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Octubre 2012 PDF Imprimir E-mail
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SELECCIÓN DE REFERENCIAS BIBLIOGRÁFICAS DE LO PUBLICADO EN RELACIÓN CON ATENCIÓN PRIMARIA

Selección realizada por Antonio Manteca González
 
ACADEMIC MEDICINE
 
McConnell MM, Eva KW. The role of emotion in the learning and transfer of clinical skills and knowledge. Acad Med. 2012; 87:1316-1322 [R,I]
22914515             R/C
EL PAPEL DE LA EMOCIÓN EN EL APRENDIZAJE Y LA TRANSFERENCIA DE HABILIDADES CLÍNICAS Y CONOCIMIENTO
 
ANNALS OF INTERNAL MEDICINE
 
Delbanco T, Walker J, Bell SK, Darer JD, Elmore JG, Farag N, et al. Inviting patients to read their doctors' notes: a quasi-experimental study and a look ahead. Ann Intern Med. 2012; 157:461-470 [QE,I]
23027317             R/C
INVITAR A LOS PACIENTES A LEER LAS NOTAS DE SUS MÉDICOS: ESTUDIO CUASIEXPERIMENTAL Y ANTICIPACIÓN
 
Schaeffner ES, Ebert N, Delanaye P, Frei U, Gaedeke J, Jakob O, et al. Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med. 2012; 157:471-481 [T,II]
23027318             R/C
DOS ECUACIONES NOVEDOSAS PARA ESTIMAR LA FUNCIÓN RENAL EN PERSONAS DE 70 AÑOS O MÁS
 
Reed M, Huang J, Graetz I, Brand R, Hsu J, Fireman B, et al. Outpatient electronic health records and the clinical care and outcomes of patients with diabetes mellitus. Ann Intern Med. 2012; 157:482-489 [QE,I]
23027319             R/C
HISTORIAS CLÍNICAS ELECTRÓNICAS DE PACIENTES AMBULATORIOS Y LA ATENCIÓN CLÍNICA Y LOS RESULTADOS DE PACIENTES CON DIABETES MELLITUS
 
Meltsner M. A patient's view of OpenNotes. Ann Intern Med. 2012; 157:523-524 [AO,I]
VISIÓN DEL PACIENTE DE OPENNOTES
 
Moyer VA; on behalf of the U.S. Preventive Services Task Force*. Screening for coronary heart disease with electrocardiography: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 [Epub ahead of print] [M,III]
22847227             R/C
CRIBAJE DE ENFEREMEDAD CARDIACA CORONARIA CON ELECTROCARDIOGRAFÍA: DECLARACIÓN DE RECOMENDACIÓN DEL US PREVENTIVE SERVICES TASK FORCE
 
Krakower D, Mayer KH. What primary care providers need to know about preexposure prophylaxis for HIV prevention: a narrative review. Ann Intern Med. 2012 [Epub ahead of print] [R,II]
22821365             R/C
LO QUE LOS PROFESIONALES DE LA ATENCIÓN PRIMARIA NECESITAN SABER SOBRE LA PROFILAXIS PREEXPOSICIÓN PARA LA PREVENCIÓN DEL HIV: REVISIÓN NARRATIVA
 
Moyer VA; on behalf of the U.S. Preventive Services Task Force*. Screening for chronic kidney disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 [Epub ahead of print] [M,III]
22928170             R/C
CRIBAJE DE LA ENFERMEDAD RENAL CRÓNICA: DECLARACIÓN DE RECOMENDACIÓN DEL US PREVENTIVE SERVICES TASK FORCE
 
ARCHIVES OF INTERNAL MEDICINE
 
Vickers AJ, Cronin AM, Maschino AC, Lewith G, Macpherson H, Foster NE, et al; for the Acupuncture Trialists' Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012: 1-10 [Epub ahead of print] [M,I]
22965186             R/C
ACUPUNTURA EN EL DOLOR CRÓNICO: METAANÁLISIS CON DATOS DE PACIENTES INDIVIDUALES
 
Chan CM, Shorr AF. Black clouds and black boxes: comment on "Long-acting ß2-agonist step-off in patients with controlled asthma". Arch Intern Med. 2012: 1 [Epub ahead of print] [AO,I]
NUBES NEGRAS Y CAJAS NEGRAS: COMENTARIO SOBRE "RETIRADA DE AGONISTAS ß2 DE LARGA DURACIÓN EN PACIENTES CON ASMA CONTROLADA"
 
Rasinski KA, Lawrence RE, Yoon JD, Curlin FA. A sense of calling and primary care physicians' satisfaction in treating smoking, alcoholism, and obesity. Arch Intern Med. 2012: 1-2 [Epub ahead of print] [AO,I]
SENSACIÓN DE VOCACIÓN Y SATISFACCIÓN DEL MÉDICO DE ATENCIÓN PRIMARIA AL TRATAR EL TABAQUISMO, EL ALCOHOLISMO Y LA OBESIDAD
 
Brozek JL, Kraft M, Krishnan JA, Cloutier MM, Lazarus SC, Li JT, et al. Long-acting ß2-agonist step-off in patients with controlled asthma: systematic review with meta-analysis. Arch Intern Med. 2012: 1-11 [Epub ahead of print] [M,II]
22928176             R/C
RETIRADA DE AGONISTAS ß2 DE LARGA DURACIÓN EN PACIENTES CON ASMA CONTROLADA: REVISIÓN SISTEMÁTICA CON METAANÁLISIS
 
Avins AL. Needling the status quo: comment on "Acupuncture for chronic pain". Arch Intern Med. 2012: 1-2 [Epub ahead of print] [AO,I]
PINCHAR EL STATUS QUO: COMENTARIO SOBRE "ACUPUNTURA EN EL DOLOR CRÓNICO"
 
Dyrbye LN, West CP, Burriss TC, Shanafelt TD. Providing primary care in the United States: the work no one sees. Arch Intern Med. 2012: 1-2 [Epub ahead of print] [AO,I]
DISPENSACIÓN DE ATENCIÓN PRIMARIA EN ESTADOS UNIDOS: EL TRABAJO QUE NADIE VE
 
Kale MS, Federman AD, Ross JS. Visits for primary care services to primary care and specialty care physicians, 1999 and 2007. Arch Intern Med. 2012: 1-2 [Epub ahead of print] [AO,I]
VISITAS PARA SERVICIOS DE ATENCIÓN PRIMARIA A MÉDICOS DE ATENCIÓN PRIMARIA Y A MÉDICOSDE ATENCIÓN ESPECIALIZADA
 
Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012: 1-9 [Epub ahead of print] [T,I]
22911330             R/C
DESGASTE Y SATISFACCIÓN CON EL BALANCE DE LA VIDA LABORAL ENTRE LOS MÉDICOS ESTADOUNIDENSES EN RELACIÓN CON LA POBLACIÓN GENERAL ESTADOUNIDENSE
 
Parker ED, Margolis KL, Trower NK, Magid DJ, Tavel HM, Shetterly SM, et al. Comparative effectiveness of 2 ß-blockers in hypertensive patients. Arch Intern Med. 2012: 1-7 [Epub ahead of print] [S,I]
22928181             R/C
EFECTIVIDAD COMPARADA DE DOS BETA-BLOQUEANTES EN PACIENTES HIPERTENSOS
 
ARCHIVOS DE BRONCONEUMOLOGIA
 
Aspa J. Neumonía adquirida en la comunidad: el futuro en el presente, complicaciones cardiovasculares y vacunas conjugadas. Arch Bronconeumol. 2012; 48:347-348 [AO,I]
NEUMONÍA ADQUIRIDA EN LA COMUNIDAD: EL FUTURO EN EL PRESENTE, COMPLICACIONES CARDIOVASCULARES Y VACUNAS CONJUGADAS
 
ATENCION PRIMARIA
 
Esquerrà M, Roura P, Masat T, Canal V, Maideu J, Cruxent R. Ecografía abdominal: una herramienta diagnóstica al alcance de los médicos de familia. Aten Primaria. 2012; 44:576-583 [EC,I]
22018792             R/C
ECOGRAFÍA ABDOMINAL: UNA HERRAMIENTA DIAGNÓSTICA AL ALCANCE DE LOS MÉDICOS DE FAMILIA
 
Alonso JC. Ecografía en atención primaria: la roca de Sísifo. Aten Primaria. 2012; 44:584-585 [AO,I]
ECOGRAFÍA EN ATENCIÓN PRIMARIA: LA ROCA DE SÍSIFO
 
Sancho A, Albiol R, Mach N. Relación entre el estado nutricional y el riesgo de presentar úlceras por presión en pacientes incluidos en el programa de atención domiciliaria. Aten Primaria. 2012; 44:586-594 [T,I]
22789771             R/C
RELACIÓN ENTRE EL ESTADO NUTRICIONAL Y EL RIESGO DE PRESENTAR ÚLCERAS POR PRESIÓN EN PACIENTES INCLUIDOS EN EL PROGRAMA DE ATENCIÓN DOMICILIARIA
 
Calderón C, Retolaza A, Payo J, Bacigalupe A, Zallo E, Mosquera I. Perspectivas de los pacientes diagnosticados de depresión y atendidos por médicos de familia y psiquiatras. Aten Primaria. 2012; 44:595-602 [C,I]
22575484             R/C
PERSPECTIVAS DE LOS PACIENTES DIAGNOSTICADOS DE DEPRESIÓN Y ATENDIDOS POR MÉDICOS DE FAMILIA Y PSIQUIATRAS
 
BRITISH MEDICAL JOURNAL
 
Boniol M, Autier P, Boyle P, Gandini S. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. BMJ. 2012; 345:e4757 [M,II]
22833605             R/C
MELANOMA CUTÁNEO ATRIBUIBLE AL USO DE CAMA SOLAR: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
Nielsen SF, Bojesen SE, Schnohr P, Nordestgaard BG. Elevated rheumatoid factor and long term risk of rheumatoid arthritis: a prospective cohort study. BMJ. 2012; 345:e5244 [S,I]
22956589             R/C
FACTOR REUMATOIDE ELEVADO Y RIESGO DE ARTRITIS REUMATOIDE A LARGO PLAZO: ESTUDIO DE COHORTES PROSPECTIVO
 
Lasker SS, Chowdhury TA. Myalgia while taking statins. BMJ. 2012; 345:e5348 [R,I]
MIALGIA AL TOMAR ESTATINAS
 
Kahan BC, Morris TP. Reporting and analysis of trials using stratified randomisation in leading medical journals: review and reanalysis. BMJ. 2012; 345:e5840 [M,II]
22983531             R/C
INFORMNE Y ANÁLISIS DE ENSAYOS USANDO ALEATORIZACIÓN ESTRATIFICADA EN REVISTAS MÉDICAS LÍDERES: REVISIÓN Y REANÁLISIS
 
Simard JF, Holmqvist M. Rheumatoid factor positivity in the general population. BMJ. 2012; 345:e5841 [AO,I]
POSITIVIDAD DEL FACTOR REUMATOIDE EN LA POBLACIÓN GENERAL
 
Wehner MR, Shive ML, Chren MM, Han J, Qureshi AA, Linos E. Indoor tanning and non-melanoma skin cancer: systematic review and meta-analysis. BMJ. 2012; 345:e5909 [M,II]
23033409             R/C
BRONCEADO EN INTERIORES Y CÁNCER DE PIEL DISTINTO AL MELANOMA: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
Stallard P, Sayal K, Phillips R, Taylor JA, Spears M, Anderson R, et al. Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial. BMJ. 2012; 345:e6058 [EC,I]
23043090             R/C
TERAPIA COGNITIVO-CONDUCTUAL EN EL AULA PARA REDUCIR LOS SÍNTOMAS DE DEPRESIÓN EN ADOLESCENTES DE ALTO RIESGO: ENSAYO CONTROLADO ALEATORIZADO PRAGMÁTICO AGRUPADO
 
Verhaegen J, Gallos ID, van Mello NM, Abdel-Aziz M, Takwoingi Y, Harb H, et al. Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies. BMJ. 2012; 345:e6077 [M,I]
23045257             R/C
EXACTITUD DE LA PRUEBA DE PROGESTERONA SIMPLE PARA PREDECIR RESULTADO DE EMBARAZO PRECOZ EN MUJERES CON DOLOR O SANGRADO: METAANÁLISIS DE ESTUDIOS DE COHORTES
 
Olsen CM, Green AC. More evidence of harms of sunbed use, particularly for young people. BMJ. 2012; 345:e6101 [AO,I]
MÁS PRUEBAS DE DAÑOS DEL USO DE CAMAS SOLARES, EN PARTICULAR EN JÓVENES
 
Nolan JP, Soar J, Perkins GD. Cardiopulmonary resuscitation. BMJ. 2012; 345:e6122 [R,I]
REANIMACIÓN CARDIOPULMONAR
 
Gray M, Turabi AE. Optimising the value of interventions for populations. BMJ. 2012; 345:e6192 [R,I]
OPTIMIZAR EL VALOR DE LAS INTERVENCIONES POBLACIONALES
 
Kadam U. Redesigning the general practice consultation to improve care for patients with multimorbidity. BMJ. 2012; 345:e6202 [AO,II]
REDISEÑAR LA CONSULTA DE MEDICINA GENERAL PARA MEJORAR LA ATENCIÓN A PACIENTES CON PLURIMORBILIDAD
 
Lenzer J. Unnecessary care: are doctors in denial and is profit driven healthcare to blame? BMJ. 2012; 345:e6230 [AO,I]
CUIDADOS INNECESARIOS: ¿SE NIEGAN LOS MÉDICOS A ACEPTAR LA REALIDAD Y HA LLEVADO EL BENEFICIO ECONÓMICO A CARGAR CON LA CULPA A LA ATENCIÓN SANITARIA?
 
Billioti de Gage S, Bégaud B, Bazin F, Verdoux H, Dartigues JF, Pérès K, et al. Benzodiazepine use and risk of dementia: prospective population based study. BMJ. 2012; 345:e6231 [S,I]
23045258             R/C
USO DE BENZODIACEPINAS Y RIESGO DE DEMENCIA: ESTUDIO PROSPECTIVO POBLACIONAL
 
Burge F, Lawson B, Mitchell G. How to move to a palliative approach to care for people with multimorbidity. BMJ. 2012; 345:e6324. doi: 10.1136/bmj.e6324. [AO,I]
CÓMO DESPLAZARSE A UN ABORDAJE PALIATIVO PARA ATENDER A LAS PERSONAS CON PLURIMORBILIDAD
 
Geersing GJ, Erkens PM, Lucassen WA, Büller HR, Cate HT, Hoes AW, et al. Safe exclusion of pulmonary embolism using the Wells rule and qualitative D-dimer testing in primary care: prospective cohort study. BMJ. 2012; 345:e6564 [S,II]
23036917             R/C
EXCLUSIÓN SEGURA DEL EMBOLISMO PULMONAR USANDO LA REGLA DE WELLS Y LA PRUEBA CUALITATIVA DE DIMERO D EN ATENCIÓN PRIMARIA: ESTUDIO DE COHORTES PROSPECTIVO
 
Orchard J. Plantar fasciitis. BMJ. 2012; 345:e6603 [R,I]
FASCITIS PLANTAR
 
Takasaki Y, Kawachi I, Brunner EJ. Japan's answer to the economic demands of an ageing population. BMJ. 2012; 345:e6632 [AO,I]
LA RESPUESTA DE JAPÓN A LAS DEMANDAS ECONÓMICAS DE UNA POBLACIÓN ENVEJECIDA
 
Samarasekera E, Sawyer L, Parnham J, Smith CH; on behalf of the Guideline Development Group. Assessment and management of psoriasis: summary of NICE guidance. BMJ. 2012; 345:e6712 [M,II]
VALORACIÓN Y MANEJO DE LA PSORIASIS: RESUMEN DE LA GUÍA NICE
 
Merry SN, Stasiak K. Preventing depression in adolescents. BMJ. 2012; 345:e6720 [AO,I]
PREVENIR LA DEPRESIÓN EN LOS ADOLESCENTES
 
Grynbaum MM. Will soda restrictions help New York win the war on obesity? BMJ. 2012; 345:e6768 [AO,I]
¿AYUDARÁN A NUEVA YORK LAS RESTRICCIONES A LOS REFRESCOS A GANAR LA GUERRA CONTRA LA OBESIDAD?
 
CIRCULATION
 
Olsen AM, Fosbøl EL, Lindhardsen J, Folke F, Charlot M, Selmer C, et al. Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction: a nationwide cohort study. Circulation. 2012; 126:1955-1963 [S,II]
22965337             R/C
RIESGO CARDIOVASCULAR A LARGO PLAZO DEL USO DE AINE SEGÚN EL TIEMPO TRANSCURRIDO DESDE EL PRIMER INFARTO DE MIOCARDIO: ESTUDIO DE COHORTES DE ÁMBITO NACIONAL
 
Gu Q, Burt VL, Dillon CF, Yoon S. Trends in antihypertensive medication use and blood pressure control among United States adults with hypertension: the national health and nutrition examination survey, 2001 to 2010. Circulation. 2012; 126:2105-2114 [S,II]
23091084             R/C
TENDENCIAS EN EL USO DE MEDICACIÓN ANTIHIPERTENSIVA Y CONTROL DE LA PRESIÓN ARTERIAL: ENCUESTA DEL EXAMEN NACIONAL DE NUTRICIÓN Y SALUD, 2001 A 2010
 
Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third Universal Definition of Myocardial Infarction. Circulation. 2012; 126:2020-2035 [M,III]
TERCERA DEFINICIÓN UNIVERSAL DE INFARTO DE MIOCARDIO
 
DIABETES CARE
 
McElduff A. Insulin detemir in pregnancy: a small but significant step forward? Diabetes Care. 2012; 35:1968-1969 [AO,I]
INSULINA DETEMIR EN EL EMBARAZO: ¿UN PASO HACIA ADELANTE PEQUEÑO PERO SIGNIFICATIVO?
 
Mathiesen ER, Hod M, Ivanisevic M, Duran S, Brøndsted L, Jovanovic L, et al; on behalf of the Detemir in Pregnancy Study Group. Maternal efficacy and safety outcomes in a randomized, controlled trial comparing insulin detemir with NPH insulin in 310 pregnant women with type 1 diabetes. Diabetes Care. 2012; 35:2012-2017 [EC,I]
22851598             R/C
RESULTADOS DE EFICACIA MATERNAL Y SEGURIDAD EN UN ENSAYO ALEATORIZADO CONTROLADO COMPARANDO INSULINA DETEMIR CON INSULINA NPH EN 310 MUJERES EMBARAZADAS CON DIABETES TIPO 1
 
Riddle MC, Karl DM. Individualizing targets and tactics for high-risk patients with type 2 diabetes: practical lessons from ACCORD and other cardiovascular trials. Diabetes Care. 2012; 35:2100-2107 [AO,I]
INDIVIDUALIZAR OBJETIVOS Y TÁCTICAS EN PACIENTES DE ALTO RIESGO CON DIABETES TIPO 2: LECCIONES PRÁCTICAS DEL ACCORD Y OTROS ENSAYOS CARDIOVASCULARES
 
DRUGS
 
Pockros PJ. Interferon-free hepatitis C therapy: how close are we? Drugs. 2012; 72:1825-1831 [R,I]
22934796             R/C
TRATAMIENTO DE LA HEPATITIS C SIN INTERFERÓN: ¿CUÁN CERCA ESTAMOS?
 
Demchuk AM, Bal S. Thrombolytic therapy for acute ischaemic stroke: what can we do to improve outcomes? Drugs. 2012; 72:1833-1845 [R,I]
22934797             R/C
TERAPIA TROMBOLÍTICA DEL ICTUS ISQUÉMICO AGUDO: ¿QUÉ PODEMOS HACER PARA MEJORAR LOS RESULTADOS?
 
Yang LP, Plosker GL. Nomegestrol acetate/estradiol: in oral contraception. Drugs. 2012; 72:1917-1928 [R,I]
22950535             R/C
ACETATO DE NOMEGESTROL/ESTRADIOL: EN LA ANTICONCEPCIÓN ORAL
 
Donadini MP, Ageno W, Douketis JD. Management of bleeding in patients receiving conventional or new anticoagulants: a practical and case-based approach. Drugs. 2012; 72:1965-1975 [R,II]
23039318             R/C
MANEJO DEL SANGRADO EN PACIENTES QUE RECIBEN ANTICOAGULANTES NUEVOS O CONVENCIONALES: ABORDAJE PRÁCTICO BASADO EN CASOS
 
Casey JR, Block SL, Hedrick J, Almudevar A, Pichichero ME. Comparison of amoxicillin/clavulanic Acid high dose with cefdinir in the treatment of acute otitis media. Drugs. 2012; 72:1991-1997 [EC,I]
23039319             R/C
COMPARACIÓN DE LA AMOXICILINA/ÁCIDO CLAVULÁNICO A ALTAS DOSIS CON CEFTIDINIR EN EL TRATAMIENTO DE LA OTITIS MEDIA AGUDA
 
Frampton JE. Aclidinium: in chronic obstructive pulmonary disease. Drugs. 2012; 72:1999-2011 [R,I]
23046206             R/C
ACLIDINIUM: EN LA EPOC
 
McCormack PL. Ferumoxytol: in iron deficiency anaemia in adults with chronic kidney disease. Drugs. 2012; 72:2013-2022 [R,I]
22994536             R/C
FERUMOXITOL: EN LA ANEMIA FERROPÉNICA EN ADULTOS CON ENFERMEDAD CRÓNICA DEL RIÑÓN
 
EUROPEAN HEART JOURNAL
 
Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, Borger MA, et al; Authors/Task Force Members, ESC Committee for Practice Guidelines (CPG). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J. 2012; 33:2569-2619 [M,III]
GUÍAS DE LA ESC PARA EL MANEJO DEL INFARTO AGUDO DE MIOCARDIO EN PACIENTES QUE PRESENTAN ELEVACIÓN DEL SEGMENTO ST: GRUPO DE TRABAJO SOBRE EL MANEJO DEL INFARTO AGUDO DE MIOCARDIO CON ELEVACIÓN DEL SEGMENTO ST DE LA SOCIEDAD EUROPEA DE CARDIOLOGÍA (ESC)
 
FAMILY MEDICINE
 
Freeman J, Delzell J Jr. Medical school graduates entering family medicine: increasing the overall number. Fam Med. 2012; 44:613-614 [AO,I]
LICENCIADOS EN MEDICINA QUE ENTRAN EN MEDICINA DE FAMILIA: AUMENTO DEL NÚMERO GLOBAL
 
Bieck AD, Biggs WS, Crosley PW, Kozakowski SM. Results of the 2012 national resident matching program: family medicine. Fam Med. 2012; 44:615-619 [T,I]
23027152             R/C
RESULTADOS DEL PROGRAMA NACIONAL DE SELECCIÓN DE RESIDENTES 2012: MEDICINA DE FAMILIA
 
Biggs WS, Bieck AD, Crosley PW, Kozakowski SM. Entry of US medical school graduates into family medicine residencies: 2011--2012. Fam Med. 2012; 44:620-626 [T,I]
23027153             R/C
ENTRADA DE LICENCIADOS EN MEDICINA DE LOS EE UU EN LAS RESIDENCIAS DE MEDICINA DE FAMILIA: 2011-2012
 
Harper CC, Henderson JT, Raine TR, Goodman S, Darney PD, Thompson KM, et al. Evidence-based IUD practice: family physicians and obstetrician-gynecologists. Fam Med. 2012; 44:637-645 [T,I]
23027156             R/C
PRÁCTICA DE DIU BASADA EN LA EVIDENCIA: MÉDICOS DE FAMILIA Y GINECOOBSTETRAS
 
Keehbauch J, Green L, Lugo N, Pepe J. The influence of ASCCP guideline changes on family medicine residency colposcopy training. Fam Med. 2012; 44:650-653 [T,I]
23027158             R/C
INFLUENCIA EN LOS CAMBIOS EN LAS GUÍAS ASCCP SOBRE LA FORMACIÓN EN COLPOSCOPIA EN LA RESIDENCIA DE MEDICINA DE FAMILIA
 
FAMILY PRACTICE
 
Hay AD, Rortveit G, Purdy S, Adams J, Sanci LA, Schermer TR, et al. Primary care research--an international responsibility. Fam Pract. 2012; 29:499-500 [AO,I]
INVESTIGACIÓN EN ATENCIÓN PRIMARIA: RESPONSABILIDAD INTERNACIONAL
 
Wallace E, Smith SM, Fahey T. Variation in medical practice: getting the balance right. Fam Pract. 2012; 29:501-502 [AO,I]
VARIACIÓN EN LA PRÁCTICA MÉDICA: EQUILIBRAR LA BALANZA
 
Mjølstad OC, Snare SR, Folkvord L, Helland F, Grimsmo A, Torp H, et al. Assessment of left ventricular function by GPs using pocket-sized ultrasound. Fam Pract. 2012; 29:534-540 [T,I]
22333323             R/C
VALORACIÓN DE LA FUNCIÓN VENTRICULAR IZQUIERDA POR MÉDICOS GENRALES MEDIANTE EL USO DE ECÓGRAFOS DE BOLSILLO
 
Delaney EK, Duckworth L, Thompson WD, Lee AJ, Murchie P. Excising squamous cell carcinomas: comparing the performance of GPs, hospital skin specialists and other hospital specialists. Fam Pract. 2012; 29:541-546 [T,I]
22321614             R/C
EXTIRPACIÓN DE CARCINOMAS DE CÉLULSAS ESPINOSAS: COMPARAR EL RENDIMIENTO DE MÉDICOS GENERALES, ESPECIALISTAS DÉRMICOS HOSPITALARIOS Y OTROS ESPECIALISTAS HOSPITALARIOS
 
Huibers L, Keizer E, Giesen P, Grol R, Wensing M. Nurse telephone triage: good quality associated with appropriate decisions. Fam Pract. 2012; 29:547-552 [T,I]
22327415             R/C
TRIAJE TELEFÓNICO ENFERMERO: BUENA CALIDAD ASOCIADA CON DECISIONES ADECUADAS
 
Pollak KI, Coffman CJ, Alexander SC, Tulsky JA, Lyna P, Dolor RJ, et al. Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity? Fam Pract. 2012; 29:553-560 [T,I]
22315467             R/C
¿PUEDEN PREDECIR CON EXACTITUD LOS MÉDICOS QUÉ PACIENTES PERDERÁN PESO, MEJORARÁN LA NUTRICIÓN E INCREMENTARÁN LA ACTIVIDAD FÍSICA?
 
Lerner Y, Levinson D. Who gets mental health treatment from the GP? Results from the Israel National Epidemiological Mental Health Survey. Fam Pract. 2012; 29:561-566 [T,I]
22389430             R/C
¿QUIÉN OBTIENE TRATAMIENTO EN SALUD MENTAL POR PARTE DEL MÉDICO GENERAL? RESULTADOS DE LA ENCUESTA NACIONAL EPIDEMIOLÓGICA DE SALUD MENTAL DE ISRAEL
 
Doyle RJ, Wang N, Anthony D, Borkan J, Shield RR, Goldman RE. Computers in the examination room and the electronic health record: physicians' perceived impact on clinical encounters before and after full installation and implementation. Fam Pract. 2012; 29:601-608 [QE,I]
22379185             R/C
LOS ORDENADORES EN LA CONSULTA Y LA HISTORIA CLÍNICA ELECTRÓNICA: IMPACTO SOBRE LAS ENTREVISTAS CLÍNICAS PERCIBIDO POR LOS MÉDICOS TRAS SU COMPLETA INSTALACIÓN Y PUESTA EN MARCHA
 
Gibbings-Isaac D, Iqbal M, Tahir MA, Kumarapeli P, de Lusignan S. The pattern of silent time in the clinical consultation: an observational multichannel video study. Fam Pract. 2012; 29:616-621 [T,I]
22291439             R/C
PATRÓN DEL TIEMPO DE SILENCIO EN LA CONSULTA CLÍNICA: VIDEOESTUDIO MULTICANAL OBSERVACIONAL
 
GASTROENTEROLOGIA Y HEPATOLOGIA
 
Ampuero J, Romero-Gómez M. Influencia de la enfermedad por hígado graso no alcohólico en la enfermedad cardiovascular. Gastroenterol Hepatol. 2012; 35:585-593 [R,I]
22541252             R/C
INFLUENCIA DE LA ENFERMEDAD POR HÍGADO GRASO NO ALCOHÓLICO EN LA ENFERMEDAD CARDIOVASCULAR
 
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
 
Murdoch DR, Slow S, Chambers ST, Jennings LC, Stewart AW, Priest PC, et al. Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDARIS randomized controlled trial. JAMA. 2012; 308:1333-1339 [EC,I]
23032549             R/C
EFECTO DE LOS SUPLEMENTOS DE VITAMINA D3 SOBRE LAS INFECCIONES RESPIRATORIAS DE VÍAS ALTAS EN ADULTOS SANOS: ENSAYO CONTROLADO ALEATORIZADO VIDARIS
 
Bangalore S, Steg G, Deedwania P, Crowley K, Eagle KA, Goto S, et al; REACH Registry Investigators. ß-Blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA. 2012; 308:1340-1349 [S,I]
23032550             R/C
USO DE BETABLOQUEANTES Y RESULTADOS CLÍNICOS EN PACIENTES AMBULATORIOS ESTABLES CON Y SIN ENFERMEDAD ARTERIAL CORONARIA
 
Linder JA. Vitamin D and the cure for the common cold. JAMA. 2012; 308:1375-1376 [AO,I]
VITAMINA D Y LA CURA DEL RESFRIADO COMÚN
 
Mets OM, de Jong PA, Prokop M. Computed tomographic screening for lung cancer: an opportunity to evaluate other diseases. JAMA. 2012; 308:1433-1434 [AO,I]
CRIBAJE CON TOMOGRAFÍA COMPUTERIZADA EN EL CÁNCER DE PULMÓN: OPORTUNIDAD PARA EVALUAR OTRAS ENFERMEDADES
 
Wolff JL. Family matters in health care delivery. JAMA. 2012; 308:1529-1530 [AO,I]
LA FAMILIA IMPORTA EN LA PRESTACIÓN DE ATENCIÓN SANITARIA
 
Carroll MD, Kit BK, Lacher DA, Shero ST, Mussolino ME. Trends in lipids and lipoproteins in US adults, 1988-2010. JAMA. 2012; 308:1545-1554 [T,II]
23073951             R/C
TENDENCIAS EN LÍPIDOS Y LIPOPROTEÍNAS EN ADULTOS ESTADOUNIDENSES
 
Schroeder SA. How clinicians can help smokers to quit. JAMA. 2012; 308:1586-1587 [AO,I]
CÓMO PUEDEN AYUDAR LOS CLÍNICOS A LOS FUMADORES A DEJARLO
 
Smith M, Halvorson G, Kaplan G. What's needed is a health care system that learns: recommendations from an IOM report. JAMA. 2012; 308:1637-1638 [AO,I]
LO QUE SE NECESITA ES UN SISTEMA DE ATENCIÓN SANITARIA QUE APRENDA: RECOMENDACIONES DE UN INFORME DE IOM
 
Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, et al. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA. 2012; 308:1660-1667 [S,I]
23093164             R/C
ASOCIACIÓN ENTRE LOS FACTORES DE RIESGO CARDIOVASCULAR CONVENCIONALES Y EL RIESGO DE ENFERMEDAD ARTERIAL PERIFÉRICA EN HOMBRES
 
Oxman AD. Improving the health of patients and populations requires humility, uncertainty, and collaboration. JAMA. 2012; 308:1691-1692 [AO,I]
MEJORAR LA SALUD DE LOS PACIENTES Y DE LAS POBLACIONES REQUIERE HUMILDAD, INCERTIDUMBRE Y COLABORACIÓN
 
MEDICINA CLINICA
 
García-Tirado J, Rieger-Reyes C, Saz-Peiró P. Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática. Med Clin (Barc). 2012; 139:358-363 [R,I]
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EFECTO DE LOS FLAVONOIDES EN LA PREVENCIÓN DEL CÁNCER DE PULMÓN: REVISIÓN SISTEMÁTICA
 
Herrera I, Gascón F. Nuevas herramientas en salud. Med Clin (Barc). 2012; 139:364-368 [AO,I]
NUEVAS HERRAMIENTAS EN SALUD
 
Trilla A. Transparencia del sistema de salud: rendir cuentas ya no es opcional. Med Clin (Barc). 2012; 139:395-397 [AO,I]
TRANSPARENCIA DEL SISTEMA DE SALUD: RENDIR CUENTAS YA NO ES OPCIONAL
 
Lista E, Jacob J, Perez JR, Bardes I. Ventilación mecánica no invasiva en urgencias. Med Clin (Barc). 2012; 139:414 [T,I]
VENTILACIÓN MECÁNICA NO INVASIVA EN URGENCIAS
 
Sacristán JA, Dilla T, Antoñanzas F. Priorización de intervenciones sanitarias en función de su efectividad: un paso intermedio en el camino hacia una medicina más eficiente. Med Clin (Barc). 2012; 139:458-460 [AO,I]
PRIORIZACIÓN DE INTERVENCIONES SANITARIAS EN FUNCIÓN DE SU EFECTIVIDAD: UN PASO INTERMEDIO EN EL CAMINO HACIA UNA MEDICINA MÁS EFICIENTE
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
Comentarios a la guía de práctica clínica de la ESC sobre prevención de la enfermedad cardiovascular (versión 2012). Un informe del Grupo de Trabajo del Comité de Guías de Práctica Clínica de la Sociedad Española de Cardiología. Rev Esp Cardiol. 2012; 65:869-873 [AO,II]
COMENTARIOS A LA GUÍA DE PRÁCTICA CLÍNICA DE LA ESC SOBRE PREVENCIÓN DE LA ENFERMEDAD CARDIOVASCULAR (VERSIÓN 2012). UN INFORME DEL GRUPO DE TRABAJO DEL COMITÉ DE GUÍAS DE PRÁCTICA CLÍNICA DE LA SOCIEDAD ESPAÑOLA DE CARDIOLOGÍA
 
Anguita M, Comin J, Almenar L, Crespo M, Delgado J, Gonzalez-Costello J, et al; Grupo de trabajo de la SEC sobre la guía de insuficiencia cardiaca ESC 2012. Comentarios a la guía de práctica clínica de la ESC sobre diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica 2012. Un informe del Grupo de Trabajo del Comite de Guias de Practica Clinica de la Sociedad Española de Cardiologia. Rev Esp Cardiol. 2012; 65:874-878 [AO,II]
COMENTARIOS A LA GUÍA DE PRÁCTICA CLÍNICA DE LA ESC SOBRE DIAGNÓSTICO Y TRATAMIENTO DE LA INSUFICIENCIA CARDIACA AGUDA Y CRÓNICA 2012. UN INFORME DEL GRUPO DE TRABAJO DEL COMITE DE GUIAS DE PRACTICA CLINICA DE LA SOCIEDAD ESPAÑOLA DE CARDIOLOGIA
 
Masip J, Gayà M, Páez J, Betbesé A, Vecilla F, Manresa R, et al. Pulsioximetría en el diagnóstico de insuficiencia cardiaca aguda. Rev Esp Cardiol. 2012; 65:879-884 [S,I]
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PULSIOXIMETRÍA EN EL DIAGNÓSTICO DE INSUFICIENCIA CARDIACA AGUDA
 
Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. Guía europea sobre prevención de la enfermedad cardiovascular en la práctica clínica (versión 2012). Rev Esp Cardiol. 2012; 65:937.e1-e66 [M,III]
GUÍA EUROPEA SOBRE PREVENCIÓN DE LA ENFERMEDAD CARDIOVASCULAR EN LA PRÁCTICA CLÍNICA (VERSIÓN 2012)
 
McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, et al. Guía de práctica clínica de la ESC sobre diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica 2012. Rev Esp Cardiol. 2012; 65:938.e1-e59 [M,III]
GUÍA DE PRÁCTICA CLÍNICA DE LA ESC SOBRE DIAGNÓSTICO Y TRATAMIENTO DE LA INSUFICIENCIA CARDIACA AGUDA Y CRÓNICA 2012
 
THE LANCET
 
Domestic abuse in the UK. Lancet. 2012; 380:1122 [AO,I]
MALOS TRATOS DOMÉSTICOS EN EL RU
 
Lin JJ, Mula M, Hermann BP. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. Lancet. 2012; 380:1180-1192 [AO,I]
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DESCUBRIR LAS COMORBILIDADES NEUROCONDUCTUALES DE LA EPILEPSIA A LO LARGO DE LA VIDA
 
James S, Held C. Improving long-term outcome after myocardial infarction. Lancet. 2012; 380:1290-1291 [AO,I]
MEJORAR LOS RESULTADOS A LARGO PLAZO TRAS EL INFARTO DE MIOCARDIO
 
Tuberculosis--from ancient plague to modern-day nemesis. Lancet. 2012; 380:1359 [AO,I]
TUBERCULOSIS: DE UNA ANTIGUA PLAGA A UNA MALDICIÓN DE LOS TIEMPOS MODERNOS
 
Surgery: never too old to be treated. Lancet. 2012; 380:1360 [AO,I]
CIRUGÍA: NUNCA DEMASIADO VIEJO PARA SER INTERVENIDO
 
Cleland JG, Clark AL. Heart failure--does it matter whether LVEF is reduced? Lancet. 2012; 380:1363-1365 [AO,I]
INSUFICIENCIA CARDIACA: ¿IMPORTA SI LA FRACCIÓN DE EYECCIÓN VENTRICULAR IZQUIERDA ESTÁ REDUCIDA?
 
Hoffner S. Unexpected high levels of multidrug-resistant tuberculosis present new challenges for tuberculosis control. Lancet. 2012; 380:1367-1369 [AO,I]
LOS NIVELES ELEVADOS NO ESPERADOS DE TUBERCULOSIS RESISTENTE A MÚLTIPLES FÁRMACOS REPRESENTAN NUEVOS RETOS PARA EL CONTROL DE LA TUBERCULOSIS
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
Kaptoge S, Di Angelantonio E, Pennells L, Wood AM, White IR, Gao P, et al; Emerging Risk Factors Collaboration. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med. 2012; 367:1310-1320 [M,II]
23034020             R/C
PROTEÍNA C REACTIVA, FIBRINÓGENO Y PREDICCIÓN DE LA ENFERMEDAD CARDIOVASCULAR
 
Polonsky KS. The past 200 years in diabetes. N Engl J Med. 2012; 367:1332-1340 [R,II]
LOS ÚLTIMOS 200 AÑOS EN LA DIABETES
 
de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012; 367:1397-1406 [EC,I]
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ENSAYO DE BEBIDAS SIN AZÚCAR O BEBIDAS AZUCARADAS Y PESO CORPORAL EN NIÑOS
 
Ebbeling CB, Feldman HA, Chomitz VR, Antonelli TA, Gortmaker SL, Osganian SK, et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med. 2012; 367:1407-1416 [EC,I]
22998339             R/C
ENSAYO ALEATORIZADO DE BEBIDAS AZUCARADAS Y PESO CORPOORAL EN ADOLESCENTES
 
Link MS. Clinical practice. Evaluation and initial treatment of supraventricular tachycardia. N Engl J Med. 2012; 367:1438-1448 [R,I]
EVALUACIÓN Y TRATAMIENTO INICIAL DE LA TAQUICARDIA SUPRAVENTGRICULAR
 
Caprio S. Calories from soft drinks--do they matter? N Engl J Med. 2012; 367:1462-1463 [AO,I]
CALORÍAS DE LOS REFRESCOS: ¿IMPORTAN?
 
Farley T, Just DR, Wansink B. Clinical decisions. Regulation of sugar-sweetened beverages. N Engl J Med. 2012; 367:1464-1466 [AO,I]
DECISIONES CLÍNICAS. REGULACIÓN DE LAS BEBIDAS AZUCARADAS
 
Devanand DP, Mintzer J, Schultz SK, Andrews HF, Sultzer DL, de la Pena D, et al. Relapse risk after discontinuation of risperidone in Alzheimer's disease. N Engl J Med. 2012; 367:1497-1507 [EC,I]
23075176             R/C
RIESGO DE RECAÍDA TRAS LA SUSPENSIÓN DE LA RISPERIDONA EN LA ENFERMEDAD DE ALZHEIMER
 
Cosedis Nielsen J, Johannessen A, Raatikainen P, Hindricks G, Walfridsson H, Kongstad O, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation. N Engl J Med. 2012; 367:1587-1595 [EC,I]
23094720             R/C
ABLACIÓN POR RADIOFRECUENCIA COMO TRATAMIENTO INICIAL EN LA FIBRILACIÓN AURICULAR PAROXÍSTICA
 
Liao X, Lochhead P, Nishihara R, Morikawa T, Kuchiba A, Yamauchi M, et al. Aspirin use, tumor PIK3CA mutation, and colorectal-cancer survival. N Engl J Med. 2012; 367:1596-1606 [S,I]
23094721             R/C
USO DE LA ASPIRINA, MUTACIÓN PIK3CA TUMORAL Y SUPERVIVENCIA EN EL CÁNCER COLORRECTAL
 
Sasson C, Magid DJ, Chan P, Root ED, McNally BF, Kellermann AL, et al; CARES Surveillance Group. Association of neighborhood characteristics with bystander-initiated CPR. N Engl J Med. 2012; 367:1607-1615 [S,II]
23094722             R/C
ASOCIACIÓN DE CARACTERÍSTICAS DEL VECINDARIO CON LA RPC INICIADA POR TRANSEÚNTE
 
Stevenson WG, Albert CM. Catheter ablation for paroxysmal atrial fibrillation. N Engl J Med. 2012; 367:1648-1649 [AO,I]
ABLACIÓN MEDIANTE CATÉTER EN LA FIBRILACIÓN AURICULAR PAROXÍSTICA
 
Pasche B. Aspirin--from prevention to targeted therapy. N Engl J Med. 2012; 367:1650-1651 [AO,I]
ASPIRINA: DESDE LA PREVENCIÓN A LA TERAPIA DIRIGIDA
 
Smith TJ, Longo DL. Talking with patients about dying. N Engl J Med. 2012; 367:1651-1652 [AO,I]
HABLAR CON LOS PACIENTES SOBRE EL HECHO DE MORIR
 
ACADEMIC MEDICINE
 
There are many ways in which emotions may influence medical education. Researchers must further explore the implications of these findings to ensure that learning is not treated simply as a rational, mechanistic process but that trainees are effectively prepared to perform under a wide range of emotional conditions.
 
ANNALS OF INTERNAL MEDICINE
 
The USPSTF recommends against screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at low risk for CHD events (D recommendation).The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at intermediate or high risk for CHD events (I statement).
The BIS2 equation should be used to estimate GFR in persons aged 70 years or older with normal or mild to moderately reduced kidney function. If cystatin C is not available, the BIS1 equation is an acceptable alternative.
As HIV prevalence climbs globally, including more than 50 000 new infections per year in the United States, we need more effective HIV prevention strategies. The use of antiretrovirals for preexposure prophylaxis (PrEP) among high-risk persons without HIV is emerging as 1 such strategy. Randomized, controlled trials have demonstrated that once-daily oral PrEP decreased HIV incidence among at-risk men who have sex with men and African heterosexuals, including serodiscordant couples. An additional randomized, controlled trial of a topical pericoital antiretroviral microbicide gel decreased HIV incidence among at-risk heterosexual South African women. Two other studies in African women did not demonstrate the efficacy of oral or topical PrEP, raising concerns about adherence patterns and efficacy in this population.The U.S. Food and Drug Administration (FDA) Antiviral Drugs Advisory Committee reviewed these studies and additional data in May 2012 and voted to advise the approval of oral tenofovir-emtricitabine for PrEP in high-risk populations. On 16 July 2012, the FDA recommended that this combination medication be approved for use as PrEP in high-risk persons without HIV. Patients may seek PrEP from their primary care providers, and those receiving PrEP require monitoring. Thus, primary care providers should become familiar with PrEP. This review outlines current knowledge about PrEP as it pertains to primary care, including identifying persons likely to benefit from PrEP; counseling to maximize adherence and reduce potential increases in risky behavior; and monitoring for potential drug toxicities, HIV acquisition, and antiretroviral drug resistance. Issues related to cost and insurance coverage are also discussed. Recent data suggest that PrEP, combined with other prevention strategies, holds promise in helping to curtail the HIV epidemic.
Patients accessed visit notes frequently, a large majority reported clinically relevant benefits and minimal concerns, and virtually all patients wanted the practice to continue. With doctors experiencing no more than a modest effect on their work lives, open notes seem worthy of widespread adoption.
Use of a commercially available certified EHR was associated with improved drug treatment intensification, monitoring, and physiologic control among patients with diabetes, with greater improvements among patients with worse control and less testing in patients already meeting guideline-recommended glycemic and lipid targets.
The USPSTF concludes that the evidence is insufficient to assess the balance of benefits and harms of routine screening for CKD in asymptomatic adults. (I statement).
 
ARCHIVES OF INTERNAL MEDICINE
 
Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.
Evidence suggests that discontinuing LABA therapy in adults and older children with asthma controlled with a combination of ICSs and LABAs results in increased asthma-associated impairment. Additional trials measuring all long-term patient-important outcomes are needed.
Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
There were no statistically significant differences in incident CV events between atenolol and metoprolol tartrate users with hypertension. Large registries similar to the one used in this analysis may be useful for addressing comparative effectiveness questions that are unlikely to be resolved by randomized trials.
 
ATENCION PRIMARIA
 
Las valoraciones de los pacientes aportan dimensiones propias sobre los componentes individual y contextual en el diagnóstico y tratamiento de la depresión. Dichas dimensiones deberían ser tenidas en cuenta en la identificación de necesidades y en el diseño de estrategias compartidas por MF y PSQ para la mejora de su asistencia.
El presente estudio demuestra que el 14% de pacientes ATDOM presentaron malnutrición y un 46% riesgo de desnutrición. La malnutrición, el grado de dependencia física, el deterioro cognitivo severo y los parámetros sanguíneos básicos se relacionan significativamente con un aumento del riesgo de ulceración, justificando la necesidad de llevar a cabo medidas de corrección y mejoría personalizada en los pacientes
Los resultados del estudio demuestran cautelosamente que los médicos de atención primaria pueden realizar ecografías abdominales de baja complejidad con competencia diagnóstica.
 
BMJ
 
A single progesterone measurement for women in early pregnancy presenting with bleeding or pain and inconclusive ultrasound assessments can rule out a viable pregnancy.
In adolescents with depressive symptoms, outcomes were similar for attention control, usual school provision, and cognitive behavioural therapy. Classroom based cognitive behavioural therapy programmes may result in increased self awareness and reporting of depressive symptoms but should not be undertaken without further evaluation and research.
Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.
In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study. Considering the extent to which benzodiazepines are prescribed and the number of potential adverse effects of this drug class in the general population, indiscriminate widespread use should be cautioned against.
Individuals in the general population with elevated rheumatoid factor have up to 26-fold greater long term risk of rheumatoid arthritis, and up to 32% 10 year absolute risk of rheumatoid arthritis. These novel findings may lead to revision of guidelines for early referral to a rheumatologist and early arthritis clinics based on rheumatoid factor testing.
Indoor tanning is associated with a significantly increased risk of both basal and squamous cell skin cancer. The risk is higher with use in early life (<25 years). This modifiable risk factor may account for hundreds of thousands of cases of non-melanoma skin cancer each year in the United States alone and many more worldwide. These findings contribute to the growing body of evidence on the harms of indoor tanning and support public health campaigns and regulation to reduce exposure to this carcinogen.
Balancing on centre or prognostic factors is common in trials but often poorly described, and the implications of balancing are poorly understood. Trialists should adjust their primary analysis for balancing factors to obtain correct P values and confidence intervals and to avoid an unnecessary loss in power.
A Wells score of =4 combined with a negative qualitative D-dimer test result can safely and efficiently exclude pulmonary embolism in primary care.
 
CIRCULATION
 
Antihypertensive medication use and blood pressure control among US adults with hypertension significantly increased over the past 10 years. Combination therapy regimens can facilitate achievement of blood pressure goals.
The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in the use of NSAIDs for patients after MI.
 
DIABETES CARE
 
Treatment with IDet resulted in lower FPG and noninferior A1C in late pregnancy compared with NPH insulin. Rates of hypoglycemia were comparable.
 
DRUGS
 
Two oral direct-acting antivirals (DAA) are now available for the treatment of chronic hepatitis C infection and several generations of DAA are in development. Expectations are that, at some time in the near future, hepatitis C will be 'curable' with an all-oral DAA regimen. This article reviews the current problems associated with interferon-based hepatitis C treatments that are combined with DAAs, including adverse events and complications of therapy, contraindications, drug-drug interactions and cost. The article further discusses difficulties with new drug development and provides an opinion on the research issues still to be dealt with and the requirements for the successful implementation of such a strategy. These include lack of efficacy in certain populations, unexpected side effects, antiviral resistance, late relapse, lack of cooperation between drug developers and cost.
Anticoagulant drugs are highly effective for the prevention and treatment of venous and arterial thromboembolism. However, their use is also associated with an increased risk for bleeding, with an associated ~10% case-fatality rate. Appropriate strategies for the management and reversal of anticoagulant-associated bleeding are clinically important and, ideally, should be standardized. These include general resuscitation, and diagnosis and local treatment of the bleeding source, and one or more of the following interventions: transfusion of red cells; transfusion of clotting factor replacements; and administration of anticoagulant antidotes and other prohaemostatic agents. Reversal strategies for the 'conventional' anticoagulants are based largely on clinical evidence, whereas evidence to guide the management of bleeding associated with 'new' anticoagulants is emerging. This review provides an evidence-based, but practical, patient-focused approach for the management of bleeding associated with the old and new anticoagulants.
Nomegestrol acetate/estradiol is a combined oral contraceptive with approval in many countries. This fixed-dose combination tablet contains nomegestrol acetate, a highly selective progestogen, and estradiol, a natural estrogen. It is the first monophasic combined oral contraceptive to contain estradiol, and is taken in 28-day cycles, consisting of 24 active therapy days with 4 placebo days (i.e. 24/4-day cycles). In two large, 1-year, randomized, open-label, multicentre, phase III trials in healthy adult women (aged 18-50 years), nomegestrol acetate/estradiol was at least as effective as drospirenone/ethinylestradiol as contraceptive therapy, as the pregnancy rates in women aged 18-35 years (primary efficacy population) in terms of the Pearl Index (primary endpoint) were numerically lower with nomegestrol acetate/estradiol, although the between-group difference was not statistically significant. In both trials, nomegestrol acetate/estradiol was given in a 24/4-day cycle, and drospirenone/ethinylestradiol was given in a 21/7-day cycle. The criteria for using condoms in case of forgotten doses were less stringent in the nomegestrol acetate/estradiol group than in the drospirenone/ethinylestradiol group. Nomegestrol acetate/estradiol therapy for up to 1 year was generally well tolerated in healthy adult women, with an acceptable tolerability profile in line with that expected for a combined oral contraceptive. The most commonly reported adverse events were acne and abnormal withdrawal bleeding (most often shorter, lighter or absent periods). Overall, compared with drospirenone/ethinylestradiol, nomegestrol acetate/estradiol appeared to be associated with less favourable acne-related outcomes, and shorter, lighter or absent periods.
Constant efforts are being made in the stroke community to aim for maximum benefit from thrombolytic therapy since the approval of intravenous recombinant tissue plasminogen activator (rt-PA; alteplase) for the management of acute ischaemic stroke. However, fear of symptomatic haemorrhage secondary to thrombolytic therapy has been a major concern for treating physicians. Certain imaging and clinical variables may help guide the clinician towards better treatment decision making. Aggressive management of some predictive variables that have been shown to be surrogate outcome measures has been related to better clinical outcomes. Achieving faster, safer and complete recanalization with evolving endovascular techniques is routinely practiced to achieve better clinical outcomes. Selection of an 'ideal candidate' for thrombolysis can maximize functional outcomes in these patients. Although speed and safety are the key factors in acute management of stroke patients, there must also be a systematic and organized pattern to assist the stroke physician in making decisions to select the 'ideal candidate' for treatment to maximize results.
Ferumoxytol is an intravenously administered iron preparation indicated in the EU and the US for the treatment of iron deficiency anaemia in adult patients with chronic kidney disease (CKD). It consists of superparamagnetic iron oxide nanoparticles coated with a semi-synthetic carbohydrate shell in an isotonic, neutral pH solution that can be administered at relatively high dose by rapid intravenous injection. In phase III, randomized, controlled trials, two doses of ferumoxytol (510?mg iron/dose) given 2-8 days apart increased mean haemoglobin levels from baseline to week 5 significantly more than oral iron (200?mg/day for 21 days) in adult patients with iron deficiency anaemia and CKD stages 1-5. Ferumoxytol was more effective than oral iron both in patients with non-dialysis-dependent CKD and in those with haemodialysis-dependent CKD. Ferumoxytol was generally well tolerated in randomized controlled clinical trials. Most adverse events were mild or moderate in intensity; serious hypersensitivity or hypotensive reactions were uncommon. Local injection-site reactions were the most common system/organ-class adverse events in a pooled analysis of clinical studies and post-marketing experience.
In children with bona fide AOM for whom clinical outcomes are assessed by validated otoscopists, 10 days of high-dose amoxicillin/clavulanic acid is significantly more effective than 5 days of cefdinir as therapy for AOM. Because of the identified age effect (correlated to child weight), higher doses of cefdinir may have led to a different conclusion; 10 days of cefdinir may also have led to a different conclusion.
Aclidinium, an inhaled, long-acting antimuscarinic agent, has been developed as a twice-daily maintenance treatment for chronic obstructive pulmonary disease (COPD). Treatment with the approved dosage of aclidinium (400?µg twice daily) statistically significantly improved bronchodilation, disease-specific health status, dyspnoea, night-time COPD symptoms and use of rescue medication compared with placebo in pivotal studies of 12 (ACCORD COPD I) or 24 (ATTAIN) weeks duration in patients with moderate to severe COPD. The improvements in bronchodilation, health status and dyspnoea were clinically meaningful compared with placebo after 24 weeks of treatment in ATTAIN; generally similar results were seen after 12 weeks of treatment in both trials. Aclidinium also statistically significantly reduced the incidence of COPD exacerbations compared with placebo in these studies (albeit neither trial was designed to assess exacerbation frequency). Inhaled aclidinium has a low systemic bioavailability; the approved dosage was generally well tolerated in clinical trials of up to 52 weeks duration. Aclidinium had an adverse event profile that was similar to that of placebo and characterized by low incidences of major adverse cardiovascular events and potential anticholinergic adverse events.
 
FAMILY MEDICINE
 
BACKGROUND: This study reports on the number of graduates entering family medicine residencies in 2011 from allopathic, osteopathic, and international medical schools. Allopathic graduate data come from medical school registrars or the American Medical Association Masterfile. The 2012 family medicine residency program director census, with a response rate of 100%, verified residents who entered training July 2011 from all medical schools. Approximately 8.4% allopathic medical school's graduates of the 17,478 graduates (July 2010 to June 2011) were first-year family medicine residents in 2011, compared with 8.0% in 2010 and 7.5% in 2009. The percent of medical school graduates entering family medicine from each of the allopathic schools was calculated and averaged over 3 years to diminish 1-year fluctuations. Allopathic medical schools' 3-year average percentage of graduates who entered family medicine residency programs in 2011 ranged from 0.6% to 21.4%. Compared to 2010, osteopathic graduates in Accreditation Council for Graduate Medical Education-accredited family medicine residencies (21.5%) increased 2.8% from 2010, whereas international medical graduates (32.1%) decreased 3.4%. An increasing trend is seen in the number of allopathic graduates entering family medicine residencies. Osteopathic and international graduates' entry to residency appears inversely related. As medical schools emphasize social accountability to improve the health of communities, higher family medicine graduation rates may occur. Initiatives in medical school admissions may increase the number of medical students more likely to select family medicine careers.
BACKGROUND: The percentage of US seniors choosing primary care careers remains well below the nation's future workforce needs. Data in this article are collected from the 2012 National Resident Matching Program (NRMP) Main Residency Match and the 2012 American Academy of Family Physicians (AAFP) Medical Education Residency Census, which had a response rate of 100%. The census verified residents who entered training July 2012 from all medical schools. The information provided includes the number of applicants to graduate medical education programs for the 2012--2013 academic year, specialty choice, and trends in specialty selection. Compared with the 2011 Match, family medicine residency programs filled 35 more positions (with 18 more US seniors) through the NRMP in 2012. In other primary care fields, 31 more primary care internal medicine positions (20 more US seniors), two fewer positions in pediatrics-primary care (one less US senior), and 18 fewer positions in internal medicine-pediatrics programs (33 fewer US seniors) filled. The 2012 NRMP results indicate a small increase in medical students choosing primary care careers for the third year in a row; however, students continue to show an overall preference for subspecialty careers.
Most family physicians providing contraceptive care were not offering methods with top-tier effectiveness, although they reported interest in updating contraceptive skills through training. Obstetrician-gynecologists had technical skills to offer intrauterine contraception but still required education on patient selection. Greater hands-on training opportunities for family physicians, and complementary education on eligible method candidates for obstetrician-gynecologists, can increase access to intrauterine contraception by women seeking contraceptive care.
Implementation of the 2001 and 2006 ASCCP guidelines significantly reduced the number colposcopies performed, resulting in greater difficulty training competent family medicine residents in colposcopy.
 
FAMILY PRACTICE
 
With tailored training, GPs were able to assess LV function with sMAE and pUS. pUS, as a supplement to the physical examination, may become an important tool in general practice.
Before computer installation and full EHR implementation, physicians expressed concerns about the impact of computer use on patient care. After installation and implementation, however, many concerns were mitigated. Using computers in the examination rooms to document and access patients' records along with online medical information and decision-making tools appears to contribute to improved physician-patient communication and collaboration.
GPs excise a considerable number of SCCs in primary care. GPs compare favourably to skin specialists in excising SCCs. The performance of infrequent GP excisers does not appear to differ significantly from that of frequent GP excisers. Further work is required to define more clearly the role of GPs in the management of SCCs.
Physicians are moderately optimistic that patients will follow their weight loss, nutrition and physical activity recommendations. Patients might perceive physicians' confidence in them and thus feel more confident themselves. Physicians, however, are not very accurate in predicting which patients will or will not change behaviours. Their optimism, although helpful for patient confidence, might make physicians less receptive to learning effective counselling techniques.
High quality of consultation has a positive, but small, impact on the appropriateness of decisions. Quality of consultation needs to be targeted in training and support of triage nurses, especially when it concerns highly urgent contacts.
Women were not aware of family doctors' interest in issues aside from physical health. They appreciated a confidential and non-threatening environment and valued follow-up and advocacy on their behalf. They expressed frustration with open access scheduling and multiple providers. To improve care, family physicians should educate patients about their role, provide safe environments for disclosure and offer follow-up and support. Recommended system changes include measures to ensure continuity of care and easy booking of appointments. Finally, family physicians should recognize that there is a need to follow these patients long term as the effects of IPV are long lasting.
The computer is a third party in the GP consultation and often requires silent time during doctor-computer interaction. Doctors' control and patients allow silence for the doctor to complete tasks often involving the computer and also for time out from the consultation. There is a clear pattern of when doctors need most to have silence and consultation models should be developed that reflect this need.
People with emotional problems above the age of 50 years are more likely to prefer help for their problems from their GP regardless of the presence of any mental disorder or of a chronic medical disease.
 
GASTROENTEROLOGIA Y HEPATOLOGIA
 
La enfermedad por hígado graso no alcohólico es un espectro patológico que va desde la simple esteatosis hasta la esteatohepatitis, en ausencia de consumo de alcohol en cantidades perjudiciales, y se considera la manifestación hepática del síndrome metabólico. Estudios recientes indican que se relaciona estrechamente con la enfermedad cardiovascular, sobre todo con el engrosamiento de la capa íntima-media de la arteria carótida, como manifestación morfoestructural de la presencia de ateromatosis subclínica. Por tanto, el manejo correcto de la enfermedad por depósito graso no alcohólico permitirá modificar la historia natural de la enfermedad tanto hepática como aterosclerótica.
 
JAMA
 
Among men in this cohort, smoking, hypertension, hypercholesterolemia, and type 2 diabetes account for the majority of risk associated with development of clinically significant PAD.
Between 1988 and 2010, favorable trends in lipid levels have occurred among adults in the United States.
In this observational study of patients with either CAD risk factors only, known prior MI, or known CAD without MI, the use of ß-blockers was not associated with a lower risk of composite cardiovascular events.
In this trial, monthly administration of 100,000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults.
 
MEDICINA CLINICA
 
Desde hace años, el cáncer de pulmón es el tumor que origina un mayor número de muertes en los países industrializados y emergentes. Un cuidado meticuloso de los aspectos nutricionales, insistiendo en altos niveles de consumo de frutas y verduras, puede suponer un importante elemento de prevención primaria. Investigando el efecto de sustancias con poder antioxidante, numerosos estudios epidemiológicos han centrado su atención en los flavonoides. El objetivo de esta revisión es analizar la evidencia científica disponible en la literatura médica respecto al papel de los flavonoides en el cáncer de pulmón. Tras una revisión bibliográfica sistemática, se identificaron un metaanálisis, una revisión sistemática, 11 estudios prospectivos de cohortes y 5 estudios de casos y controles.
Tras analizar la evidencia científica establecida por estos trabajos, se observó un pequeño efecto protector del consumo de flavonoides (especialmente a altas dosis) frente al desarrollo de cáncer de pulmón, aunque no todos los estudios lo confirman. En este sentido, parecen no existir diferencias entre la ingesta selectiva de distintos tipos de flavonoides y el consumo de flavonoides totales, pero sí se observan diferencias entre las distintas poblaciones estudiadas.
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
La saturación de oxígeno mediante pulsioximetría es útil para establecer el diagnóstico y la gravedad de la insuficiencia cardiaca en situaciones agudas como el infarto de miocardio y puede tener implicaciones pronósticas. El diagnóstico debe sospecharse cuando la saturación de oxígeno mediante pulsioximetría basal es <93.
 
LANCET
 
Epilepsy is a common neurological disorder that is complicated by psychiatric, cognitive, and social comorbidities that have become a major target of concern and investigation in view of their adverse effect on the course and quality of life. In this report we define the specific psychiatric, cognitive, and social comorbidities of paediatric and adult epilepsy, their epidemiology, and real life effects; examine the relation between epilepsy syndromes and the risk of neurobehavioural comorbidities; address the lifespan effect of epilepsy on brain neurodevelopment and brain ageing and the risk of neurobehavioural comorbidities; consider the overarching effect of broader brain disorders on both epilepsy and neurobehavioural comorbidities; examine directions of causality and the contribution of selected epilepsy-related characteristics; and outline clinic-friendly screening approaches for these problems and recommended pharmacological, behavioural, and educational interventions.
 
NEJM
 
Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up (the prespecified primary outcome).
Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children
Regular use of aspirin after diagnosis was associated with longer survival among patients with mutated-PIK3CA colorectal cancer, but not among patients with wild-type PIK3CA cancer. The findings from this molecular pathological epidemiology study suggest that the PIK3CA mutation in colorectal cancer may serve as a predictive molecular biomarker for adjuvant aspirin therapy.
In a large cohort study, we found that patients who had an out-of-hospital cardiac arrest in low-income black neighborhoods were less likely to receive bystander-initiated CPR than those in high-income white neighborhoods
In a study of people without known cardiovascular disease, we estimated that under current treatment guidelines, assessment of the CRP or fibrinogen level in people at intermediate risk for a cardiovascular event could help prevent one additional event over a period of 10 years for every 400 to 500 people screened.
In comparing radiofrequency ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation, we found no significant difference between the treatment groups in the cumulative burden of atrial fibrillation over a period of 2 years
In patients with Alzheimer's disease who had psychosis or agitation that had responded to risperidone therapy for 4 to 8 months, discontinuation of risperidone was associated with an increased risk of relapse.
 
 
 
 

                      

XXVIII Congreso de Comunicación y Salud

 

 

21 Jor. Residentes y Tutores semFYC

 


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