05). 79% of the participants expressed a need for training in Palliative Care.</div></div><div><h3>Conclusions</h3><div>Primary Care professionals have moderate difficulty in approaching Palliative Care, especially in communication between the team, symptom relief, and coordination in the community.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102457"},"PeriodicalIF":0.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386443","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}

引用次数: 0

Indicadores bioquímicos y cardiovasculares asociados a la fuerza prensil manual en niños y adolescentes. Una revisión de alcance 与儿童和青少年手前力相关的生化和心血管指标。范围审查

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-11 DOI: 10.1016/j.semerg.2025.102459

J. Martínez-Torres , J.A. Gallo-Villegas , D.C. Aguirre-Acevedo

{"title":"Indicadores bioquímicos y cardiovasculares asociados a la fuerza prensil manual en niños y adolescentes. Una revisión de alcance","authors":"J. Martínez-Torres , J.A. Gallo-Villegas , D.C. Aguirre-Acevedo","doi":"10.1016/j.semerg.2025.102459","DOIUrl":"10.1016/j.semerg.2025.102459","url":null,"abstract":"<div><div>Handgrip strength is an indicator of the biological health of children and adolescents. The review's objective is to identify the biochemical and cardiovascular indicators related to handgrip strength. A scoping review was developed, in which the search was conducted in Medline, Web of Science, Science Direct, Scielo, and Sportdiscus from EBSCO. Original research was included if it involved handgrip strength and biochemical or cardiovascular indicators. In the initial search, 15,198 records were identified in databases. 31 studies were selected for this review. These reports identified 36 indicators (29 biochemical and 7 cardiovascular) that had been analyzed for their association with hand grip strength. Blood pressure (n=10; 32.3%) and homeostatic model assessment for insulin resistance (n=7; 22.5%) were the most frequently studied characteristics. In the biochemical indicators, a pattern was found in which handgrip strength had a proportional relationship with HDL levels and an inversely proportional relationship with various cardiometabolic scores. No relationship patterns were found in the cardiovascular indicators.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 4","pages":"Article 102459"},"PeriodicalIF":0.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379152","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}

引用次数: 0

Análisis de características demográficas, de salud y adherencia a la dieta mediterránea en mujeres embarazadas. Cuestionario MEDAS 分析孕妇的人口特征、健康和地中海饮食坚持。单给我

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-08 DOI: 10.1016/j.semerg.2025.102454

B. López Villalba , B. Marcos Puig , A. García Belinchón , M. Morales-Suarez-Varela

{"title":"Análisis de características demográficas, de salud y adherencia a la dieta mediterránea en mujeres embarazadas. Cuestionario MEDAS","authors":"B. López Villalba , B. Marcos Puig , A. García Belinchón , M. Morales-Suarez-Varela","doi":"10.1016/j.semerg.2025.102454","DOIUrl":"10.1016/j.semerg.2025.102454","url":null,"abstract":"<div><h3>Objective</h3><div>To identify differences in adherence to the Mediterranean diet and to evaluate the influence of sociodemographic, lifestyle and clinical characteristics associated with the presentation of pathologies during pregnancy.</div></div><div><h3>Material and methods</h3><div>Nested case-control study carried out at the Hospital Universitario y Politécnico La Fe of Valencia with women admitted to the obstetrics ward who had given birth between 10/06/2024 and 25/07/2024. The instruments used included sociodemographic and lifestyle questionnaires, the MEDAS questionnaire and the electronic medical record.</div></div><div><h3>Results</h3><div>101 women with a mean age of 32 years participated. Adherence to the MEDAS questionnaire was good in 81.2%, medium in 12.9% and low in 5.9%. Women with good adherence had a higher mean age, a predominance of European origin, a lower BMI at the end of pregnancy, a higher educational level, and a higher intake of folic acid and iron supplements. Regarding pregnancy and delivery characteristics, the presence of glucose problems was more common in women with other pathology, but the biochemical parameters analyzed did not show a robust association with the presence of pathology during pregnancy. Finally, the characteristics of the newborn showed no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>The implementation of nutritional strategies aimed at increasing adherence to the Mediterranean diet could have a positive impact on the health of pregnant women, especially in relation to the consumption of essential supplements.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 5","pages":"Article 102454"},"PeriodicalIF":0.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349619","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}

引用次数: 0

Asociación entre las variables sociodemográficas, los hábitos saludables y el estrés con síndrome metabólico: un estudio descriptivo y transversal 社会人口变量、健康习惯和压力与代谢综合征之间的关联：一项描述性和横断面研究

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-08 DOI: 10.1016/j.semerg.2025.102455

Á.A. López-González , E. Martínez-Almoyna Rifá , H. Paublini Oliveira , C. Martorell Sánchez , P.J. Tárraga López , J.I. Ramírez-Manent

{"title":"Asociación entre las variables sociodemográficas, los hábitos saludables y el estrés con síndrome metabólico: un estudio descriptivo y transversal","authors":"Á.A. López-González , E. Martínez-Almoyna Rifá , H. Paublini Oliveira , C. Martorell Sánchez , P.J. Tárraga López , J.I. Ramírez-Manent","doi":"10.1016/j.semerg.2025.102455","DOIUrl":"10.1016/j.semerg.2025.102455","url":null,"abstract":"<div><h3>Introduction</h3><div>Metabolic syndrome (MS) is a pathological condition that encompasses various cardiometabolic risk factors, such as obesity, dyslipidemia, hyperglycemia, and elevated blood pressure levels. It is considered a multifactorial pathological condition. The aim of this study is to assess how variables such as age, sex, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress are associated with the prevalence of MS, determined using two different criteria.</div></div><div><h3>Materials and Methods</h3><div>This is a descriptive, cross-sectional study conducted on 24,224 Spanish workers, evaluating the association between sociodemographic variables, health habits, and stress with MS, determined using two criteria: the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP-III), and the International Diabetes Federation (IDF).</div></div><div><h3>Results</h3><div>All the variables analyzed showed an association with the presence of MS when applying both criteria. Among them, the variables with the strongest association were age: odds ratio 5.55 (95% CI: 4.80-6.30) for MS using the NCEP ATP-III criteria and 6.71 (95% CI: 5.30-8.13) for IDF criteria; and type of job: odds ratio 3.42 (95% CI: 2.95-3.90) for NCEP ATP-III and 3.57 (95% CI: 3.12-4.03) for IDF.</div></div><div><h3>Conclusions</h3><div>The profile of an individual at higher risk of developing MS under both criteria would be an older male, manual laborer, smoker, habitual alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high levels of stress.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102455"},"PeriodicalIF":0.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348640","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}

引用次数: 0

El valor estratégico de la medicina rural: Declaración de Úbeda 农村医疗的战略价值：Ubeda宣言

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-08 DOI: 10.1016/j.semerg.2025.102453

J.G. Garcia Ballesteros , A. Barquilla García , R.M. Micó-Pérez , M. Jiménez de la Cruz , M.A. Prieto Díaz , M.J. Cruz Rodríguez , I. Araujo Ramos , C. Manzanares Arnaiz

引用次数: 0

Estado de malnutrición como factor pronóstico de eventos cardiovasculares adversos mayores (MACE) en los pacientes con fibrilación auricular 营养不良状况作为耳纤颤患者主要不良心血管事件的预测因素

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-07 DOI: 10.1016/j.semerg.2025.102458

P. Moltó-Balado , J.L. Clua-Espuny , S. Reverté-Villarroya , M.T. Balado-Albiol , M. García-Olcina , A. Simeó-Monzó , A. Serra-Garcia , J. Canela-Royo

{"title":"Estado de malnutrición como factor pronóstico de eventos cardiovasculares adversos mayores (MACE) en los pacientes con fibrilación auricular","authors":"P. Moltó-Balado , J.L. Clua-Espuny , S. Reverté-Villarroya , M.T. Balado-Albiol , M. García-Olcina , A. Simeó-Monzó , A. Serra-Garcia , J. Canela-Royo","doi":"10.1016/j.semerg.2025.102458","DOIUrl":"10.1016/j.semerg.2025.102458","url":null,"abstract":"<div><h3>Objective</h3><div>To examine nutritional status among patients with atrial fibrillation (AF) and its relationship with major adverse cardiovascular events (MACE), and to determine whether nutritional status is a risk factor for MACE in patients with AF.</div></div><div><h3>Material and methods</h3><div>Observational, retrospective, community-based study (n=40,297) aged 65-95years in Terres de l’Ebre (Catalonia, Spain) between 2015 and 2021. A total of 2,574 patients with a diagnosis of AF were included. The CONUT scale was used to assess nutritional status and Cox regression analyses were performed.</div></div><div><h3>Results</h3><div>67.91% of AF patients developed MACE. Malnutrition as assessed by the CONUT scale was significantly higher in AF patients who developed MACE (<em>P</em>   .001).</div></div><div><h3>Conclusions</h3><div>Malnutrition is a prognostic factor for MACE in AF patients. Poorer nutritional status doubles the risk of MACE.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102458"},"PeriodicalIF":0.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348639","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}

引用次数: 0

Lp(a). Lo que sabemos, lo que desconocemos y lo que esperamos 液化石油气(a)。我们知道什么，我们不知道什么，我们希望什么

IF 0.9

Medicina de Familia-SEMERGEN Pub Date : 2025-02-07 DOI: 10.1016/j.semerg.2025.102451

A. Moyá Amengual , A. Serrano-Cumplido

{"title":"Lp(a). Lo que sabemos, lo que desconocemos y lo que esperamos","authors":"A. Moyá Amengual , A. Serrano-Cumplido","doi":"10.1016/j.semerg.2025.102451","DOIUrl":"10.1016/j.semerg.2025.102451","url":null,"abstract":"<div><div>There is no doubt that lipoprotein(a) [Lp(a)] is a structurally complex molecule with unique biological functions. It plays an important role in the inflammatory process through multiple mechanisms, contributes to endothelial dysfunction, activation of monocytes, macrophages and proliferation of smooth muscle cells, and promotes the development of atherosclerotic cardiovascular disease (ASCVD). It is important to point out the complex bidirectional relationship between Lp(a) and inflammation, influencing one another and even exerting anti-inflammatory effects in certain situations. Likewise, Lp(a) can favor the development of heart valve disease, especially of the aortic valve.</div><div>Numerous publications emphasize the need to determine Lp(a) levels in the population at least once in life and possible strategies to mitigate the risk of ASCVD generated by high Lp(a) levels. However, doubts or lack of knowledge persist about the need to measure this parameter, either due to the uncertainty of how to manage patients with high levels of Lp(a), due to insufficient knowledge about its physiological function or because its levels persist unchanged, to a large extent, throughout life as the genetic character of this molecule takes precedence. On the other hand, there are still no specific approved therapies that reduce its levels and arouse sufficient interest for its management. However, many societies, such as the European Society of Cardiology (SEC) or the Spanish Society of Atherosclerosis (SEA), raise the need to determine Lp(a) and intensive management of cardiovascular risk factors in patients with high Lp(a) levels along with therapies that mitigate the associated ASCVD risk. Likewise, the identification of high levels of Lp(a) offers the opportunity to screen family members, better control of cardiovascular risk and the possibility of developing clinical trials that profile individual and population risk that allow for more personalized actions.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 7","pages":"Article 102451"},"PeriodicalIF":0.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349864","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}

引用次数: 0