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Diciembre 2013 PDF Imprimir E-mail
Martes, 07 de Enero de 2014 00:00

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SELECCIÓN DE REFERENCIAS BIBLIOGRÁFICAS DE LO PUBLICADO EN RELACIÓN CON ATENCIÓN PRIMARIA

Selección realizada por Antonio Manteca González
 
ACADEMIC MEDICINE
 
Sklar DP. How many doctors will we need? A special issue on the physician workforce. Acad Med 2013;88:1785-1787 [AO,I]
NÚMERO ESPECIAL SOBRE EL PERSONAL MÉDICO
 
Howell JD. The changing meaning of a health care workforce. Acad Med 2013;88:1795-1797 [AO,I]
EL SIGNIFICADO CAMBIANTE DEL PERSONAL DE ATENCIÓN SANITARIA
 
Pershing S, Fuchs VR. Restructuring medical education to meet current and future health care needs. Acad Med 2013;88:1798-1801 [AO,II]
REESTRUCTURAR LA FORMACIÓN MÉDICA PARA ADECUAR LAS NECESIDADES ASISTENCIALES SANITARIAS ACTUALES Y FUTURAS
 
Whitcomb ME. Decreasing the length of residency training: a public policy perspective. Acad Med 2013;88:1802-1803 [AO,I]
DISMINUIR LA DURACIÓN DE LA FORMACIÓN DE LA RESIDENCIA: PERSPECTIVA DE POLÍTICA PÚBLICA
 
Mahon KE, Henderson MK, Kirch DG. Selecting tomorrow's physicians: the key to the future health care workforce. Acad Med 2013;88:1806-1811 [R,II]
SELECCIONAR A LOS MÉDICOS DE MAÑANA: LA CLAVE DEL FUTURO DEL PERSONAL DE ATENCIÓN SANITARIA
 
Grover A, Niecko-Najjum LM. Physician workforce planning in an era of health care reform. Acad Med 2013;88:1822-1826 [AO,I]
PLANIFICACIÓN DEL PERSONAL MÉDICO EN UNA ERA DE REFORMA SANITARIA
 
Grover A, Niecko-Najjum LM. Primary care teams: are we there yet? Implications for workforce planning. Acad Med 2013;88:1827-1829 [AO,I]
EQUIPOS DE ATENCIÓN PRIMARIA: ¿TODAVÍA ESTAMOS AHÍ? IMPLICACIONES PARA LA PLANIFICACIÓN DE PERSONAL
 
ANNALS OF INTERNAL MEDICINE
 
Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. Oral high-dose multivitamins and minerals after myocardial infarction: randomized trial. Ann Intern Med 2013;159:797-805 [EC,I]
                                R/C
MULTIVITAMINAS Y MINERALES ORALES A DOSIS ALTAS TRAS INFARTO DE MIOCARDIO: ENSAYO ALEATORIZADO
 
Grodstein F, O'Brien J, Kang JH, Cook NR, Okereke O, Manson JAE, et al. Long-term multivitamin supplementation and cognitive function in men: a randomized trial. Ann Intern Med 2013;159:806-814 [EC,I]
                                R/C
SUPLEMENTOS DE VITAMINAS A LARGO PLAZO Y FUNCIÓN COGNITIVA EN HOMBRES: ENSAYO ALEATORIZADO
 
Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER. Enough is enough: stop wasting money on vitamin and mineral supplements. Ann Intern Med 2013;159:850-851 [AO,II]
YA ES SUFICIENTE: BASTA DE DESPERDICIAR DINERO EN SUPLEMENTOS DE VITAMINAS Y MINERALES
 
Lederle FA. Abdominal aortic aneurysm: still no pill. Ann Intern Med 2013;159:852-853 [AO,I]
ANEURISMA AÓRTICO ABDOMINAL: TODAVÍA NO HAY PASTILLAS
 
Qaseem A, Hopkins RH, Sweet DE, Starkey M, Shekelle P. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: a clinical practice guideline from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med 2013 [Epub ahead of print] [M,II]
CRIBAJE, MONITORIZACIÓN Y TRATAMIENTO DE LA ENFERMEDAD RENAL CRÓNICA EN ESTADIOS 1 A 3: GUÍA DE PRÁCTICA CLÍNICA DEL COMITÉ DE GUÍAS CLÍNICAS DEL AMERICAN COLLEGE OF PHYSICIANS
 
Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2013 [Epub ahead of print] [M,II]
SUPLEMENTOS DE VITAMINAS Y MINERALES EN LA PREVENCIÓN PRIMARIA DE LA ENFERMEDAD CARDIOVASCULAR Y EL CÁNCER: REVISIÓN SISTEMÁTICA ACTUALIZADA DE LA EVIDENCIA PARA EL USPSTF
 
ARCHIVOS DE BRONCONEUMOLOGIA
 
Dacal R, Tumbeiro M, Alves MT, Santalla ML, Acuña A, Marcos P. Síndrome de apnea-hipopnea del sueño en pacientes normopeso: características y comparación con pacientes con sobrepeso y obesidad. Arch Bronconeumol 2013;49:513-517 [T,I]
SÍNDROME DE APNEA-HIPOPNEA DEL SUEÑO EN PACIENTES NORMOPESO: CARACTERÍSTICAS Y COMPARACIÓN CON PACIENTES CON SOBREPESO Y OBESIDAD
 
ATENCION PRIMARIA
 
Zurro AM. El Task Force español sobre promoción y prevención. Demasiados años de insistencia improductiva. Aten Primaria 2013;45:501-502 [AO,I]
EL TASK FORCE ESPAÑOL SOBRE PROMOCIÓN Y PREVENCIÓN. DEMASIADOS AÑOS DE INSISTENCIA IMPRODUCTIVA
 
Irizar MI, Arrondo MA, Insausti MJ, Mujica J, Etxabarri P, Ganzarain R. Epidemiología de la neumonía adquirida en la comunidad. Aten Primaria 2013;45:503-513 [T,II]
EPIDEMIOLOGÍA DE LA NEUMONÍA ADQUIRIDA EN LA COMUNIDAD
 
Ramos-Morcillo AJ, Martínez-López EJ, Fernández-Salazar S, Del-Pino-Casado R. Diseño y validación de un cuestionario sobre las actitudes ante la prevención y promoción de la salud en atención primaria (CAPPAP) Aten Primaria 2013;45:514-521 [T,I]
DISEÑO Y VALIDACIÓN DE UN CUESTIONARIO SOBRE LAS ACTITUDES ANTE LA PREVENCIÓN Y PROMOCIÓN DE LA SALUD EN ATENCIÓN PRIMARIA (CAPPAP)
 
García-Giralda L, Quiralte J, Sánchez MG, López JC, Aracil J. Impacto de la administración del cuestionario Asthma Control Test en atención primaria sobre la puntuación de control del asma. Aten Primaria 2013;45:522-527 [QE,I]
IMPACTO DE LA ADMINISTRACIÓN DEL CUESTIONARIO ASTHMA CONTROL TEST EN ATENCIÓN PRIMARIA SOBRE LA PUNTUACIÓN DE CONTROL DEL ASMA
 
Carrera-Lasfuentes P, Aguilar-Palacio I, Clemente E, Malo S, Rabanaque MJ. Consumo de medicamentos en población adulta: influencia del autoconsumo. Aten Primaria 2013;45:528-535 [T,I]
CONSUMO DE MEDICAMENTOS EN POBLACIÓN ADULTA: INFLUENCIA DEL AUTOCONSUMO
 
Cerecedo MJ, Tovar M, Rozadilla A. Medicalización de la vida en la consulta: ¿hacia dónde caminamos? Aten Primaria 2013;45:536-540 [AO,II]
MEDICALIZACIÓN DE LA VIDA EN LA CONSULTA: ¿HACIA DÓNDE CAMINAMOS?
 
BRITISH MEDICAL JOURNAL
 
Campbell J, Colvin LA. Management of low back pain. BMJ 2013;347:bmj.f3148 [R,I]
MANEJO DE LA LUMBALGIA
 
Ballantyne JC. Treating pain in patients with drug-dependence problems. BMJ 2013;347:bmj.f3213 [R,I]
TRATAR EL DOLOR EN PACIENTES CON PROBLEMAS DE DROGODEPENDENCIA
 
Azad MB, Coneys JG, Kozyrskyj AL, Field CJ, Ramsey CD, Becker AB, et al. Probiotic supplementation during pregnancy or infancy for the prevention of asthma and wheeze: systematic review and meta-analysis. BMJ 2013;347:f6471 [M,II]
SUPLEMENTOS PROBIÓTICOS DURANTE EL EMBARAZO O LA INFANCIA PARA LA PREVENCIÓN DEL ASMA Y LAS SIBILANCIAS: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
Macauley Y, O'Donnell P, Duncan HF. Dental pain. BMJ 2013;347:f6539 [R,I]
DOLOR DENTAL
 
Quint JK, Herrett E, Bhaskaran K, Timmis A, Hemingway H, Wedzicha JA, et al. Effect of ß blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records. BMJ 2013;347:f6650 [S,II]
EFECTO DE LOS BETABLOQUEANTES SOBRE LA MORTALIDAD TRAS INFARTO DE MIOCARDIO EN ADULTOS CON EPOC: ESTUDIO DE COHORTE POBLACIONAL DE LAS HISTORIAS CLÍNICAS ELECTRÓNICAS DE R.U.
 
Laakkonen ML, Pitkälä K. Supporting people who care for adults with dementia. BMJ 2013;347:f6691[AO,II]
APOYAR A LAS PERSONAS QUE CUIDAN A ADULTOS CON DEMENCIA
 
Shen L, Shah BR, Reyes EM, Thomas L, Wojdyla D, Diem P, et al. Role of diuretics, ß blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study. BMJ 2013;347:f6745 [EC,II]
PAPEL DE LOS DIURÉTICOS, BETABLOQUEANTES Y ESTATINAS EN EL AUMENTO DE RIESGO DE DIABETES EN PACIENTES CON TOLERANCIA ALTERADA A LA GLUCOSA: REANÁLISIS DE DATOS DEL ESTUDIO NAVIGATOR
 
Jakes AD, Bhandari S. Investigating polyuria. BMJ 2013;347:f6772 [R,I]
INVESTIGAR LA POLIURIA
 
Benson RA, Palin R, Holt PJ, Loftus IM. Diagnosis and management of hyperhidrosis. BMJ 2013;347:f6800 [R,I]
DIAGNÓSTICO Y MANEJO DE LA HIPERHIDROSIS
 
Nakahara S, Tomio J, Takahashi H, Ichikawa M, Nishida M, Morimura N, et al. Evaluation of pre-hospital administration of adrenaline (epinephrine) by emergency medical services for patients with out of hospital cardiac arrest in Japan: controlled propensity matched retrospective cohort study. BMJ 2013;347:f6829 [S,II]
EVALUACIÓN DE LA ADMINISTRACIÓN PREHOSPITALARIA DE ADRENALINA (EPINEFRINA) POR LOS SERVICIOS MÉDICOS DE URGENCIAS EN PACIENTES CON PARADA CARDIACA EXTRAHOSPITALARIA EN JAPÓN: ESTUDIO PROSPECTIVO DE COHORTE CONTROLADO COMPARADO DE PROPENSIÓN
 
Little P, Stuart B, Hobbs FD, Butler CC, Hay AD, Campbell J, et al; DESCARTE investigators. Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study. BMJ 2013;347:f6867 [S,I]
PREDICTORES DE COMPLICACIONES SUPURATIVAS EN EL DOLOR AGUDO DE GARGANTA EN ATENCIÓN PRIMARIA: ESTUDIO PROSPECTIVO DE COHORTE CLÍNICA
 
Threapleton DE, Greenwood DC, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2013;347:f6879 [M,II]
INGESTA DE FIBRA DIETÉTICA Y RIESGO DE ENFERMEDAD CARDIOVASCULAR: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
George J, Majeed W, Mackenzie IS, Macdonald TM, Wei L. Association between cardiovascular events and sodium-containing effervescent, dispersible, and soluble drugs: nested case-control study. BMJ 2013;347:f6954 [CC,II]
ASOCIACIÓN ENTRE ACONTECIMIENTOS CARDIOVASCULARES Y FÁRMACOS SOLUBLES, DISPERSABLES Y EFERVESCENTES QUE CONTIENEN SODIO
 
Thompson M, Talley AV, Blair PS, Buckley DI, Heneghan C, Hay AD. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ 2013;347:f7027 [M,II]
                                R/C
DURACIÓN DE LOS SÍNTOMAS DE INFECCIONES DE VÍAS RESPIRATORIAS EN NIÑOS: REVISIÓN SISTEMÁTICA
 
Sheather J, Brannan S. Patient confidentiality in a time of care.data. BMJ 2013;347:f7042 [AO,II]
CONFIDENCIALIDAD DEL PACIENTE EN UN TIEMPO DE DATOS ASISTENCIALES
 
Rutten FH, Groenwold RH. ß blockers for adults with chronic obstructive pulmonary disease. BMJ 2013;347:f7050 [AO,I]
BETABLOQUEANTES EN ADULTOS CON EPOC
 
Godlee F. Genomics—from the lab to clinical practice. BMJ 2013;347:f7103
GENÓMICA: DEL LABORATORIO A LA PRÁCTICA CLÍNICA
 
Krumholz HM. Target cardiovascular risk rather than cholesterol concentration. BMJ 2013;347:f7110 [AO,II]
RIESGO CARDIOVASCULAR COMO DIANA EN VEZ DE CONCENTRACIÓN DE COLESTEROL
 
Osborn DA, Sinn JK. Probiotic supplements. BMJ 2013;347:f7138 [AO,I]
SUPLEMENTOS PROBIÓTICOS
 
Dowrick C, Frances A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ 2013;347:f7140 [AO,II]
MEDICALIZAR LA INFELICIDAD: LA NUEVA CLASIFICACIÓN DE LA DEPRESIÓN PONE A MÁS PACIENTES EN RIESGO DE QUE SE LES ADMINISTRE TRATAMIENTO FARMACOLÓGICO DEL QUE NO SE VAN A BENEFICIAR
 
Moynihan R, Heneghan C, Godlee F. Too Much Medicine: from evidence to action. BMJ 2013;347:f7141 [AO,II]
DEMASIADA MEDICINA: DE LA EVIDENCIA A LA ACCIÓN
 
Pipis M, Dehabadi M, Matthews E, Gould L. Tremor. BMJ 2013;347:f7200 [R,I]
TEMBLOR
 
Parashar UD, Nelson EA, Kang G. Diagnosis, management, and prevention of rotavirus gastroenteritis in children. BMJ 2013;347:f7204 [R,I]
DIAGNÓSTICO, MANEJO Y PREVENCIÓN DE LA GASTROENTERIRTIS POR ROTAVIRUS EN NIÑOS
 
Jessup S. Patient perspective: mild depression must not be ignored. BMJ 2013;347:f7225 [AO,I]
PERSPECTIVA DEL PACIENTE: NO SE DEBE PASAR POR ALTO
 
Godlee F. Where should the world invest? BMJ 2013;347:f7236 [AO,II]
¿DÓNDE DEBERÍA INVERTIR EL MUNDO?
 
Olasveengen TM. Adrenaline for out of hospital cardiac arrest? BMJ 2013;347:f7268 [AO,I]
¿ADRENALINA EN LA PARADA CARDIACA EXTRAHOSPITALARIA?
 
Kalso E, Aldington DJ, Moore RA. Drugs for neuropathic pain. BMJ 2013;347:f7339. doi [R,I]
FÁRMACOS PARA EL DOLOR NEUROPÁTICO
 
Baron RB. Eat more fibre. BMJ 2013;347:f7401 [AO,I]
COMA MÁS FIBRA
 
Bhaskaran K, Armstrong B, Wilkinson P, Haines A. Air pollution as a carcinogen. BMJ 2013;347:f7607 [AO,I]
CONTAMINACIÓN AÉREA COMO CARCINÓGENO
 
Spence D. Bad medicine: restless legs syndrome. BMJ 2013;347:f7615 [R,I]
MALA MEDICINA: SÍNDROME DE PIERNAS INQUIETAS
 
CIRCULATION
 
Lindeman JH, Abdul-Hussien H, van Bockel JH, Wolterbeek R, Kleemann R. Clinical trial of doxycycline for matrix metalloproteinase-9 inhibition in patients with an abdominal aneurysm: doxycycline selectively depletes aortic wall neutrophils and cytotoxic T cells. Circulation 2009;119:2209-2216 [EC,I]
ENSAYO CLÍNICO CON DOXICICLINA PARA LA INHIBICIÓN DE MATRIZ DE METALOPROTEINASA 9 EN PACIENTES CON ANEURISMA AÓRTICO: LA DOXICICLINA DISMINUYE DE MANERA SELECTIVA LOS NEUTRÓFILOS Y LAS CÉLULAS T CITOTÓXICAS EN LA PARED AÓRTICA
 
Capodanno D, Angiolillo DJ. Management of antiplatelet therapy in patients with coronary artery disease requiring cardiac and noncardiac surgery. Circulation 2013;128:2785-2798 [R,I]
MANEJO DE LA TERAPIA ANTIPLAQUETARIA EN PACIENTES CON ENFERMEDAD ARTERIAL CORONARIA QUE REQUIEREN CIRUGÍA CARDIACA Y NO CARDIACA
 
Beinart R, Nazarian S. Effects of external electrical and magnetic fields on pacemakers and defibrillators: from engineering principles to clinical practice. Circulation 2013;128:2799-2809 [R,I]
EFECTOS DE LOS CAMPOS ELÉCTRICOS Y MAGNÉTICOS EXTERNOS SOBRE LOS MARCAPASOS Y LOS DESFIBRILADORES: DE LOS PRINCIPIOS DE INGENIERÍA A LA PRÁCTICA CLÍNICA
 
Ganesh SK, Arnett DK, Assimes TL, Basson CT, Chakravarti A, Ellinor PT, et al; American Heart Association Council on Functional Genomics and Translational Biology, Council on Epidemiology and Prevention, Council on Basic Cardiovascular Sciences, Council on Cardiovascular Disease in the Young, Council on Cardiovascul. Genetics and genomics for the prevention and treatment of cardiovascular disease: update: a scientific statement from the American Heart Association. Circulation 2013;128:2813-2851 [M,II]
GENÉTICA Y GENÓMICA EN LA PREVENCIÓN Y TRATAMIENTO DE LA ENFERMEDAD CARDIOVASCULAR: DECLARACIÓN CIENTÍFICA DE LA AHA
 
DIABETES CARE
 
Biessels GJ. Brain MRI correlates of cognitive dysfunction in type 2 diabetes: the needle recovered from the haystack? Diabetes Care 2013;36:3855-3856 [AO,I]
IMÁGENES DE RESONANCIA MAGNÉTICA CEREBRAL EN LA DISFUNCIÓN COGNITIVA EN LA DIABETES TIPO 2: ¿LA AGUJA DESCUBIERTA EN EL PAJAR?
 
Porcellati F, Lucidi P, Bolli GB, Fanelli CG. Thirty years of research on the dawn phenomenon: lessons to optimize blood glucose control in diabetes. Diabetes Care 2013;36:3860-3862 [AO,II]
30 AÑOS DE INVESTIGACIÓN DEL FENÓMENO DEL ALBA: LECCIONES PARA OPTIMIZAR EL CONTROL GLUCÉMICO EN LA DIABETES
 
Yki-Järvinen H, Rosenstock J, Durán-Garcia S, Pinnetti S, Bhattacharya S, Thiemann S, et al. Effects of adding linagliptin to basal insulin regimen for inadequately controlled type 2 diabetes: a >=52-week randomized, double-blind study. Diabetes Care 2013;36:3875-3881 [EC,I]
EFECTOS DE AÑADIR LINAGLIPTINA AL RÉGIMEN BASAL DE INSULINA EN LA DIABETES TIPO 2 INADECUADAMENTE CONTROLADA: ESTUDIO ALEATORIZADO DOBLE CIEGO DE 52 SEMANAS O MÁS
 
Wallace IR, McEvoy CT, Hunter SJ, Hamill LL, Ennis CN, Bell PM, et al. Dose-response effect of fruit and vegetables on insulin resistance in people at high risk of cardiovascular disease: a randomized controlled trial. Diabetes Care 2013;36:3888-3896 [EC,I]
EFECTO DOSIS-RESPUESTA DE FRUTAS Y VERDURAS SOBRE LA RESISTENCIA A LA INSULINA EN PERSONAS CON ALTO RIESGO DE ENFERMEDAD CARDIOVASCULAR: ENSAYO ALEATORIZADO CONTROLADO
 
Kim NH, Cho NH, Yun CH, Lee SK, Yoon DW, Cho HJ, et al. Association of obstructive sleep apnea and glucose metabolism in subjects with or without obesity. Diabetes Care 2013;36:3909-3915 [T,I]
ASOCIACIÓN ENTRE APNEA OBSTRUCTIVA DEL SUEÑO Y EL METABOLISMO DE GLUCOSA EN SUJETOS CON Y SIN OBESIDAD
 
Tanaka S, Yoshimura Y, Kamada C, Tanaka S, Horikawa C, Okumura R, et al; Japan Diabetes Complications Study Group. Intakes of dietary fiber, vegetables, and fruits and incidence of cardiovascular disease in Japanese patients with type 2 diabetes. Diabetes Care 2013;36:3916-3922 [S,I]
INGESTA DE FIBRA DIETÉTICA, VERDURAS Y FRUTAS E INCIDENCIA DE ENFERMEDAD CARDIOVASCULAR EN PACIENTES JAPONESES CON DIABETES TIPO 2
 
Lipska KJ, Inzucchi SE, Van Ness PH, Gill TM, Kanaya A, Strotmeyer ES, et al; Health ABC Study. Elevated HbA1c and fasting plasma glucose in predicting diabetes incidence among older adults: are two better than one? Diabetes Care 2013;36:3923-3929 [S,I]
LA HBA1C ELEVADA Y LA GLUCOSA PLASMÁTICA EN AYUNAS EN LA PREDICCIÓN DE INCIDENCIA DE DIABETES ENTRE ADULTOS MAYORES: ¿SON DOS MEJOR QUE UNO?
 
Hedderson MM, Darbinian J, Havel PJ, Quesenberry CP, Sridhar S, Ehrlich S, et al. Low prepregnancy adiponectin concentrations are associated with a marked increase in risk for development of gestational diabetes mellitus. Diabetes Care 2013;36:3930-3937 [CC,I]
UNA ADIPONECTINA BAJA ANTES DEL EMBARAZO SE ASOCIA CON UN INCREMENTO MARCADO DE DESARROLLO DE DIABETES MELLITUS GESTACIONAL
 
Zhou X, Qiao Q, Ji L, Ning F, Yang W, Weng J, et al. Nonlaboratory-based risk assessment algorithm for undiagnosed type 2 diabetes developed on a nation-wide diabetes survey. Diabetes Care 2013;36:3944-3952 [T,I]
ALGORITMO DE VALORACIÓN DE RIESGO DE DIABETES TIPO 2 SIN DIAGNOSTICAR SIN USAR PRUEBAS DE LABORATORIO DESARROLLADO A PARTIR DE UNA ENCUESTA SOBRE DIABETES DE ÁMBITO NACIONAL
 
Habel LA, Danforth KN, Quesenberry CP, Capra A, Van Den Eeden SK, Weiss NS, et al. Cohort study of insulin glargine and risk of breast, prostate, and colorectal cancer among patients with diabetes. Diabetes Care 2013;36:3953-3960 [S,I]
ESTUDIO DE COHORTE DE INSULINA GLARGINA Y RIESGO DE CÁNCER DE MAMA, DE PRÓSTATA Y COLORRECTAL ENTRE PACIENTES CON DIABETES
 
Liu Y, Wang M, Morris AD, Doney AS, Leese GP, Pearson ER, et al. Glycemic exposure and blood pressure influencing progression and remission of diabetic retinopathy: a longitudinal cohort study in GoDARTS. Diabetes Care 2013;36:3979-3984 [S,I]
LA EXPOSICIÓN GLUCÉMICA Y LA PRESIÓN ARTERIAL INFLUYEN SOBRE LA PROGRESIÓN Y LA REMISIÓN DE LA RETINOPATÍA DIABÉTICA: ESTUDIO LONGITUDINAL DE COHORTE GoDARTS
 
Ferrannini E, Berk A, Hantel S, Pinnetti S, Hach T, Woerle HJ, et al. Long-term safety and efficacy of empagliflozin, sitagliptin, and metformin: an active-controlled, parallel-group, randomized, 78-week open-label extension study in patients with type 2 diabetes. Diabetes Care 2013;36:4015-4021 [EC,I]
EFECTO A LARGO PLAZO Y EFICACIA DE LA EMPAGLIFLOZINA, SITAGLIPTINA Y METFORMINA: ESTUDIO ALEATORIZADO DE GRUPO PARALELO,CONTROLADO ACTIVAMENTE, SIN ENMASCARAR PARA EL INVESTIGADOR, DE 78 SEMANAS, EN PACIENTES CON DIABETES TIPO 2
 
Buckingham B, Beck RW, Ruedy KJ, Cheng P, Kollman C, Weinzimer SA, et al; Diabetes Research in Children Network (DirecNet) and Type 1 Diabetes TrialNet Study Groups. Effectiveness of early intensive therapy on ß-cell preservation in type 1 diabetes. Diabetes Care 2013;36:4030-4035 [EC,II]
EFECTIVIDAD DEL TRATAMIENTO INTENSIVO PRECOZ SOBRE LA PRESERVACIÓN DE LA CÉLULA BETA EN LA DIABETES TIPO 1
 
Bus SA, Waaijman R, Arts M, de Haart M, Busch-Westbroek T, van Baal J, et al. Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes Care 2013;36:4109-4116 [EC,I]
EFECTO DEL CALZADO HECHO A MEDIDA SOBRE LA RECURRENCIA DE ÚLCERAS EN EL PIE EN LA DIABETES: ENSAYO CONTROLADO ALEATORIZADO MULTICÉNTRICO
 
Greenwood DC, Threapleton DE, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Diabetes Care 2013;36:4166-4171 [M,II]
ÍNDICE GLUCÉMICO, CARGA GLUCÉMICA, CARBOHIDRATOS Y DIABETES TIPO 2: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DOSIS-RESPUESTA DE ESTUDIOS PROSPECTIVOS
 
DRUGS
 
Elbehairy AF, Webb KA, Neder JA, O'Donnell DE. Should mild COPD be treated? Evidence for early pharmacological intervention. Drugs 2013;73:1991-2001 [R,II]
¿SE DEBE TRATAR EL EPOC LEVE?
 
Henness S, Yang LP. Modified-release prednisone: in patients with rheumatoid arthritis. Drugs 2013;73:2067-2076 [EC,I]
PREDNISONA DE LIBERACIÓN MODIFICADA: EN PACIENTES CON ARTRITIS REUMATOIDE
 
EUROPEAN HEART JOURNAL
 
Berdowski J, de Beus MF, Blom M, Bardai A, Bots ML, Doevendans PA, et al. Exercise-related out-of-hospital cardiac arrest in the general population: incidence and prognosis. Eur Heart J 2013;34:3616-3623 [S,II]
PARADA CARDIACA EXTRAHOSPITALARIA RELACIONADA CON EL EJERCICIO EN LA POBLACIÓN GENERAL: INCIDENCIA Y PRONÓSTICO
 
Andersen K, Farahmand B, Ahlbom A, Held C, Ljunghall S, Michaëlsson K, et al. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J 2013;34:3624-3631 [S,I]
RIESGO DE ARRITMIAS EN 52.755 ESQUIADORES DE FONDO: ESTUDIO DE COHORTE
 
Sunde K. Sudden cardiac arrest during sports. Eur Heart J 2013;34:3596-3598 [AO,I]
PARADA CARDIACA REPENTINA DURANTE EL DEPORTE
 
La Gerche A, Schmied CM. Atrial fibrillation in athletes and the interplay between exercise and health. Eur Heart J 2013;34:3599-3602 [AO,I]
FIBRILACIÓN AURICULAR EN DEPORTISTAS Y LA INTERACCIÓN ENTRE EJERCICIO Y SALUD
 
Brugada P, Brugada J, Roy D. Brugada syndrome 1992-2012: 20 years of scientific excitement, and more. Eur Heart J 2013;34:3610-3615 [R,I]
SÍNDROME DE BRUGADA 1992-2012: 20 AÑOS DE EMOCIÓN CIENTÍFICA, Y MÁS
 
Al Mheid I, Patel RS, Tangpricha V, Quyyumi AA. Vitamin D and cardiovascular disease: is the evidence solid? Eur Heart J 2013;34:3691-3698 [R,I]
VITAMINA D Y ENFERMEDAD CARDIOVASCULAR: ¿ES SÓLIDA LA EVIDENCIA?
 
FAMILY MEDICINE
 
Dickinson WP. Building highly functional interprofessional teams in our practices. Fam Med 2013;45:689-690 [AO,I]
CONSTRUIR EQUIPOS ALTAMENTE PROFESIONALES EN NUESTRAS CONSULTAS
 
Stock R, Mahoney E, Carney PA. Measuring team development in clinical care settings. Fam Med 2013;45:691-700 [T,I]
MEDIR EL DESARROLLO DEL EQUIPO EN LOS DISPOSITIVOS DE ATENCIÓN CLÍNICA
 
Carney PA, Waller E, Eiff MP, Saultz JW, Jones S, Fogarty CT, et al. Measuring family physician identity: the development of a new instrument. Fam Med 2013;45:708-718 [C,II]
MEDIR LA IDENTIDAD DEL MÉDICO DE FAMILIA: DESARROLLO DE UN NUEVO INSTRUMENTO
 
Foley K, Neuberger M, Noel M, Sleight D, Vanschagen J, Wadland W. Advancing geriatrics fellowship programs through a community-based residency network. Fam Med 2013;45:719-725 [QE,I]
AVANZAR EN LOS PROGRAMAS DE ROTACIÓN GERIÁTRICA A TRAVÉS DE UNA RED DE RESIDENCIA COMUNITARIA
 
FAMILY PRACTICE
 
Tarrant C, Wobi F, Angell E. Tackling health inequalities: socio-demographic data could play a bigger role. Fam Pract 2013;30:613-614 [AO,I]
AFRONTAR LAS DESIGUALDADES EN SALUD: LOS DATOS SOCIODEMOGRÁFICOS PODRÍAN JUGAR UN PAPEL MÁS IMPORTANTE
 
Al-Ani S, Spigt M, Hofset P, Melbye H. Predictors of exacerbations of asthma and COPD during one year in primary care. Fam Pract 2013;30:621-628 [S,I]
PREDICTORES DE EXACERBACIONES DE ASMA Y EPOC DURANTE UN AÑO EN ATENCIÓN PRIMARIA
 
Milos V, Jakobsson U, Westerlund T, Melander E, Mölstad S, Midlöv P. Theory-based interventions to reduce prescription of antibiotics--a randomized controlled trial in Sweden. Fam Pract 2013;30:634-640 [EC,I]
INTERVENCIONES BASADAS EN LA TEORÍA PARA REDUCIR LA PRESCRIPCIÓN DE ANTIBIÓTICOS: ENSAYO ALEATORIZADO CONTROLADO EN SUECIA
 
Lao C, Brown C, Obertová Z, Edlin R, Rouse P, Hodgson F, et al. The costs of identifying undiagnosed prostate cancer in asymptomatic men in New Zealand general practice. Fam Pract 2013;30:641-647 [CE,I]
LOS COSTES DE IDENTIFICAR EL CÁNCER DE PRÓSTATA SIN DIAGNOSTICAR EN HOMBRES ASINTOMÁTICOS EN LA MEDICINA GENERAL EN NUEVA ZELANDA
 
Hamoen EH, Reukers DF, Numans ME, Barentsz JO, Witjes JA, Rovers MM. Discrepancies between guidelines and clinical practice regarding prostate-specific antigen testing. Fam Pract 2013;30:648-654 [S,I]
DISCREPANCIAS ENTRE LAS GUÍAS Y LA PRÁCTICA CLÍNICA RESPECTO AL ANÁLISIS DE PSA
 
Wilson C, Hogg R, Henderson M, Wilson P. Patterns of primary care service use by families with young children. Fam Pract 2013;30:679-694 [S,I]
PATRONES DE USO DE LOS SERVICIOS DE ATENCIÓN PRIMARIA POR PARTE DE FAMILIAS CON NIÑOS PEQUEÑOS
 
Dijksman I, Dinant GJ, Spigt MG. eDiagnostics: a promising step towards primary mental health care. Fam Pract 2013;30:695-704 [T,I]
eDIAGNÓSTICO: UN PASO PROMETEDOR HACIA LA ATENCIÓN DE SALUD MENTAL PRIMARIA
 
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
 
Steinhubl SR, Muse ED, Topol EJ. Can mobile health technologies transform health care? JAMA 2013;310:2395-2396 [AO,I]
¿PUEDEN LAS TECNOLOGÍAS MÓVILES DE LA SALUD TRANSFORMAR LA ATENCIÓN SANITARIA?
 
Korn D, Carlat D. Conflicts of interest in medical education: recommendations from the Pew task force on medical conflicts of interest. JAMA 2013;310:2397-2398 [R,II]
CONFLICTOS DE INTERÉS EN LA FORMACIÓN MÉDICA: RECOMENDACIONES DEL GRUPO DE TRABAJO PEW SOBRE CONFLICTOS DE INTERÉS MÉDICOS
 
Ikramuddin S, Livingston EH. New insights on bariatric surgery outcomes. JAMA 2013;310:2401-2402 [AO,I]
NUEVAS REFLEXIONES SOBRE LOS RESULTADOS DE LA CIRUGÍA BARIÁTRICA
 
Robinson JG. Accumulating evidence for statins in primary prevention. JAMA 2013;310:2405-2406 [AO,I]
ACUMULAR EVIDENCIA SOBRE LAS ESTATINAS EN PREVENCIÓN PRIMARIA
 
Martínez-García MA, Capote F, Campos-Rodríguez F, Lloberes P, Díaz de Atauri MJ, Somoza M, et al; Spanish Sleep Network. Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension: the HIPARCO randomized clinical trial. JAMA 2013;310:2407-2415 [EC,II]
EFECTO DEL CPAP SOBRE LA PRESIÓN ARTERIAL EN PACIENTES CON SAOS E HIPERTENSIÓN RESISTENTE: ENSAYO CLÍNICO ALEATORIZADO HIPARCO
 
Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013;310:2435-2442 [CC,I]
USO DE INHIBIDORES DE LA BOMBA DE PROTONES Y DE ANTAGONISTAS DEL RECEPTOR DE HISTAMINA 2 Y DÉFICIT DE VITAMINA B12
 
Berger TG, Shive M, Harper GM. Pruritus in the older patient: a clinical review. JAMA 2013;310:2443-2450 [M,II]
PRURITO EN PACIENTES MAYORES: REVISIÓN CLÍNICA
 
Taylor FC, Huffman M, Ebrahim S. Statin therapy for primary prevention of cardiovascular disease. JAMA 2013;310:2451-2452 [R,II]
TERAPIA CON ESTATINAS EN LA PREVENCIÓN PRIMARIA DE ENFERMEDAD CARDIOVASCULAR
 
Montori VM, Brito JP, Murad MH. The optimal practice of evidence-based medicine: incorporating patient preferences in practice guidelines. JAMA 2013 18;310:2503-2504 [AO,I]
24165826
LA PRÁCTICA ÓPTIMA DE LA MEDICINA BASADA EN LA EVIDENCIA: INCORPORAR LAS PREFERENCIAS DE LOS PACIENTES A LAS GUÍAS DE PRÁCTICA CLÍNICA
 
Gandhi S, Fleet JL, Bailey DG, McArthur E, Wald R, Rehman F, et al. Calcium-channel blocker-clarithromycin drug interactions and acute kidney injury. JAMA 2013;310:2544-2553 [S,II]
INTERACCIONES FARMACOLÓGICAS ENTRE BLOQUEADORES DE LOS CANALES DEL CALCIO Y CLARITROMICINA Y DAÑO RENAL AGUDO
 
Connelly M. Cognitive behavioral therapy for treatment of pediatric chronic migraine. JAMA 2013;310:2617-2618 [AO,I]
TERAPIA COGNITIVO-CONDUCTUAL EN EL TRATAMIENTO DE LA MIGRAÑA CRÓNICA PEDIÁTRICA
 
Powers SW, Kashikar-Zuck SM, Allen JR, LeCates SL, Slater SK, Zafar M, et al. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA 2013;310:2622-2630 [EC,I]
TERAPIA COGNITIVO-CONDUCTUAL MÁS AMITRIPTILINA EN LA MIGRAÑA CRÓNICA EN NIÑOS Y ADOLESCENTES: ENSAYO CLÍNICO ALEATORIZADO
 
Dysken MW, Sano M, Asthana S, Vertrees JE, Pallaki M, Llorente M, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA 2014;311:33-44 [EC,II]
EFECTO DE LA VITAMINA E Y LA MEMANTINA SOBRE EL DECLIVE FUNCIONAL EN LA ENFERMEDAD DE ALZHEIMER: ENSAYO ALEATORIZADO COOPERATIVO TEAM-ADVA
 
JAMA INTERNAL MEDICINE
 
Johnston CB. Patient satisfaction and its discontents. JAMA Intern Med 2013;173:2025-2026 [AO,I]
LA SATISFACCIÓN DEL PACIENTE Y SUS INSATISFACCIONES
 
Welch HG. Informed choice in cancer screening. JAMA Intern Med 2013;173:2088 [AO,I]
ELECCIÓN INFORMADA EN EL CRIBAJE DEL CÁNCER
 
MEDICINA CLINICA
 
Briongos S, García C, Badimón JJ. Avances en el tratamiento anticoagulante oral de la fibrilación auricular. Med Clin (Barc) 2013;141:487-493 [R,I]
AVANCES EN EL TRATAMIENTO ANTICOAGULANTE ORAL DE LA FIBRILACIÓN AURICULAR
 
Peiró AM. Utilización de la farmacogenética en la práctica clínica: tratamiento del dolor. Med Clin (Barc) 2013;141:501-506 [R,I]
UTILIZACIÓN DE LA FARMACOGENÉTICA EN LA PRÁCTICA CLÍNICA: TRATAMIENTO DEL DOLOR
 
Campos MG, Oliart RM, Martínez A, Méndez GF, Angulo JO. Reversión del síndrome metabólico por el consumo de ácidos grasos poliinsaturados. Med Clin (Barc) 2013;141:513-518 [EC,II]
REVERSIÓN DEL SÍNDROME METABÓLICO POR EL CONSUMO DE ÁCIDOS GRASOS POLIINSATURADOS
 
Pérez MR, Almazán R, Martínez JM, Alves MT, Segura MC, Pérez R. Intervención educativa para la prevención de osteoporosis en un servicio de Atención Primaria rural. Med Clin (Barc) 2013;141:519-521 [EC,I]
INTERVENCIÓN EDUCATIVA PARA LA PREVENCIÓN DE OSTEOPOROSIS EN UN SERVICIO DE ATENCIÓN PRIMARIA RURAL
 
Pérez-Rojo G, Izal M, Montorio I, Regato P, Espinosa JM. Prevalencia de malos tratos hacia personas mayores que viven en la comunidad en España. Med Clin (Barc) 2013;141:522-526 [T,I]
PREVALENCIA DE MALOS TRATOS HACIA PERSONAS MAYORES QUE VIVEN EN LA COMUNIDAD EN ESPAÑA
 
Sanfélix-Gimeno G. Oportunidades de mejora en el tratamiento de la osteoporosis. Tiempo de abordar lo importante. Med Clin (Barc) 2013;141:527-528 [AO,I]
OPORTUNIDADES DE MEJORA EN EL TRATAMIENTO DE LA OSTEOPOROSIS. TIEMPO DE ABORDAR LO IMPORTANTE
 
MORBIDITY AND MORTALITY WEEKLY REPORT
 
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. CDC Guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR Recomm Rep 2013;62(RR-10):1-19 [M,III]
PAUTAS PARA EVALUAR LA PROTECCIÓN CONTRA EL VIRUS DE LA HEPATITIS B EN EL PERSONAL DE ATENCIÓN SANITARIA Y PARA ADMINISTRAR EL MANEJO POSTEXPOSICIÓN
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
Bardaji A. REGICOR: 35 años de excelencia en investigación cardiovascular. Rev Esp Cardiol 2013;66:923-925 [R,II]
REGICOR: 35 AÑOS DE EXCELENCIA EN INVESTIGACIÓN CARDIOVASCULAR
 
Coll B, Betriu A, Feinstein SB, Valdivielso JM, Zamorano JL, Fernandez E. Papel de la ecografía carotídea en la reclasificación del riesgo cardiovascular de sujetos de riesgo bajo-intermedio. Rev Esp Cardiol 2013;66:929-934 [T,I]
                                R/C
PAPEL DE LA ECOGRAFÍA CAROTÍDEA EN LA RECLASIFICACIÓN DEL RIESGO CARDIOVASCULAR DE SUJETOS DE RIESGO BAJO-INTERMEDIO
 
SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE
 
Liira H. Computers and compassion in general practice. Scand J Prim Health Care 2013;31:182 [AO,I]
ORDENADORES Y COMPASIÓN EN LA MEDICINA GENERAL
 
Spee LA, Lisman-Van Leeuwen Y, Benninga MA, Bierma-Zeinstra SM, Berger MY. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice. Scand J Prim Health Care 2013;31:197-202 [T,I]
PREVALENCIA, CARACTERÍSTICAS Y MANEJO DEL DOLOR ABDOMINAL FUNCIONAL INFANTIL EN LA MEDICINA GENERAL
 
Heins M, Schellevis F, Rijken M, Donker G, van der L, Korevaar J. Partners of cancer patients consult their GPs significantly more often with both somatic and psychosocial problems. Scand J Prim Health Care 2013;31:203-208 [S,II]
LAS PAREJAS DE PACIENTES DE CÁNCER CONSULTAN A SUS MÉDEICOS GENERALES SIGNIFICATIVAMENTE MÁS A MENUDO CON PROBLEMAS TANTO SOMÁTICOS COMO PSICOSOMÁTICOS
 
McQuiston J, Rosborg M, Sternhagen AB, Llor C, Bjerrum L. Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe. Scand J Prim Health Care 2013;31:235-240 [M,II]
DIFERENTES RECOMENDACIONES PARA EL TRATAMIENTO ANTIBIÓTICO EMPÍRICO DE PRIMERA ELECCIÓN PARA LAS INFECCIONES DE VÍAS URINARIAS NO COMPLICADAS EN EUROPA
 
THE LANCET
 
Horton R, Lo S. Investing in health: why, what, and three reflections. Lancet 2013;382:1859-1861 [AO,I]
INVERTIR EN SALUD: POR QUÉ, QUÉ Y TRES REFLEXIONES
 
Xiao D1, Chen Z2, Wang C3. Effects of a short-term mass-media campaign against smoking. Lancet 2013;382:1964-1966 [AO,I]
EFECTOS DE UNA CAMPAÑA A CORTO PLAZO EN LOS MEDIOS DE COMUNICACIÓN CONTRA EL TABACO
 
Hankey GJ. Training caregivers of disabled patients after stroke. Lancet 2013;382:2043-2044 [AO,I]
ENTRENAR A LOS CUIDADORES DE PACIENTES DISCAPACITADOS TRAS UN ICTUS
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
Zineh I, Pacanowski M, Woodcock J. Pharmacogenetics and coumarin dosing--recalibrating expectations. N Engl J Med 2013;369:2273-2275 [AO,I]
FARMACOGENÉTICA Y DOSIFICACIÓN DE CUMARINAS--RECALIBRAR LAS EXPECTATIVAS
 
Larson EB, Yaffe K, Langa KM. New insights into the dementia epidemic. N Engl J Med 2013;369:2275-2277 [AO,I]
NUEVAS REFLEXIONES SOBRE LA EPIDEMIA DE DEMENCIA
 
Schiffman M, Solomon D. Clinical practice. Cervical-cancer screening with human papillomavirus and cytologic cotesting. N Engl J Med 2013;369:2324-2331 [R,II]
PRÁCTICA CLÍNICA. CRIBAJE DEL CÁNCER DE CÉRVIX CON PRUEBA CONJUNTA DE PAPILOMAVIRUS HUMANO Y CITOLOGÍA
 
Furie B. Do pharmacogenetics have a role in the dosing of vitamin K antagonists? N Engl J Med 2013;369:2345-2346 [AO,I]
¿JUEGA UN PAPEL LA FARMACOGENÉTICA EN LA DOSIFICACIÓN DE ANTAGONISTAS DE LA VITAMINA K?
 
Hviid A, Melbye M, Pasternak B. Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism. N Engl J Med 2013;369:2406-2415 [S,II]
USO DE ISRS DURANTE EL EMBARAZO Y RIESGO DE AUTISMO
 
Hollis A, Ahmed Z. Preserving antibiotics, rationally. N Engl J Med 2013;369:2474-2476 [AO,I]
PRESERVAR LOS ANTIBIÓTICOS, RACIONALMENTE
 
Smith AK, Lo B, Aronson L. Elder self-neglect--how can a physician help? N Engl J Med 2013;369:2476-2479 [AO,I]
AUTOABANDONO EN EL ANCIANO ¿CÓMO PUEDE AYUDAR EL MÉDICO?
 
Blumenthal D, Stremikis K, Cutler D. Health care spending--a giant slain or sleeping? N Engl J Med 2013;369:2551-2557 [R,II]
GASTO EN ATENCIÓN SANITARIA ¿UN GIGANTE MUERTO O DURMIENDO?
 
 
ACADEMIC MEDICINE
 
It is widely recognized that the United States is going to experience a serious shortage of physicians in the coming years unless the number of physicians completing residency training and entering practice is greatly increased. Members of the academic medicine community have approached this issue by calling on Congress to eliminate the cap that currently limits the number of residency positions that Medicare will support. Simply eliminating the cap, however, will not ensure an adequate supply of physicians. In this commentary the author argues that decreasing the length of training required in core clinical specialties will be required to effectively address the workforce shortage by allowing more residents to be trained in core specialties without greatly increasing the number of training programs and the aggregate amount that Medicare currently spends on graduate medical education.
U.S. health care is changing, and it will continue to change across multiple dimensions: a different mix of patients; more ambulatory, chronic care and less acute, inpatient care; an older population; expanded insurance coverage; a team approach to care; rapid growth of subspecialty care; growing emphasis on cost-effective care; and rapid technological change. These changes demand a corresponding evolution in physician roles and training. However, despite innovation in content and teaching methods, there has been little alteration to the basic structure of medical education since the Flexner Report sparked widespread reform in 1910. Looking to the future, medical education might evolve to include preparation for a team approach to care via practical training for multispecialty collaborative practice and preparing physicians to be leaders of primary care teams that include nonphysician providers; shorter training for some physicians via flexible pathways and "fast tracks" at each phase of training; cost-effective care in clinical practice; increased training in geriatrics; and "on ramps" and "off ramps" along the physician career path for flexible training over a lifetime. Although the challenges facing the health care system are great, meeting changing health care needs must begin at the foundation, in medical education.
Recent U.S. health care reform efforts have focused on three main goals: improving health care for individuals, improving population health, and lowering costs. Physicians, who traditionally have practiced with considerable autonomy, will be required to become members of the team-based patient care models necessary to achieve these goals. In this perspective, the authors assert that medical school admissions, the selection of the future physician workforce, is a key component of health care reform. They review the historical context for medical school admission processes, which have placed a premium on grades and standardized test scores, and examine how admission practices are undergoing fundamental changes in order to select physicians with both the academic and interpersonal and intrapersonal competencies necessary to operate in the health care system of the future. The authors describe how new techniques, such as holistic review and multiple mini-interviews, are contributing to the shift toward competency-based medical education. Innovations underway at the Association of American Medical Colleges to transform medical school admissions also are explored. The authors conclude by arguing that although the admission process has great potential to transform the future health care workforce, major overhauls of the health care payment and delivery systems must be achieved alongside innovations in health professions education to truly transform the U.S. health care system.
In this commentary, the author describes how the meaning of the health care workforce has changed, focusing on the physician workforce. Some questions have been asked consistently over the years: How many should we have? What type? Where should they work? In 1830 there were no licensing laws, and every literate American could be a member of the health care workforce by following detailed instructions in a popular handbook. Subsequent years saw the initiation of state licensing laws and the reform of medical education. Medical specialties and specialty boards were created, although it was not until after World War II that the dominance of the general practitioner gave way to specialists. For over a century, estimates of physician supply have swung between "too many" and "too few." Rural and economically disadvantaged communities have long struggled with access to health care providers. The author also identifies some issues that have only been considered fairly recently, such as the ethnic and gender diversity of the workforce. Wars have played a major role in changing ideas about the workforce, often in ways that long outlast the actual dates of the conflict. The meaning of the health care workforce has always been deeply embedded in a specific social, political, and economic context.
Workforce planning in an era of health care reform is a challenge as both delivery systems and patient demographics change. Current workforce projections are based on a future health care system that is either an identified "ideal" or a modified version of the existing system. The desire to plan for such an "ideal system," however, may threaten access to necessary services if it does not come to fruition or is based on theoretical rather than empirical data.Historically, workforce planning that concentrated only on an "ideal system" has been centered on incorrect assumptions. Two examples of such failures presented in the 1980s when the Graduate Medical Education National Advisory Committee recommended a decrease in the physician workforce on the basis of predetermined "necessary and appropriate" services and in the 1990s, when planners expected managed care and health maintenance organizations to completely overhaul the existing health care system. Neither accounted for human behavior, demographic changes, and actual demand for health care services, leaving the nation ill-prepared to care for an aging population with chronic disease.In this article, the authors argue that workforce planning should begin with the current system and make adjustments based on empirical data that accurately reflect current trends. Actual health care use patterns will become evident as systemic changes are realized-or not-over time. No single approach will solve the looming physician shortage, but the danger of planning only for an ideal system is being unprepared for the actual needs of the population.
Recent studies suggest that team-based primary care models could contribute to eliminating the predicted physician shortages. In this article, the authors explore existing team-based clinical care delivery models, comparing specialist and primary care teams, that include patient-centered medical homes and accountable care organizations. Next, the authors describe the barriers to adopting these models on a large scale, particularly the regulatory, financial, and cultural factors as well as scope of practice considerations for nonphysician providers. The authors' aim is not to evaluate the merits of team-based primary care models but, rather, to ascertain whether such models should be at the center of current physician workforce planning policies. The authors argue that although emerging evidence indicates that primary care teams can improve patient outcomes, few data exist to suggest that these models will drastically reduce the need for additional physicians or other providers. Thus, the authors conclude that additional research is needed to evaluate the ability of such models to alleviate provider deficits. And, while policy makers should work toward their ideal health care system, they also must expand the physician workforce to meet the growing demand for health care services in the existing one.
 
ANNALS OF INTERNAL MEDICINE
 
Conclusion: In male physicians aged 65 years or older, long-term use of a daily multivitamin did not provide cognitive benefits.
Conclusion: High-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events in patients after MI who received standard medications. However, this conclusion is tempered by the nonadherence rate.
This guideline is based on a systematic evidence review evaluating the published literature on this topic from 1985 through November 2011 that was identified by using MEDLINE and the Cochrane Database of Systematic Reviews. Searches were limited to English-language publications. The clinical outcomes evaluated for this guideline included all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, chronic heart failure, composite vascular outcomes, composite renal outcomes, end-stage renal disease, quality of life, physical function, and activities of daily living. This guideline grades the evidence and recommendations by using ACP's clinical practice guidelines grading system. RECOMMENDATION 1: ACP recommends against screening for chronic kidney disease in asymptomatic adults without risk factors for chronic kidney disease. (Grade: weak recommendation, low-quality evidence) RECOMMENDATION 2: ACP recommends against testing for proteinuria in adults with or without diabetes who are currently taking an angiotensin-converting enzyme inhibitor or an angiotensin II-receptor blocker. (Grade: weak recommendation, low-quality evidence) RECOMMENDATION 3: ACP recommends that clinicians select pharmacologic therapy that includes either an angiotensin-converting enzyme inhibitor (moderate-quality evidence) or angiotensin II-receptor blocker (high-quality evidence) in patients with hypertension and stage 1 to 3 chronic kidney disease. (Grade: strong recommendation) RECOMMENDATION 4: ACP recommends that clinicians choose statin therapy to manage elevated low-density lipoprotein in patients with stage 1 to 3 chronic kidney disease. (Grade: strong recommendation, moderate-quality evidence)
Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multivitamin supplements on cancer in men only and no effect on CVD.
 
ARCHIVOS DE BRONCONEUMOLOGIA
 
La frecuencia de SAHS en normopeso era menor que en los sobrepeso y obesos. La frecuencia de SAHS y SM simultáneamente en normopeso frente a obesos fue menor. Los pacientes normopeso eran con más frecuencia mujeres, más jóvenes y sin hábitos tóxicos. Los factores predictores de SAHS en normopeso eran sexo y edad, sin que existiera relación entre SM y SAHS.
 
ATENCION PRIMARIA
 
El CAPPAP es un instrumento de fácil y rápida administración, que es bien aceptado por los profesionales y que presenta unos resultados psicométricos aceptables, tanto a nivel global como a nivel de cada dimensión.
La incidencia de NAC fue de 8,3 casos/1.000 habitantes/año. Algo más de una de cada 4 neumonías precisaron ingreso y fallecieron el 2,7% de los pacientes con NAC. Solo la edad se asoció con la mortalidad.
La administración del cuestionario ACT® mejoró la puntuación indicativa de control del asma en ambas poblaciones del estudio, obteniendo una mayor puntuación aquellos pacientes atendidos por médicos con experiencia previa en el uso del ACT®. La administración del ACT® podría contribuir a mejorar la evolución longitudinal del paciente favoreciendo la adecuación del tratamiento.
El poder de la medicina ha hecho atractiva la idea de «medicalizar» aspectos de la vida que se pueden percibir como problemas médicos aun sin serlo. La medicina, como reflejo de la cultura del bienestar, genera en ocasiones falsas necesidades, y aspectos de la vida cotidiana son medicalizados con el pretexto de tratar falsas enfermedades como astenia primaveral y timidez, o procesos biológicos naturales como la menopausia.
A pesar del mayor bienestar material, cada día atendemos a más personas que se quejan de malestares que quizá tengan más que ver con «estar mal» que con auténticas «enfermedades». La lista puede ser interminable: tristeza, niños hiperactivos, vigorexias o adolescentes problemáticos, entre otros. En este artículo se revisan algunas intervenciones que desde la consulta contribuyen a fomentar dichas situaciones. La adversidad cotidiana adquiere hoy rango de enfermedad, de ahí el notable aumento de las consultas en los diferentes dispositivos sanitarios.
El consumo de fármacos en Aragón es elevado, así como la prevalencia de autoconsumo. Resulta de gran interés conocer el perfil de estos pacientes para poder realizar intervenciones dirigidas a reducir el consumo innecesario y mejorar la adecuación y seguridad de los fármacos utilizados
 
BRITISH MEDICAL JOURNAL
 
The durations of earache and common colds are considerably longer than current guidance given to parents in the United Kingdom and the United States; for other symptoms such as sore throat, acute cough, bronchiolitis, and croup the current guidance is consistent with our findings. Updating current guidelines with new evidence will help support parents and clinicians in evidence based decision making for children with respiratory tract infections.
Exposure to sodium-containing formulations of effervescent, dispersible, and soluble medicines was associated with significantly increased odds of adverse cardiovascular events compared with standard formulations of those same drugs. Sodium-containing formulations should be prescribed with caution only if the perceived benefits outweigh these risks.
The use of ß blockers started either at the time of hospital admission for myocardial infarction or before a myocardial infarction is associated with improved survival after myocardial infarction in patients with COPD.
Pre-hospital administration of adrenaline by emergency medical services improves the long term outcome in patients with out of hospital cardiac arrest, although the absolute increase of neurologically intact survival was minimal.
Important suppurative complications after an episode of acute sore throat in primary care are uncommon. History and examination and scores to predict bacterial infection cannot usefully identify those who will develop complications. Clinicians will need to rely on strategies such as safety netting or delayed prescription in managing the uncertainty and low risk of complications.
We found no evidence to support a protective association between perinatal use of probiotics and doctor diagnosed asthma or childhood wheeze. Randomised controlled trials to date have not yielded sufficient evidence to recommend probiotics for the primary prevention of these disorders. Extended follow-up of existing trials, along with further clinical and basic research, are needed to accurately define the role of probiotics in the prevention of childhood asthma.
Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of ß blockers was non-significant.
Greater dietary fibre intake is associated with a lower risk of both cardiovascular disease and coronary heart disease. Findings are aligned with general recommendations to increase fibre intake. The differing strengths of association by fibre type or source highlight the need for a better understanding of the mode of action of fibre components.
 
CIRCULATION
 
A brief period of doxycycline treatment has a profound but selective effect on vascular inflammation and reduces aortic wall neutrophil and cytotoxic T-cell content. Results of this study are relevant for pharmaceutical stabilization of the abdominal aneurysm and possibly for other inflammatory conditions that involve neutrophils and/or cytotoxic T cells.
 
DIABETES CARE
 
Results of this study should be viewed cautiously, given the relatively short duration of glargine use to date and the large number of potential associations examined.
Increased consumption of F&Vs, as advocated in public-health advice, has no effect on IR in overweight individuals who are at high risk of CVD when body weight is maintained. Recent evidence from systematic reviews indicates that particular classes or types of F&Vs may have particular antidiabetic properties; hence, it is possible that benefits may only be observed in response to a more specific fruit or vegetable intervention.
Offloading-improved custom-made footwear does not significantly reduce the incidence of plantar foot ulcer recurrence in diabetes compared with custom-made footwear that does not undergo such improvement, unless it is worn as recommended.
The presence of OSA in nonobese individuals is significantly associated with impaired glucose metabolism, which can be responsible for future risk for diabetes and cardiovascular disease.
Older adults with both IFG and elevated HbA1c have a substantially increased odds of developing diabetes over 7 years. Combined screening with FPG and HbA1c may identify older adults at very high risk for diabetes.
Progression and regression of DR were strongly associated with blood pressure and glycemic exposure.
Included studies were observational and should be interpreted cautiously. However, our findings are consistent with protective effects of low dietary GI and GL, quantifying the range of intakes associated with lower risk. Future research could focus on the type of sugars and other carbohydrates associated with greatest risk.
In new-onset type 1 diabetes, HCLC followed by SAP therapy did not provide benefit in preserving ß-cell function compared with current standards of care.
Linagliptin added to basal insulin therapy significantly improved glycemic control relative to placebo without increasing hypoglycemia or body weight.
Long-term empagliflozin treatment provided sustained glycemic and weight control and was well tolerated with a low risk of hypoglycemia in patients with type 2 diabetes.
Prepregnancy low adiponectin concentrations, a marker of decreased insulin sensitivity and altered adipocyte endocrine function, is associated with reduced glucose tolerance during pregnancy and may identify women at high risk for GDM to target for early intervention.
The New Chinese Diabetes Risk Score based on nonlaboratory data appears to be a reliable screening tool to detect undiagnosed type 2 diabetes in Chinese population.
Increased dietary fiber, particularly soluble fiber, and vegetables and fruits were associated with lower incident stroke but not CHD in patients with type 2 diabetes.
 
DRUGS
 
Chronic obstructive pulmonary disease (COPD) is a common and often progressive inflammatory disease of the airways that is both preventable and treatable. It is well established that those with mild-to-moderate disease severity represent the majority of patients with COPD, yet this subpopulation is relatively under-studied. Because of an insidious pre-clinical phase, COPD is both under-diagnosed and under-treated. Recent studies have confirmed that even patients with mild, grade 1 COPD [i.e. those with a reduced forced expiratory volume in one second (FEV1)/forced vital capacity ratio but normal FEV1], have measurable physiological impairment with increased morbidity and a higher risk of mortality compared with non-smoking healthy controls. Beyond the imperative of smoking cessation-the pivotal intervention in all COPD stages-the role of pharmacotherapy for prevention of disease progression has yet to be established. The main objective of this review is to provide a concise overview of the heterogeneous pathophysiology of COPD with only mild airway obstruction on spirometry and obstacles for early diagnosis. We emphasize that the absence of sufficiently powered trials involving a large number of patients precludes definitive recommendations in support of (or against) long-term pharmacological treatment in mild COPD. Despite these limitations, we present a rationale for earlier pharmacological intervention derived from recent physiological studies performed in symptomatic patients with mild COPD.
Prednisone is a well-established treatment option in rheumatoid arthritis. Low-dose glucocorticoid therapy alleviates disease signs and symptoms, is better tolerated than high-dose therapy, and its addition to disease-modifying anti-rheumatic drugs (DMARDs) inhibits radiographic disease progression. A low-dose, modified-release (MR) formulation of prednisone, administered in the evening, was developed to counter the circadian rise in pro-inflammatory cytokine levels that contributes to disease activity. In a 12-week, randomized trial (CAPRA-2) in adult patients with rheumatoid arthritis who were receiving stable DMARD therapy, the addition of MR prednisone reduced disease signs and symptoms by =20 % according to the American College of Rheumatology criteria (in 48 % of patients vs. 29 % with placebo; p < 0.002 [primary endpoint]). In another 12-week trial (CAPRA-1), addition of evening MR prednisone to stable DMARD therapy reduced the mean duration of morning stiffness to a greater extent than addition of morning immediate-release (IR) prednisone (22.7 vs. 0.4 %; p = 0.045 [primary endpoint]). The improvement in morning stiffness with MR prednisone was maintained for 9-12 months during the open-label extension of CAPRA-1. These findings were supported by data from observational studies in various adult populations with rheumatoid arthritis. Treatment with evening MR prednisone for up to 12 months was generally well tolerated, with an overall similar tolerability profile compared with evening placebo or morning IR prednisone, and no new safety concerns. MR prednisone was estimated to be cost effective relative to IR prednisone in patients with rheumatoid arthritis in a UK pharmacoeconomic model.
 
EUROPEAN HEART JOURNAL
 
Exercise-related OHCA has a low incidence, particularly in the young. Cardiac arrests occurring during or shortly after exercise carry a markedly better prognosis than non-exercise-related arrests in persons >35 years. This study establishes the favourable outcome of exercise-related OHCA and should have direct implications for public health programs to prevent exercise-related sudden death.
Among male participants of a 90 km cross-country skiing event, a faster finishing time and a high number of completed races were associated with higher risk of arrhythmias. This was mainly driven by a higher incidence of AF and bradyarrhythmias. No association with SVT or VT/VF/CA was found.
Vitamin D deficiency, prevalent in 30-50% of adults in developed countries, is largely due to inadequate cutaneous production that results from decreased exposure to sunlight, and to a lesser degree from low dietary intake of vitamin D. Serum levels of 25-hydroxyvitamin D (25-OH D) <20 ng/mL indicate vitamin D deficiency and levels >30 ng/mL are considered optimal. While the endocrine functions of vitamin D related to bone metabolism and mineral ion homoeostasis have been extensively studied, robust epidemiological evidence also suggests a close association between vitamin D deficiency and cardiovascular morbidity and mortality. Experimental studies have demonstrated novel actions of vitamin D metabolites on cardiomyocytes, and endothelial and vascular smooth muscle cells. Low 25-OH D levels are associated with left ventricular hypertrophy, vascular dysfunction, and renin-angiotensin system activation. Despite a large body of experimental, cross-sectional, and prospective evidence implicating vitamin D deficiency in the pathogenesis of cardiovascular disease, a causal relationship remains to be established. Moreover, the cardiovascular benefits of normalizing 25-OH D levels in those without renal disease or hyperparathyroidism have not been established, and questions of an epiphenomenon where vitamin D status merely reflects a classic risk burden have been raised. Randomized trials of vitamin D replacement employing cardiovascular endpoints will provide much needed evidence for determining its role in cardiovascular protection.
This article describes recent progress on a novel disease that started as a scientific curiosity and has not yet found its end as a scientific revolution.
 
FAMILY MEDICINE
 
Early experience with this model of GF development indicates that new fellowships can be established in community-based residencies that competitively recruit and train fellows who are inclined to practice in areas of greatest need. Creation of more non-metropolitan GF programs could provide a means to stabilize and redistribute the geriatrician workforce.
We successfully developed and tested a survey designed to measure family medicine identity in residencies, with five domains. Survey item responses were different between residents and faculty, which indicates the instrument may be sensitive to important changes over time.
We developed and tested a measure of team development that has strong psychometric properties. This tool could be used to study how team functioning affects clinical outcomes and as a quality improvement tool to improve team function.
 
FAMILY PRACTICE
 
The study confirms that previous exacerbations strongly predict future exacerbations in patients with COPD or asthma. Identification and a closer follow-up of patients at risk of such events could promote earlier treatment when necessary and prevent a rapid deterioration of their condition.
Screening of asymptomatic men for PCa is widely practiced. Most of the costs of screening were incurred in general practice. Calls for men to receive increased information on the harms and benefits of screening will substantially increase the costs. The current costs could be reduced by better targeting of screening.
Theory-based interventions have limited impact on reducing the prescription of antibiotics against URTIs in primary care. Future studies are needed to draw firm conclusions about their effects.
From 2002 to 2011, PSA incidence testing rates increased, particularly in men with urinary symptoms and cardiovascular disease, despite several international guidelines that suggest a judicious use of PSA tests.
Using the Internet to diagnose mental health problems in primary care seems very promising. This system of using eDiagnostics before referral to a mental health institution may change the management of mental health care. Further research should investigate whether this tool is valid, reliable and (cost) effective.
The analysis provides an insight into the determinants and patterns of health service use by families with young children at two stages of development. While some of our findings are expected or supported by previous research, others highlight areas that require further investigation.
 
JAMA
 
Among patients with OSA and resistant hypertension, CPAP treatment for 12 weeks compared with control resulted in a decrease in 24-hour mean and diastolic blood pressure and an improvement in the nocturnal blood pressure pattern. Further research is warranted to assess longer-term health outcomes.
Among patients with mild to moderate AD, 2000 IU/d of alpha tocopherol compared with placebo resulted in slower functional decline. There were no significant differences in the groups receiving memantine alone or memantine plus alpha tocopherol. These findings suggest benefit of alpha tocopherol in mild to moderate AD by slowing functional decline and decreasing caregiver burden.
Previous and current gastric acid inhibitor use was significantly associated with the presence of vitamin B12 deficiency. These findings should be considered when balancing the risks and benefits of using these medications.
It is important to evaluate elderly patients for dermatological, systemic, and neurological etiologies of itch. A simple-to-apply diagnostic and therapeutic algorithm can be used. Xerosis, drug reactions, and neuropathy should be considered when evaluating pruritus.
CLINICAL QUESTION:
Do statins reduce rates of cardiovascular events when used for primary prevention?
BOTTOM LINE:
When used for primary prevention, statins are associated with lower rates of all-cause mortality, major vascular events, and revascularizations compared with placebo. Statin therapy is not associated with increased rates of life-threatening adverse effects such as cancer.
In patients with stable coronary artery disease or low-risk ACS treated with zotarolimus-eluting stents, 3 months of dual antiplatelet therapy was noninferior to 12 months for NACCE, without significantly increasing the risk of stent thrombosis.
Among older adults taking a calcium-channel blocker, concurrent use of clarithromycin compared with azithromycin was associated with a small but statistically significant greater 30-day risk of hospitalization with acute kidney injury. These findings support current safety warnings regarding concurrent use of CYP3A4 inhibitors and calcium-channel blockers.
Among young persons with chronic migraine, the use of CBT plus amitriptyline resulted in greater reductions in days with headache and migraine-related disability compared with use of headache education plus amitriptyline. These findings support the efficacy of CBT in the treatment of chronic migraine in children and adolescents.
Most academic medical centers (AMCs) have developed financial conflict of interest (COI) policies to govern relationships between their faculty and the drug and medical device industries. The purpose of these policies is to prevent the prospect of personal financial gain by physicians and staff from adversely affecting the core AMC missions of patient care, medical education, and research. Such policies typically regulate a wide range of activities, such as promotional speakers bureaus, industry-funded continuing medical education (CME) programs, access of sales representatives to trainees and staff, and the composition of purchasing and formulary committees.
 
MEDICINA CLINICA
 
Los inhibidores de la vitamina K han sido los fármacos más eficaces en el tratamiento anticoagulante de la fibrilación auricular durante las últimas décadas. Su abordaje presenta muchos incovenientes, que han hecho aunar los esfuerzos en el diseño de nuevas moléculas. Dabigatrán, rivaroxabán y, próximamente, apixabán, están disponibles en el mercado como alternativa al acenocumarol. Todos ellos han demostrado una eficacia al menos similar a warfarina en la prevención del ictus y fenómenos embólicos, y dabigatrán 150 mg y apixabán, incluso superior. Todo ello con un perfil de seguridad mejor, especialmente en lo que a hemorragias graves/fatales e intracraneales se refiere. Esto supone una verdadera revolución. El avance de estos nuevos anticoagulantes únicamente va a estar limitado por el mayor coste económico, ya que de un modo progresivo probablemente pasen a ser los protagonistas de la anticoagulación oral en los pacientes con fibrilación auricular de origen no valvular.
Los datos obtenidos permiten avanzar en el conocimiento de los malos tratos hacia personas mayores en España, donde los precedentes de investigación en este área son aislados. No obstante, la cifra estimada de prevalencia de malos tratos no debe caer dentro del alarmismo social ni, por el contrario, en una «dejadez social».
Los grupos que consumieron ácidos grasos poliinsaturados n-3 y los contenidos en la nuez de castilla en dosis diarias moderadas durante 6 semanas mejoraron el componente dislipidemia del SM, hipertrigliceridemia y nivel bajo de HDL.
La mejoría de parámetros objetivos relacionados con la osteoporosis indica la validez de la educación sanitaria como medida preventiva en este grupo de mujeres. Sería interesante analizar la repercusión de esta mejoría a largo plazo en términos de reducir la incidencia de osteoporosis y de fracturas.
 
MORBIDITY AND MORTALITY WEEKLY REPORT
 
This report contains CDC guidance that augments the 2011 recommendations of the Advisory Committee on Immunization Practices (ACIP) for evaluating hepatitis B protection among health-care personnel (HCP) and administering post-exposure prophylaxis. Explicit guidance is provided for persons working, training, or volunteering in health-care settings who have documented hepatitis B (HepB) vaccination years before hire or matriculation (e.g., when HepB vaccination was received as part of routine infant [recommended since 1991] or catch-up adolescent [recommended since 1995] vaccination). In the United States, 2,890 cases of acute hepatitis B were reported to CDC in 2011, and an estimated 18,800 new cases of hepatitis B occurred after accounting for underreporting of cases and asymptomatic infection. Although the rate of acute hepatitis B virus (HBV) infections have declined approximately 89% during 1990-2011, from 8.5 to 0.9 cases per 100,000 population in the United States, the risk for occupationally acquired HBV among HCP persists, largely from exposures to patients with chronic HBV infection. ACIP recommends HepB vaccination for unvaccinated or incompletely vaccinated HCP with reasonably anticipated risk for blood or body fluid exposure. ACIP also recommends that vaccinated HCP receive postvaccination serologic testing (antibody to hepatitis B surface antigen [anti-HBs]) 1-2 months after the final dose of vaccine is administered (CDC. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2011;60 [No. RR-7]). Increasing numbers of HCP have received routine HepB vaccination either as infants (recommended since 1991) or as catch-up vaccination (recommended since 1995) in adolescence. HepB vaccination results in protective anti-HBs responses among approximately 95% of healthy-term infants. Certain institutions test vaccinated HCP by measuring anti-HBs upon hire or matriculation, even when anti-HBs testing occurs greater than 2 months after vaccination. This guidance can assist clinicians, occupational health and student health providers, infection-control specialists, hospital and health-care training program administrators, and others in selection of an approach for assessing HBV protection for vaccinated HCP. This report emphasizes the importance of administering HepB vaccination for all HCP, provides explicit guidance for evaluating hepatitis B protection among previously vaccinated HCP (particularly those who were vaccinated in infancy or adolescence), and clarifies recommendations for postexposure management of HCP exposed to blood or body fluids.
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
Existe una clara disociación entre la estratificación del riesgo cardiovascular mediante los factores de riesgo tradicionales y la presencia de placa ateromatosa, ya que 1/4 sujetos con riesgo cardiovascular bajo-intermedio presentaba ateromatosis carotídea.
 
SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE
 
GP use of partners of cancer patients is increased 6-24 months after diagnosis, but health problems vary between cancer types. GPs should be alert for somatic and psychosocial problems in partners of cancer patients.
In almost 90% of children included in this study the GP suspected no organic cause for the abdominal pain. GPs diagnose FAP in children without alarm symptoms and order diagnostic testing in one out of four children presenting with abdominal pain. No difference was found in GPs' management between children with a diagnosis of GPFAP and other diagnoses. Only about half of the children with a GP diagnosis of FAP fulfilled time-criteria of FAP as defined in the literature
Within the European countries there are considerable differences in recommendations for empiric first-choice antibiotic treatment of uUTI. In order to reduce the increasing antimicrobial resistance in Europe, it is important to agree on the most appropriate antibiotics for empiric treatment of uUTI.
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
We did not detect a significant association between maternal use of SSRIs during pregnancy and autism spectrum disorder in the offspring. On the basis of the upper boundary of the confidence interval, our study could not rule out a relative risk up to 1.61, and therefore the association warrants further study. (Funded by the Danish Health and Medicines Authority.).
 
 
 

                      

 

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