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Junio 2014 PDF Imprimir E-mail
Lunes, 07 de Julio 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

 

Gabel S. Expanding the scope of leadership training in medicine. Acad Med 2014;89:848-852 [AO,I]

24662199             R/C

EXPANDIR EL ÁMBITO DE LAS PRÁCTICAS DE LIDERAZGO EN MEDICINA

 

Grace ES, Wenghofer EF, Korinek EJ. Predictors of physician performance on competence assessment: findings from CPEP, the Center for Personalized Education for Physicians. Acad Med 2014;89:912-919 [S,I]

24871243             R/C

PREDICTORES DEL RENDIMIENTO DEL MÉDICO EN LA VALORACIÓN DE LA COMPETENCIA: HALLAZGOS DEL CPEP

 

Swendiman RA. Deep listening. Acad Med 2014;89:950 [AO,I]

24865836

ESCUCHA PROFUNDA

 

ANNALS OF INTERNAL MEDICINE

 

van Hees F, Habbema JD, Meester RG, Lansdorp-Vogelaar I, van Ballegooijen M, Zauber AG. Should colorectal cancer screening be considered in elderly persons without previous screening?: a cost-effectiveness analysis. Ann Intern Med 2014;160:750-759 [CE,II]

24887616             R/C

¿SE DEBERÍA CONSIDERAR EL CRIBAJE DE CÁNCER COLORRECTAL EN LAS PERSONAS MAYORES SIN CRIBAJE PREVIO?: ANÁLISIS DE RENTABILIDAD

 

Al-Khatib SM, Allen LaPointe NM, Chatterjee R, Crowley MJ, Dupre ME, Kong DF, et al. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med 2014;160:760-773 [M,II]

24887617             R/C

TRATAMIENTOS PARA EL CONTROL DEL RITMO Y DE LA FRECUENCIA EN PACIENTES CON FIBRILACIÓN AURICULAR: REVISIÓN SISTEMÁTICA

 

Moyer VA; U.S. Preventive Services Task Force. Screening for cognitive impairment in older adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2014;160:791-797 [M,III]

24663815             R/C

CRIBAJE DEL DETERIORO COGNITIVO EN ANCIANOS: DECLARACIÓN DE RECOMENDACIÓN DEL USPSTF

 

Clark AV, Landefeld CS. A "green banana" worth buying in older age: colorectal cancer screening for persons older than 75 years without previous screening. Ann Intern Med 2014;160:804-805 [AO,I]

24887619

MERECE LA PENA COMPRAR UN "PLÁTANO VERDE" A EDAD AVANZADA: CRIBAJE DEL CÁNCER COLORRECTAL EN PERSONAS DE MÁS DE 75 AÑOS SIN CRIBAJES PREVIOS

 

Kubo A, Shlager L, Marks AR, Lakritz D, Beaumont C, Gabellini K, et al. Prevention of vertical transmission of hepatitis B: an observational study. Ann Intern Med 2014;160:828-835 [T,I]

24862434             R/C

PREVENCIÓN DE LA TRANSMISIÓN VERTICAL DE LA HEPATITIS B: ESTUDIO OBSERVACIONAL

 

Bushnell C, McCullough L. Stroke prevention in women: synopsis of the 2014 American Heart Association/American Stroke Association guideline. Ann Intern Med 2014;160:853-857 [M,II]

24935489             R/C

PREVENCIÓN DEL ICTUS EN MUJERES: SINOPSIS DE LA GUÍA 2014 DE LA AHA/ASA

 

ARCHIVOS DE BRONCONEUMOLOGIA

 

Almirall J, Blanquer J, Bello S. Neumonía adquirida en la comunidad en fumadores. Arch Bronconeumol 2014;50:250-254  [AO,I]

24387877             R/C

NEUMONÍA ADQUIRIDA EN LA COMUNIDAD EN FUMADORES

 

ATENCION PRIMARIA

 

Coira G, Bailon E. La invisibilidad de los cuidados que realizan las mujeres. Aten Primaria 2014;46:271-272 [AO,I]

24947845

LA INVISIBILIDAD DE LOS CUIDADOS QUE REALIZAN LAS MUJERES

 

Marzo-Castillejo M. El cribado de cáncer de mama. ¿Debe seguir todo igual? Aten Primaria 2014;46:273-275 [AO,II]

24947846

EL CRIBADO DE CÁNCER DE MAMA. ¿DEBE SEGUIR TODO IGUAL?

 

Gorina M, Limonero JT, Peñart X, Jiménez J, Gassó J. Comparación de la satisfacción de los usuarios de atención domiciliaria: modelo integrado vs. modelo dispensarizado. Aten Primaria 2014;46:276-282 [T,II]

24768653             R/C

COMPARACIÓN DE LA SATISFACCIÓN DE LOS USUARIOS DE ATENCIÓN DOMICILIARIA: MODELO INTEGRADO VS. MODELO DISPENSARIZADO

 

Constaín GA, Ricardo C, Rodríguez-Gázquez Mde L, Alvarez M, Marín C, Agudelo C. Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia. Aten Primaria 2014;46:283-289 [T,I]

24703389             R/C

VALIDEZ Y UTILIDAD DIAGNÓSTICA DE LA ESCALA EAT-26 PARA LA EVALUACIÓN DEL RIESGO DE TRASTORNOS DE LA CONDUCTA ALIMENTARIA EN POBLACIÓN FEMENINA DE MEDELLÍN, COLOMBIA

 

Parodi N, Villán YF, Granados MI, Royuela A. Prescripción potencialmente inapropiada en mayores de 65 años en un centro de salud de atención primaria. Aten Primaria 2014;46:290-297 [T,I]

24661973             R/C

PRESCRIPCIÓN POTENCIALMENTE INAPROPIADA EN MAYORES DE 65 AÑOS EN UN CENTRO DE SALUD DE ATENCIÓN PRIMARIA

 

Llauger MA, Rosas A, Burgos F, Torrente E, Tresserras R, Escarrabill J; en nombre del grupo de trabajo de espirometría del Plan Director de las Enfermedades del Aparato Respiratorio (PDMAR). Accesibilidad y utilización de la espirometría en los centros de atención primaria de Cataluña. Aten Primaria 2014;46:298-306 [T,I]

24768654             R/C

ACCESIBILIDAD Y UTILIZACIÓN DE LA ESPIROMETRÍA EN LOS CENTROS DE ATENCIÓN PRIMARIA DE CATALUÑA

 

Córdoba R. El desafío de los cigarrillos electrónicos. Aten Primaria 2014;46:307-312 [R,II]

24704194             R/C

EL DESAFÍO DE LOS CIGARRILLOS ELECTRÓNICOS

 

BRITISH MEDICAL JOURNAL

 

Tammemagi MC, Lam S. Screening for lung cancer using low dose computed tomography. BMJ 2014;348:g2253 [R,I]

24865600             R/C

CRIBAJE DEL CÁNCER DE PULMÓN USANDO TOMOGRAFÍA COMPUTADORIZADA DE DOSIS BAJA

 

Levy A. Interpreting raised serum prolactin results. BMJ 2014;348:g3207 [R,I]

24859901

INTERPRETACIÓN DE LOS RESULTADOS DE PROLACTINA SÉRICA ELEVADA

 

Dormuth CR, Filion KB, Paterson JM, James MT, Teare GF, Raymond CB, et al; Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases. BMJ 2014;348:g3244 [T,II]

24874977             R/C

ESTATINAS DE GRAN POTENCIA Y RIESGO DE APARICIÓN DE DIABETES: ESTUDIO OBSERVACIONAL MULTICÉNTRICO SOBRE BASES DE DATOS ADMINISTRATIVAS

 

Selak V, Elley CR, Bullen C, Crengle S, Wadham A, Rafter N, et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ 2014;348:g3318 [EC,I]

24868083             R/C

EFECTO DEL TRATAMIENTO CON DOSIS FIJAS COMBINADAS SOBRE EL CUMPLIMIENTO Y EL CONTROL DE FACTORES DE RIESGO EN PACIENTES CON RIESGO ALTO DE ENFERMEDAD CARDIOVASCULAR: ENSAYO CONTROLADO ALEATORIZADO EN ATENCIÓN PRIMARIA

 

Ford AC, Moayyedi P. Whom should we "test and treat" for Helicobacter pylori? BMJ 2014;348:g3320 [R,II]

24846521

¿A QUIÉN DEBERÍAMOS "ANALIZAR Y TRATAR" DEL HELICOBACTER PYLORI?

 

McCartney M. What should we die from? BMJ 2014;348:g3380 [AO,I]

24868097

¿DE QUÉ DEBERÍAMOS MORIR?

 

Capewell S. Sugar sweetened drinks should carry obesity warnings. BMJ 2014;348:g3428 [AO,I]

24870354

LAS BEBIDAS AZUCARADAS DEBERÍAN LLEVAR ADVERTENCIAS CONTRA LA OBESIDAD

 

Gumbinger C, Reuter B, Stock C, Sauer T, Wiethölter H, Bruder I, et al; AG Schlaganfall. Time to treatment with recombinant tissue plasminogen activator and outcome of stroke in clinical practice: retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials. BMJ 2014;348:g3429 [S,I]

24879819             R/C

MOMENTO DEL TRATAMIENTO CON ACTIVADOR DEL PLASMINÓGENO TISULAR RECOMBINANTE Y RESULTADOS DEL ICTUS EN LA PRÁCTICA CLÍNICA: ANÁLISIS RETROSPECTIVO DE DATOS DE LOS SEGUROS SOBRE CALIDAD HOSPITALARIA EN COMPARACIÓN CON LOS RESULTADOS DE LOS ENSAYOS CLÍNICOS ALEATORIZADOS

 

Huffman MD. Fixed dose combinations of cardiovascular drugs. BMJ 2014;348:g3480 [AO,I]

24868084

DOSIS FIJAS COMBINADAS DE FÁRMACOS CARDIOVASCULARES

 

Vaughan Jones S, Ambros-Rudolph C, Nelson-Piercy C. Skin disease in pregnancy. BMJ 2014;348:g3489 [R,I]

24895225

ENFERMEDAD DE LA PIEL EN EL EMBARAZO

 

Seow H, Brazil K, Sussman J, Pereira J, Marshall D, Austin PC, et al. Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis. BMJ 2014;348:g3496 [S,I]

24906901             R/C

IMPACTO DE LOS EQUIPOS ESPECIALIZADOS DE CUIDADOS PALIATIVOS EXTRAHOSPITALARIOS SOBRE LAS HOSPITALIZACIONES Y LAS VISITAS A URGENCIAS DE ENFERMOS TERMINALES Y MUERTES EN EL HOSPITAL: ANÁLISIS COMBINADO

 

Maund E, Tendal B, Hróbjartsson A, Jørgensen KJ, Lundh A, Schroll J, et al. Benefits and harms in clinical trials of duloxetine for treatment of major depressive disorder: comparison of clinical study reports, trial registries, and publications. BMJ 2014;348:g3510 [R,I]

24899650             R/C

BENEFICIOS Y PERJUICIOS EN LOS ENSAYOS CLÍNICOS DE DULOXETINA PARA EL TRATAMIENTO DEL TRASTORNO DEPRESIBO MAYOR: COMPARACIÓN DE INFORMES DE ESTUDIOS CLÍNICOS, REGISTROS DE ENSAYOS Y PUBLICACIONES

 

Rueda-Clausen CF, Padwal RS. Pharmacotherapy for weight loss. BMJ 2014;348:g3526 [R,I]

24907124

FARMACOTERAPIA PARA PERDER PESO

 

McDermott C. Patient outcomes at both ends of the stethoscope. BMJ 2014;348:g3575  [AO,I]

RESULTADOS EN EL PACIENTE A AMBOS LADOS DEL ESTETOSCOPIO

 

Doshi P, Zito J, dosReis S. Digging for data on harms in duloxetine trials. BMJ 2014;348:g3578 [AO,I]

24904123

AHONDAR EN BÚSQUEDA DE DATOS SOBRE PERJUICIOS EN LOS ENSAYOS SOBRE DULOXETINA

 

Lu CY, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penfold RB, et al. Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. BMJ 2014;348:g3596 [QE,I]

24942789             R/C

CAMBIOS EN EL USO DE LOS ANTIDEPRESIVOS POR PARTE DE LOS JÓVENES Y COMPORTAMIENTO SUICIDA TRAS LAS ADVERTENCIAS DE LA FDA Y COBERTURA POR LOS MEDIOS DE COMUNICACIÓN: ESTUDIO CUASI EXPERIMENTAL

 

Yeo B, Turner NC, Jones A. An update on the medical management of breast cancer. BMJ 2014;348:g3608 [R,I]

24912480

ACTUALIZACIÓN SOBRE EL TRATAMIENTO MÉDICO DEL CÁNCER DE MAMA

 

Jørgensen T, Jacobsen RK, Toft U, Aadahl M, Glümer C, Pisinger C. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population: Inter99 randomised trial. BMJ 2014;348:g3617 [EC,II]

24912589             R/C

EFECTO DEL CRIBAJE Y EL CONSEJO SOBRE HÁBITOS EN LA INCIDENCIA DE ENFERMEDAD CARDIACA ISQUÉMICA EN LA POBLACIÓN GENERAL: ENSAYO ALEATORIZADO INTER99

 

Wolfe SM. A morphine-oxycodone combo pill: toward the "holy grail" for opioids or a justifiably rejected drug? BMJ 2014;348:g3620 [AO,I]

24912942

PÍLDORA COMBINADA DE MORFINA-OXICODONA: ¿HACIA EL "SANTO GRIAL" DE LOS OPIOIDES O UN FÁRMACO JUSTIFICADAMENTE RECHAZADO?

 

Jones C, Pollit V, Fitzmaurice D, Cowan C4; Guideline Development Group. The management of atrial fibrillation: summary of updated NICE guidance. BMJ 2014;348:g3655 [M,III]

24948694

TRATAMIENTO DE LA FIBRILACIÓN AURICULAR: RESUMEN DE LA GUÍA NICE ACTUALIZADA

 

Schöttker B, Jorde R, Peasey A, Thorand B, Jansen EH, Groot Ld, et al; Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States. BMJ 2014;348:g3656 [M,II]

24938302             R/C

VITAMINA D Y MORTALIDAD: METAANÁLISIS DE DATOS DE PARTICIPANTES INDIVIDUALES DE UN GRAN CONSORCIO DE ESTUDIOS DE COHORTE DE EUROPA Y LOS ESTADOS UNIDOS

 

Gøtzsche PC, Jørgensen KJ, Krogsbøll LT. General health checks don't work. BMJ 2014;348:g3680 [AO,I]

24912801

LOS EXÁMENES GENERALES DE SALUD NO FUNCIONAN

 

Murtagh F. Can palliative care teams relieve some of the pressure on acute services? BMJ 2014;348:g3693 [AO,I]

24906714

¿PUEDEN LOS EQUIPOS DE CUIDADOS PALIATIVOS ALIVIAR ALGO DE LA PRESIÓN SOBRE LOS SERVICIOS DE AGUDOS?

 

Boyd K, Murray SA. Why is talking about dying such a challenge? BMJ 2014;348:g3699 [AO,I]

24906715

¿POR QUÉ SUPONE ESE RETO EL HABLAR SOBRE LA MUERTE?

 

Weedon-Fekjær H, Romundstad PR, Vatten LJ. Modern mammography screening and breast cancer mortality: population study. BMJ 2014;348:g3701 [S,II]

24951459             R/C

EL MODERNO CRIBAJE MAMOGRÁFICO Y LA MORTALIDAD POR CÁNCER DE MAMA: ESTUDIO POBLACIONAL

 

Greenhalgh T, Howick J, Maskrey N; Evidence Based Medicine Renaissance Group. Evidence based medicine: a movement in crisis? BMJ 2014;348:g3725 [R,I]

24927763

MEDICINA BASADA EN LA EVIDENCIA: ¿UN MOVIMIENTO EN CRISIS?

 

Greenstone M, Hack M. Obstructive sleep apnoea. BMJ 2014;348:g3745 [R,I]

24939874

APNEA OBSTRUCTIVA DEL SUEÑO

 

Chen Q, Sjölander A, Runeson B, D'Onofrio BM, Lichtenstein P, Larsson H. Drug treatment for attention-deficit/hyperactivity disorder and suicidal behaviour: register based study. BMJ 2014;348:g3769 [S,I]

24942388             R/C

TRATAMIENTO FARMACOLÓGICO DEL TRASTORNO DE HIPERACTIVIDAD/DÉFICIT DE ATENCIÓN Y COMPORTAMIENTO SUICIDA: ESTUDIO BASADO EN REGISTROS

 

Elmore JG, Harris RP. The harms and benefits of modern screening mammography. BMJ 2014;348:g3824 [AO,I]

24938686

PERJUICIOS Y BENEFICIOS DEL CRIBAJE MAMOGRÁFICO MODERNO

 

Windecker S, Stortecky S, Stefanini GG, daCosta BR, Rutjes AW, Di Nisio M et al. Revascularisation versus medical treatment in patients with stable coronary artery disease: network meta-analysis. BMJ 2014;348:g3859 [M,II]

                               R/C

REVASCULARIZACIÓN FRENTE A TRATAMIENTO MÉDICO EN PACIENTES CON ENFERMEDAD ARTERIAL CORONARIA ESTABLE: METAANÁLISIS EN RED

 

Rees J, Bultitud M, Challacombe B. The management of lower urinary tract symptoms in men. BMJ 2014;348:g3861 [R,II]

                               R/C

MANEJO DE LOS SÍNTOMAS DE VÍAS URINATIAS BAJAS EN HOMBRES

 

Sridhar D, Frenk J, Gostin L, Moon S. Global rules for global health: why we need an independent, impartial WHO. BMJ 2014;348:g3841 [AO,I]

24942299

REGLAS MUNDIALES PARA LA SALUD MUNDIAL: POR QUÉ NECESITAMOS UNA OMS INDEPENDIENTE E IMPARCIAL

 

McCartney M. How to undermine general practice. BMJ 2014;348:g4061 [AO,I]

24934620

CÓMO MINAR LA MEDICINA GENERAL

 

Ziada K, Moliterno DJ. Revascularisation for patients with stable coronary artery disease. BMJ 2014;348:g4099 [AO,I]

REVASCULARIZACIÓN EN PACIENTES CON ENFERMEDAD ARTERIAL CORONARIA ESTABLE

 

Jain A, Nundy S, Abbasi K. Corruption: medicine's dirty open secret. BMJ 2014;348:g4184 [AO,I]

24965786

CORRUPCIÓN: EL SUCIO SECRETO ABIERTO DE LA MEDICINA

 

BRITISH JOURNAL OF PSYCHIATRY

 

Orrell M, Aguirre E, Spector A, Hoare Z, Woods RT, Streater A, et al. Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial. Br J Psychiatry 2014  [Epub ahead of print] [EC,I]

24676963             R/C

TERAPIA DE MANTENIMIENTO DE ESTIMULACIÓN COGNITIVA EN LA DEMENCIA: ENSAYO CONTROLADO ALEATORIZADO PRAGMÁTICO A DOBLE CIEGO MULTICÉNTRICO

 

Mayou R. Is the DSM-5 chapter on somatic symptom disorder any better than DSM-IV somatoform disorder?  Br J Psychiatry 2014;204:418-419 [AO,I]

¿ES EL CAPÍTULO DEL DSM-5 SOBRE TRASTORNO DE SÍNTOMAS SOMÁTICOS MEJOR DE ALGUNA MANERA QUE EL TRASTORNO SOMATOFORME DEL DSM-IV?

 

D'Amico F, Knapp M, Beecham J, Sandberg S, Taylor E, Sayal K. Use of services and associated costs for young adults with childhood hyperactivity/conduct problems: 20-year follow-up. Br J Psychiatry 2014  [Epub ahead of print] [S,II]

24676966             R/C

USO DE SERVICIOS Y SUS COSTES ASOCIADOS POR PARTE DE JÓVENES CON PROBLEMAS DE CONDUCTA E HIPERACTIVIDAD EN LA INFANCIA: 20 AÑOS DE SEGUIMIENTO

 

Qin P, Hawton K, Mortensen PB, Webb R. Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study. Br J Psychiatry 2014 [Epub ahead of print] [T,II]

24578445             R/C

EFECTOS COMBINADOS DE ENFERMEDAD FÍSICA Y TRASTORNO PSIQUIÁTRICO COMÓRBIDO SOBRE EL RIESGO DE SUICIDIO DENTRO DE UN ESTUDIO POBLACIONAL NACIONAL

 

Vicens C, Bejarano F, Sempere E, Mateu C, Fiol F, Socias I, et al. Comparative efficacy of two interventions to discontinue long-term benzodiazepine use: cluster randomised controlled trial in primary care. Br J Psychiatry 2014 [Epub ahead of print] [EC,I]

24526745             R/C

EFICACIA COMPARADA DE DOS INTERVENCIONES PARA DETENER EL USO DE BENZODIACEPINAS A LARGO PLAZO: ENSAYO CONTROLADO ALEATORIZADO POR GRUPOS EN ATENCIÓN PRIMARIA

 

CANADIAN MEDICAL ASSOCIATION JOURNAL

 

Giddings G. Measles vaccination: a shot of common sense. CMAJ 2014;186:651 [AO,I]

24863920

VACUNA DEL SARAMPIÓN: UN DISPARO DE SENTIDO COMÚN

 

Caro-Bruce E, Flaxman G. Vulvar pruritus in a postmenopausal woman. CMAJ 2014;186:688-689 [T,I]

24549132

PRURITO VULVAR EN MUJER POSTMENOPÁUSICA

 

Cook VE, Chan ES. Anaphylaxis in the acute care setting. CMAJ 2014;186:694 [AO,I]

24591280

ANAFILAXIA EN EL ÁMBITO DE LA ATENCIÓN AGUDA

 

Dixon A, Clarkin C, Barrowman N, Correll R, Osmond MH, Plint AC. Reduction of radial-head subluxation in children by triage nurses in the emergency department: a cluster-randomized controlled trial. CMAJ 2014;186:E317-E323 [EC,I]

24664649             R/C

REDUCCIÓN DE LA SUBLUXACIÓN DE LA CABEZA DEL RADIO EN NIÑOS POR LAS ENFERMERAS DE TRIAJE EN EL SERVICIO DE URGENCIAS: ENSAYO CONTROLADO ALEATORIZADO POR GRUPOS

 

Afifi TO, MacMillan HL, Boyle M, Taillieu T, Cheung K, Sareen J. Child abuse and mental disorders in Canada. CMAJ 2014;186:E324-E332 [T,I]

24756625             R/C

MALTRATO INFANTIL Y TRASTORNOS MENTALES EN CANADÁ

 

Kennedy SA, Baerlocher MO. New and experimental approaches to back pain. CMAJ 2014;186:E340 [AO,I]

24516088

ABORDAJES NUEVOS Y EXPERIMENTALES DEL DOLOR DE ESPALDA

 

CIRCULATION

 

Smilowitz NR, Donnino R, Schwartzbard A. Glucagon-like Peptide-1 receptor agonists for diabetes mellitus: a role in cardiovascular disease. Circulation 2014;129:2305-2312 [R,I]

24891623

AGONISTAS DEL RECEPTOR GLP-1 PARA LA DIABETES MELLITUS: PAPEL EN LA ENFERMEDAD CARDIOVASCULAR

 

Wong CX, Lau DH, Sanders P. Atrial fibrillation epidemic and hospitalizations: how to turn the rising tide? Circulation 2014;129:2361-2363 [AO,I]

24842944

EPIDEMIA DE FIBRILACIÓN AURICULAR Y HOSPITALIZACIONES: ¿CÓMO PARAR LA SUBIDA DE LA MAREA?

 

Patel NJ, Deshmukh A, Pant S, Singh V, Patel N, Arora S, et al. Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: implications for healthcare planning. Circulation 2014;129:2371-2379 [T,II]

24842943             R/C

TENDENCIAS CONTEMPORÁNEAS DE HOSPITALIZACIÓN POR FIBRILACIÓN AURICULAR EN LOS EE UU, DE 2000 A 2010: IMPLICACIONES PARA LA PLANIFICACIÓN DE LA ATENCIÓN SANITARIA

 

Zaman S, Kovoor P. Sudden cardiac death early after myocardial infarction: pathogenesis, risk stratification, and primary prevention. Circulation 2014;129:2426-2435 [R,I]

24914016

MUERTE SÚBITA CARDIACA PRECOZ TRAS INFARTO DE MIOCARDIO: PATOGÉNESIS, ESTRATIFICACIÓN DEL RIESGO Y PREVENCIÓN PRIMARIA

 

Goldfine AB, Phua EJ, Abrahamson MJ. Glycemic management in patients with coronary artery disease and prediabetes or type 2 diabetes mellitus. Circulation 2014;129:2567-2573 [R,I]

24934464

MANEJO GLUCÉMICO EN PACIENTES CON ENFERMEDAD ARTERIAL CORONARIA Y PREDIABETES O DIABETES MELLITUS TIPO 2

 

Menon V, Lincoff AM. Cardiovascular safety evaluation in the development of new drugs for diabetes mellitus. Circulation 2014;129:2705-2713 [R,II]

24958753

EVALUACIÓN DE LA SEGURIDAD CARDIOVASCULAR EN EL DESARROLLO DE NUEVOS FÁRMACOS PARA LA DIABETES MELLITUS

 

Antman EM, Appel LJ, Balentine D, Johnson RK, Steffen LM, Miller EA, et al. Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the american heart association sodium conference 2013 planning group. Circulation 2014;129:e660-e679 [T,I]

24799511             R/C

 

DIABETES CARE

 

Home P, Riddle M, Cefalu WT, Bailey CJ, Bretzel RG, Del Prato S, et al. Insulin therapy in people with type 2 diabetes: opportunities and challenges? Diabetes Care 2014;37:1499-1508 [R,I]

24855154             R/C

TRATAMIENTO CON INSULINA EN PERSONAS CON DIABETES TIPO 2: ¿OPORTUNIDADES Y RETOS?

 

Feig DS, Hwee J, Shah BR, Booth GL, Bierman AS, Lipscombe LL. Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, population-based study in Ontario, Canada, 1996-2010. Diabetes Care 2014;37:1590-1596 [S,I]

24705609             R/C

TENDENCIAS EN LA INCIDENCIA DE DIABETES EN EL EMBARAZO Y RESULTADOS PERINATALES GRAVES: ESTUDIO POBLACIONAL EXTENSO EN ONTARIO, CANADÁ, DE 1996 A 2010

 

Laxy M, Mielck A, Hunger M, Schunk M, Meisinger C, Rückert IM, et al. The association between patient-reported self-management behavior, intermediate clinical outcomes, and mortality in patients with type 2 diabetes: results from the KORA-A study. Diabetes Care 2014;37:1604-1612 [S,II]

24667462             R/C

ASOCIACIÓN ENTRE AUTOMANEJO INFORMADO POR EL PACIENTE, RESULTADOS CLÍNICOS INTERMEDIOS Y MORTALIDAD EN PACIENTES CON DIABETES TIPO 2: RESULTADOS DEL ESTUDIO KORA-A

 

Häring HU, Merker L, Seewaldt-Becker E, Weimer M, Meinicke T, Broedl UC, et al; EMPA-REG MET Trial Investigators. Empagliflozin as add-on to metformin in patients with type 2 diabetes: a 24-week, randomized, double-blind, placebo-controlled trial. Diabetes Care 2014;37:1650-1659. doi [EC,II]

24722494             R/C

EMPAGLIFLOOZINA AÑADIDA A LA METFORMINA EN PACIENTES CON DIABETES TIPO 2: ENSAYO DE 24 SEMANAS ALEATORIZADO DOBLE CIEGO CONTROLADO CON PLACEBO

 

Waaijman R, de Haart M, Arts ML, Wever D, Verlouw AJ, Nollet F, et al. Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients. Diabetes Care 2014;37:1697-1705 [S,I]

24705610             R/C

FACTORES DE RIESGO PARA LA RECURRENCIA DE LA ÚLCERA PLANTAR DEL PIE EN PACIENTES CON NEUROPATÍA DIABÉTICA

 

Margolis KL, O'Connor PJ, Morgan TM, Buse JB, Cohen RM, Cushman WC, et al. Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial. Diabetes Care 2014;37:1721-1728 [EC,II]

24595629             R/C

RESULTADOS DE LAS ESTRATEGIAS COMBINADAS DE MANEJO DE LOS FACTORES DE RIESGO CARDIOVASCULAR EN LA DIABETES TIPO 2: ENSAYO ALEATORIZADO ACCORD

 

Pal K, Eastwood SV, Michie S, Farmer A, Barnard ML, Peacock R, et al. Computer-based interventions to improve self-management in adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2014;37:1759-1766 [M,I]

24855158             R/C

INTERVENCIONES MEDIANTE ORDENADOR PARA MEJORAR EL AUTOMANEJO EN ADULTOS CON DIABETES TIPO 2: REVISIÓN SISTEMÁTICA Y METAANÁLISIS

 

Grunberger G. Insulin analogs-are they worth it? Yes! Diabetes Care 2014;37:1767-1770 [AO,I]

24855159             R/C

¿MERECEN LA PENA LOS ANÁLOGOS DE LA INSULINA? ¡SÍ!

 

Davidson MB. Insulin analogs-is there a compelling case to use them? No! Diabetes Care 2014;37:1771-1774 [AO,I]

24855160             R/C

¿HAY UNA RAZÓN CONVINCENTE PARA UTILIZAR LOS ANÁLOGOS DE LA INSULINA? ¡NO!

 

DRUGS

 

Alsultan A, Peloquin CA. Therapeutic drug monitoring in the treatment of tuberculosis: an update. Drugs 2014;74:839-854 [R,II]

24846578             R/C

MONITORIZACIÓN TERAPÉUTICA DE LOS FÁRMACOS EN EL TRATAMIENTO DE LA TUBERCULOSIS: ACTUALIZACIÓN

 

Bschor T. Lithium in the treatment of major depressive disorder. Drugs 2014;74:855-862 [R,I]

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LITIO EN EL TRATAMIENTO DEL TRASTORNO DEPRESIVO MAYOR

 

Hilgenfeld R, Seipke G, Berchtold H, Owens DR. The evolution of insulin glargine and its continuing contribution to diabetes care. Drugs 2014;74:911-927 [R,II]

24866023             R/C

EVOLUCIÓN DE LA INSULINA GLARGINA Y SU CONTINUA CONTRIBUCIÓN A LA ATENCIÓN A LA DIABETES

 

Bichoupan K, Dieterich DT. Hepatitis C in HIV-infected patients: impact of direct-acting antivirals. Drugs 2014;74:951-961 [R,I]

24866024             R/C

HEPATITIS C EN PACIENTES INFECTADOS CON VIH: IMPACTO DE LOS ANTIVÍRICOS DIRECTOS

 

Chrusciel P, Rysz J, Banach M. Defining the role of trimetazidine in the treatment of cardiovascular disorders: some insights on its role in heart failure and peripheral artery disease. Drugs 2014;74:971-980 [R,I]

24902800             R/C

DEFINIR EL PAPEL DE LA TRIMETAZIDINA EN EL TRATAMIENTO DE LOS TRASTORNOS CARDIOVASCULARES: ALGUNAS REFLEXIONES SOBRE SU PAPEL EN LA INSUFICIENCIA CARDIACA Y LA ENFERMEDAD ARTERIAL PERIFÉRICA

 

EUROPEAN HEART JOURNAL

 

Arnold SV, Spertus JA, Nallamothu BK. The hostile heart: anger as a trigger for acute cardiovascular events. Eur Heart J 2014;35:1359-1360 [AO,I]

24591549

EL CORAZÓN HOSTIL: LA IRA COMO DESENCADENANTE DE ACONTECIMIENTOS CARDIOVASCULARES AGUDOS

 

Della Rocca DG, Pepine CJ. Some thoughts on the continuing dilemma of angina pectoris. Eur Heart J 2014;35:1361-1364 [AO,I]

23045268

ALGUNOS PENSAMIENTOS SOBRE EL CONTINUO DILEMA DE LA ANGINA DE PECHO

 

Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J 2014;35:1365-1372 [R,I]

24282187             R/C

DEPRESIÓN Y ENFERMEDAD CARDIOVASCULAR: REVISIÓN CLÍNICA

 

Gustad LT, Laugsand LE, Janszky I, Dalen H, Bjerkeset O. Symptoms of anxiety and depression and risk of acute myocardial infarction: the HUNT 2 study. Eur Heart J 2014;35:1394-1403 [S,II]

24057077             R/C

SÍNTOMAS DE ANSIEDAD Y DEPRESIÓN Y RIESGO DE INFARTO AGUDO DE MIOCARDIO: ESTUDIO HUNT 2

 

Mostofsky E, Penner EA, Mittleman MA. Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis†. Eur Heart J 2014;35:1404-1410 [M,II]

24591550             R/C

ESTALLIDOS DE IRA COMO DESENCADENANTE DE ACONTECIMIENOTOS AGUDOS CARDIOVASCULARES: REVISIÓN SISTEMÁTICA Y METAANÁLISIS

 

Connolly SJ. Real-world experience with atrial fibrillation ablation: cause for concern. Eur Heart J 2014;35:1430-1432 [AO,I]

24468887

EXPERIENCIA EN EL MUNDO REAL CON LA ABLACIÓN EN LA FIBRILACIÓN AURICULAR: CAUSA DE PREOCUPACIÓN

 

Wasmer K, Breithardt G, Eckardt L. The young patient with asymptomatic atrial fibrillation: what is the evidence to leave the arrhythmia untreated? Eur Heart J 2014;35:1439-1447 [R,I]

24639425             R/C

EL PACIENTE JOVEN CON FIBRILACIÓN AURICULAR ASINTOMÁTICA: ¿CUÁL ES LA EVIDENCIA PARA DEJAR LA ARRITMIA SIN TRATAR?

 

Nattel S, Guasch E, Savelieva I, Cosio FG, Valverde I, Halperin JL, et al. Early management of atrial fibrillation to prevent cardiovascular complications. Eur Heart J 2014;35:1448-1456 [R,II]

24536084             R/C

MANEJO PRECOZ DE LA FIBRILACIÓN AURICULAR PARA PREVENIR LAS COMPLICACIONES CARDIOVASCULARES

 

FAMILY MEDICINE

 

Willis DR, Bennett I, Jones BG, Renshaw SE, Holley M, Dankoski ME. Practice-based learning and improvement in family medicine student clerkships: a CERA study. Fam Med 2014;46:423-428 [T,II]

24911296             R/C

APRENDIZAJE BASADO EN LA PRÁCTICA Y MEJORÍA DE LAS ROTACIONES DE LOS ESTUDIANTES EN MEDICINA DE FAMILIA: ESTUDIO CERA

 

Taylor JS, George PF, MacNamara MM, Zink D, Patel NK, Gainor J, et al. A new clinical skills clerkship for medical students. Fam Med 2014;46:433-439 [S,I]

24911298             R/C

NUEVA ROTACIÓN SOBRE HABILIDADES CLÍNICAS PARA ESTUDIANTES DE MEDICINA

 

Collins L, Sato R, LaNoue M, Michaluk L, Verma M. Impact of a patient-centered medical home clerkship curriculum. Fam Med 2014;46:440-446 [C,I]

24911299             R/C

IMPACTO DE UN CURRÍCULO DE ROTACIÓN CENTRADA EN EL PACIENTE

 

Ringoir L, Pedersen SS, Widdershoven JW, Pouwer F, Keyzer JM, Romeijnders AC, et al. Beta-blockers and depression in elderly hypertension patients in primary care. Fam Med 2014;46:447-453 [T,I]

24911300             R/C

BETA-BLOQUEANTES Y DEPRESIÓN EN PACIENTES ANCIANOS CON HIPERTENSIÓN EN ATENCIÓN PRIMARIA

 

FAMILY PRACTICE

 

Solberg LI. Patient outcomes measures-the next promising answer? Fam Pract 2014;31:245-246 [AO,I]

24835234

MEDIDAS DE RESULTADOS EN EL PACIENTE ¿LA PRÓXIMA RESPUESTA PROMETEDORA?

 

Unverzagt S, Oemler M, Braun K, Klement A. Strategies for guideline implementation in primary care focusing on patients with cardiovascular disease: a systematic review. Fam Pract 2014;31:247-266 [M,II]

24367069             R/C

ESTRATEGIAS PARA LA PUESTA EN MARCHA DE GUÍAS EN ATENCIÓN PRIMARIA CENTRADAS EN LOS PACIENTES CON ENFERMEDAD CARDIOVASCULAR: REVISIÓN SISTEMÁTICA

 

van der Zwaard BC, Poppe E, Vanwanseele B, van der Horst HE, Elders PJ. Development and evaluation of a leaflet containing shoe advice: a randomized controlled trial. Fam Pract 2014;31:267-272 [EC,I]

24435069             R/C

DESARROLLO Y EVALUACIÓN DE UN FOLLETO CON CONSEJOS PARA LOS PIES: ENSAYO CONTROLADO ALEATORIZADO

 

Boffin N, Moreels S, Vanthomme K, Van Casteren V. Falls among older general practice patients: a 2-year nationwide surveillance study. Fam Pract 2014;31:281-289 [T,II]

24532609             R/C

CAÍDAS EN PACIENTES ANCIANOS EN MEDICINA GENERAL: ESTUDIO DE VIGILANCIA DURANTE 2 AÑOS

 

Fitzmaurice DA, McCahon D, Baker J, Murray ET, Jowett S, Sandhar H, et al. Is screening for AF worthwhile? Stroke risk in a screened population from the SAFE study. Fam Pract 2014;31:298-302 [S,I]

24728774             R/C

¿MERECE LA PENA EL CRIBADO DE LA FIBRILACIÓN AURICULAR? RIESGO DE ICTUS EN UNA POBLACIÓN CRIBADA DEL ESTUDIO SAFE

 

Görig T, Mayer M, Bock C, Diehl K, Hilger J, Herr RM, et al. Dietary counselling for cardiovascular disease prevention in primary care settings: results from a German physician survey. Fam Pract 2014;31:325-332 [T,I]

24639564             R/C

CONSEJO DIETÉTICO PARA LA PREVENCIÓN DE LA ENFERMEDAD CARDIOVASCULAR EN EL ÁMBITO DE LA ATENCIÓN PRIMARIA: RESULTADOS DE UNA ENCUESTA EN MÉDICOS ALEMANES

 

Stijnen MM, Van Hoof MS, Wijnands-Hoekstra IY, Guldemond-Hecker Y, Duimel-Peeters IG, Vrijhoef HJ, et al. Detected health and well-being problems following comprehensive geriatric assessment during a home visit among community-dwelling older people: who benefits most? Fam Pract 2014;31:333-340 [T,I]

24736294             R/C

PROBLEMAS DE SALUD Y BIENESTAR DETECTADOS SIGUIENDO UNA VALORACIÓN GERIÁTRICA INTEGRAL DURANTE LA VISITA DOMICILIARIA EN PERSONAS MAYORES QUE VIVEN EN LA COMUNIDAD: ¿QUIÉN SE BENEFICIA MÁS?

 

Furler JS, Blackberry ID, Walker C, Manski-Nankervis JA, Anderson J, O'Neal D, et al. Stepping up: a nurse-led model of care for insulin initiation for people with type 2 diabetes. Fam Pract 2014;31:349-356 [C,I]

24473676             R/C

UN PASO ADELANTE: MODELO DE ATENCIÓN DIRIGIDO POR ENFERMERAS PARA LA INICIACIÓN EN LA INSULINA DE PERSONAS CON DIABETES TIPO 2

 

Bishop FL, Howick J, Heneghan C, Stevens S, Hobbs FD, Lewith G. Placebo use in the UK: a qualitative study exploring GPs' views on placebo effects in clinical practice. Fam Pract 2014;31:357-363 [C,I]

24736295             R/C

USO DE PLACEBO EN RU: ESTUDIO CUALITATIVO PARA EXPLORAR LOS PUNTOS DE VISTA DE LOS MÉDICOS GENERALES SOBRE LOS EFECTOS PLACEBO EN LA PRÁCTICA CLÍNICA

 

Jenkinson CE, Winder RE, Sugg HV, Roberts MJ, Ridgway N, Kuyken W, et al. Why do GPs exclude patients from participating in research? An exploration of adherence to and divergence from trial criteria. Fam Pract 2014;31:364-370 [C,I]

24621557             R/C

¿POR QUÉ EXCLUYEN LOS MÉDICOS GENERALES A PACIENTES DE LA PARTICIPACIÓN EN LA INVESTIGACIÓN? EXPLORACIÓN DEL SEGUIMIENTO Y DE LA DISCREPANCIA DE LOS CRITERIOS DE LOS ENSAYOS

 

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

 

Mortensen EM, Halm EA, Pugh MJ, Copeland LA, Metersky M, Fine MJ, et al. Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. JAMA 2014;311:2199-2208 [S,I]

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ASOCIACIÓN DE LA AZITROMICINA CON MORTALIDAD Y ACONTECIMIENTOS CARDIOVASCULARES ENTRE PACIENTES MAYORES HOSPITALIZADOS CON NEUMONÍA

 

Al-Khatib SM, Hellkamp AS, Fonarow GC, Mark DB, Curtis LH, Hernandez AF, et al. Association between prophylactic implantable cardioverter-defibrillators and survival in patients with left ventricular ejection fraction between 30% and 35%. JAMA 2014;311:2209-2215 [S,I]

24893088             R/C

ASOCIACIÓN ENTRE CARDIOVERSORES-DESFIBRILADORES IMPLANTABLES PREVENTIVOS Y SUPERVIVENCIA EN PACIENTES CON FRACCIÓN DE EYECCIÓN VENTRICULAR IZQUIERDA ENTRE 30 Y 35 %

 

Salt restriction. JAMA 2014;311:2229 [AO,I]

24893092

RESTRICCIÓN DE SAL

 

Seaquist ER. Addressing the burden of diabetes. JAMA 2014;311:2267-2268 [AO,I]

24915253

ABORDAR LA CARGA DE DIABETES

 

Jampol LM, Bressler NM, Glassman AR. Revolution to a new standard treatment of diabetic macular edema. JAMA 2014;311:2269-2270 [AO,I]

24915254

REVOLUCIÓN HACIA UN NUEVO ESTÁNDAR DE TRATAMIENTO DEL EDEMA MACULAR DIABÉTICO

 

Sacks DB, John WG. Interpretation of hemoglobin A1c values. JAMA 2014;311:2271-2272 [AO,I]

24915255

INTERPRETACIÓN DE LOS VALORES DE HEMOGLOBINA A1C

 

Roumie CL, Greevy RA, Grijalva CG, Hung AM, Liu X, Murff HJ, et al. Association between intensification of metformin treatment with insulin vs sulfonylureas and cardiovascular events and all-cause mortality among patients with diabetes. JAMA 2014;311:2288-2296 [S,II]

24915260             R/C

ASOCIACIÓN ENTRE INTENSIFICACIÓN DEL TRATAMIENTO DE METFORMINA CON INSULINA FRENTE A SULFONILUREAS Y ACONTECIMIENTOS CARDIOVASCULARES Y MORTALIDAD POR CUALQUIER CAUSA ENTRE PACIENTES CON DIABETES

 

Wallia A, Molitch ME. Insulin therapy for type 2 diabetes mellitus. JAMA 2014;311:2315-2325 [M,II]

24915263             R/C

TERAPIA CON INSULINA EN LA DIABETES MELLITUS TIPO 2

 

Andrews MA, O'Malley PG. Diabetes overtreatment in elderly individuals: risky business in need of better management. JAMA 2014;311:2326-2327 [AO,I]

24915264

SOBRETRATAMIENTO DE LA DIABETES EN LAS PERSONAS MAYORES: ASUNTO ARRIESGADO QUE REQUIERE UN MANEJO MEJOR

 

Beckman JA. Thrombolytic therapy for pulmonary embolism. JAMA 2014;311:2385-2386 [AO,I]

24938561

TERAPIA TROMBOLÍTICA EN EL EMBOLISMO PULMONAR

 

Coresh J, Turin TC, Matsushita K, Sang Y, Ballew SH, Appel LJ, et al; for the CKD Prognosis Consortium. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. JAMA 2014 [Epub ahead of print] [M,II]

24892770             R/C

CAÍDA EN LA TASA DE FLUJO GLOMERULAR ESTIMADA Y RIESGO POSTERIOR DE ENFERMEDAD RENAL TERMINAL Y MORTALIDAD

 

Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, et al; LIFE study investigators. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA 2014;311:2387-2396 [EC,II]

24866862             R/C

EFECTO DE LA ACTIVIDAD FÍSICA ESTRUCTURADA SOBRE LA PREVENCIÓN DE DISCAPACIDAD IMPORTANTE DE LA MOVILIDAD EN ANCIANOS: ENSAYO CLÍNICO ALEATORIZADO ESTUDIO LIFE

 

Cooney G, Dwan K, Mead G. Exercise for depression. JAMA 2014;311:2432-2433 [AO,II]

24938566             R/C

EJERCICIO PARA LA DEPRESIÓN

 

Ludwig DS, Friedman MI. Increasing adiposity: consequence or cause of overeating? JAMA 2014;311:2167-2168 [AO,I]

24839118

AUMENTO DE LA ADIPOSIDAD: ¿CONSECUENCIA O CAUSA DEL EXCESO DE COMIDA?

 

Herath SC, Poole P. Prophylactic antibiotic therapy in chronic obstructive pulmonary disease. JAMA 2014;311:2225-2226 [AO,II]

24893090             R/C

TERAPIA DE PROFILAXIS ANTIBIÓTICA EN LA EPOC

 

Vongpatanasin W. Resistant hypertension: a review of diagnosis and management. JAMA 2014;311:2216-2224 [R,II]

24893089             R/C

HIPERTENSIÓN RESISTENTE: REVISIÓN DEL DIAGNÓSTICO Y TRATAMIENTO

 

O'Meara S, Richardson R, Lipsky BA. Topical and systemic antimicrobial therapy for venous leg ulcers . JAMA 2014;311:2534-2535 [AO,I]

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TERAPIA ANTIMICROBIANA TÓPICA Y SISTÉMICA PARA LAS ÚLCERAS VENOSAS DE LAS PIERNAS

 

Pisano ED, Yaffe MJ. Breast cancer screening: should tomosynthesis replace digital mammography? JAMA 2014;311:2488-2489 [AO,I]

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CRIBAJE DEL CÁNCER DE MAMA: ¿DEBERÍA LA TOMOSÍNTESIS REEMPLAZAR A LA MAMOGRAFÍA DIGITAL?

 

Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA 2014;311:2499-2507 [T,II]

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CRIBAJE DEL CÁNCER DE MAMA USANDO TOMOSÍNTESIS EN COMBINACIÓN CON MAMOGRAFÍA DIGITAL

 

JAMA INTERNAL MEDICINE

 

Foy AJ, Ting JG. The harms of an unnecessary preoperative echocardiogram: a teachable moment. JAMA Intern Med 2014;174:853-854 [AO,I]

24687089

LOS PERJUICIOS DE UN ECOCARDIOGRAMA PERIOPERATORIO INNECESARIO: MOMENTO DE APRENDIZAJE

 

Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med 2014;174:890-898 [EC,II]

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REDUCCIÓN DE PRESCRIPCIONES INADECUADAS DE BENZODIACEPINAS ENTRE ANCIANOS A TRAVÉS DE LA EDUCACIÓN DIRECTA DEL PACIENTE: ENSAYO ALEATORIZADO AGRUPADO EMPOWER

 

Huffman JC, Mastromauro CA, Beach SR, Celano CM, DuBois CM, Healy BC, et al. Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial. JAMA Intern Med 2014;174:927-936 [EC,I]

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ATENCIÓN COORDINADA A LA DEPRESIÓN Y LOS TRASTORNOS DE ANSIEDAD EN PACIENTES CON ACONTECIMIENTOS CARDIACOS RECIENTES: ENSAYO CLÍNICO ALEATORIZADO MOSAIC

 

Tosteson AN, Fryback DG, Hammond CS, Hanna LG, Grove MR, Brown M, et al. Consequences of false-positive screening mammograms. JAMA Intern Med 2014;174:954-961 [S,I]

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CONSECUENCIAS DE LOS FALSOS POSITIVOS EN LAS MAMOGRAFÍAS DE CRIBAJE

 

Li WQ, Qureshi AA, Robinson KC, Han J. Sildenafil use and increased risk of incident melanoma in US men: a prospective cohort study. JAMA Intern Med 2014;174:964-970 [S,I]

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USO DE SILDENAFILO Y AUMENTO DEL RIESGO DE MELANOMA EN HOMBRES ESTADOUNIDENSES: ESTUDIO DE COHORTE PROSPECTIVO

 

JAMA PSYCHIATRY

 

Correll CU, Carbon M. Efficacy of pharmacologic and psychotherapeutic interventions in psychiatry: to talk or to prescribe: is that the question? JAMA Psychiatry 2014;71:624-626 [AO,I]

24789579

EFICACIA DE LAS INTERVENCIONES FARMACOLÓGICAS Y PSICOTERAPÉUTICAS EN PSIQUIATRÍA: HABLAR O PRESCRIBIR ¿ES ESE EL DILEMA?

 

Huhn M, Tardy M, Spineli LM, Kissling W, Förstl H, Pitschel-Walz G, et al. Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: a systematic overview of meta-analyses. JAMA Psychiatry 2014;71:706-715 [M,II]

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EFICACIA DE LA FARMACOTERAPIA Y LA PSICOTERAPIA EN LOS TRASTORNOS PSIQUIÁTRICOS DEL ADULTO: RESUMEN SISTEMÁTICO DE METAANÁLISIS

 

MEDICINA CLINICA

 

González-Molero I, Rojo G, Morcillo S, Pérez-Valero V, Rubio-Martín E, Gutierrez-Repiso C, Soriguer F. Relación entre déficit de vitamina D y síndrome metabólico. Med Clin (Barc) 2014;142:473-477 [S,II]

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RELACIÓN ENTRE DÉFICIT DE VITAMINA D Y SÍNDROME METABÓLICO

 

González-Clemente JM, Font B, Lahoz R, Llauradó G, Gambús G; Grupo de investigadores del Estudio INERCIA. Inercia clínica en pacientes con diabetes mellitus tipo 2 no insulinizados en tratamiento con hipoglucemiantes orales. Estudio INERCIA. Med Clin (Barc) 2014;142:478-484 [T,II]

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INERCIA CLÍNICA EN PACIENTES CON DIABETES MELLITUS TIPO 2 NO INSULINIZADOS EN TRATAMIENTO CON HIPOGLUCEMIANTES ORALES. ESTUDIO INERCIA

 

Gomis R, Artola S, Conthe P, Vidal J, Casamor R, Font B; investigadores del Grupo de Estudio OBEDIA. Prevalencia de diabetes mellitus tipo 2 en pacientes ambulatorios con sobrepeso u obesidad en España. Estudio OBEDIA. Med Clin (Barc) 2014;142:485-492 [T,II]

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PREVALENCIA DE DIABETES MELLITUS TIPO 2 EN PACIENTES AMBULATORIOS CON SOBREPESO U OBESIDAD EN ESPAÑA. ESTUDIO OBEDIA

 

González-Parra E, Egido J. Vitamina D, síndrome metabólico y diabetes mellitus. Med Clin (Barc) 2014;142:493-496 [AO,I]

24629694

VITAMINA D, SÍNDROME METABÓLICO Y DIABETES MELLITUS

 

Limón-Ramírez R, Gea-Velázquez de Castro MT, Aranaz-Andrés JM. Diseño de una estrategia multimodal incluyendo marketing sanitario para la mejora del cumplimiento de la higiene de manos. Med Clin (Barc) 2014;142:505-511 [R,I]

24387954

DISEÑO DE UNA ESTRATEGIA MULTIMODAL INCLUYENDO MARKETING SANITARIO PARA LA MEJORA DEL CUMPLIMIENTO DE LA HIGIENE DE MANOS

 

Morillas RM, Sala M, Planas R. Profilaxis de la encefalopatía hepática. Med Clin (Barc) 2014;142:512-514 [AO,I]

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PROFILAXIS DE LA ENCEFALOPATÍA HEPÁTICA

 

Faro M, Sáez-Francàs N, Castro-Marrero J, Aliste L, Collado A, Alegre J. Impacto de la fibromialgia en el síndrome de fatiga crónica. Med Clin (Barc) 2014;142:519-525 [T,I]

24387955             R/C

IMPACTO DE LA FIBROMIALGIA EN EL SÍNDROME DE FATIGA CRÓNICA

 

Martín-Ramiro JJ, Alvarez-Martín E, Gil-Prieto R. Mortalidad atribuible al exceso de peso en España. Med Clin (Barc) 2014;142:526-530 [T,II]

24183117             R/C

MORTALIDAD ATRIBUIBLE AL EXCESO DE PESO EN ESPAÑA

 

Rico-Villademoros F, Calandre EP. Fibromialgia: ¿comorbilidad marcadora de vulnerabilidad? Med Clin (Barc) 2014;142:538-539 [AO,I]

24315748

FIBROMIALGIA: ¿COMORBILIDAD MARCADORA DE VULNERABILIDAD?

 

Hernández FJ, Ruilope LM. ¿Es útil calcular el riesgo cardiovascular a 30 años? Med Clin (Barc) 2014;142:540-541 [AO,I]

24656124

¿ES ÚTIL CALCULAR EL RIESGO CARDIOVASCULAR A 30 AÑOS?

 

Catalá-López F, Hutton B, Moher D. Declaración de transparencia para las publicaciones científicas. Med Clin (Barc) 2014;142:554-555 [AO,II]

24703420

DECLARACIÓN DE TRANSPARENCIA PARA LAS PUBLICACIONES CIENTÍFICAS

 

REVISTA ESPAÑOLA DE CARDIOLOGIA

 

Ferreira-González I. Bases para la interpretación de los estudios de no inferioridad: a propósito de los estudios ROCKET–AF, RE-LY y ARISTOTLE. Rev Esp Cardiol 2014;67:432-435  [R,I]

24863590             R/C

BASES PARA LA INTERPRETACIÓN DE LOS ESTUDIOS DE NO INFERIORIDAD: A PROPÓSITO DE LOS ESTUDIOS ROCKET–AF, RE-LY Y ARISTOTLE

 

Valdés S, García-Torres F, Maldonado-Araque C, Goday A, Calle-Pascual A, Soriguer F, et al; Esta dirección electrónica esta protegida contra spam bots. Necesita activar JavaScript para visualizarla study group. Prevalencia de obesidad, diabetes mellitus y otros factores de riesgo cardiovascular en Andalucía. Comparación con datos de prevalencia nacionales. Estudio Esta dirección electrónica esta protegida contra spam bots. Necesita activar JavaScript para visualizarla . Rev Esp Cardiol 2014;67:442-448 [T,I]

24863592             R/C

PREVALENCIA DE OBESIDAD, DIABETES MELLITUS Y OTROS FACTORES DE RIESGO CARDIOVASCULAR EN ANDALUCÍA. COMPARACIÓN CON DATOS DE PREVALENCIA NACIONALES. ESTUDIO Esta dirección electrónica esta protegida contra spam bots. Necesita activar JavaScript para visualizarla

 

Gurbel PA, Rafeedheen R, Tantry US. Tratamiento antiagregante plaquetario personalizado. Rev Esp Cardiol 2014;67:480-487  [R,I]

24863597             R/C

TRATAMIENTO ANTIAGREGANTE PLAQUETARIO PERSONALIZADO

 

SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE

 

Sigurdsson EL. Salt: a taste of death? Scand J Prim Health Care 2014;32:53-54 [AO,I]

24939739

SAL ¿SABOR A MUERTE?

 

Zandén L, Bergh H. A home-based method for the detection of impaired glucose tolerance in hypertensive primary care patients. Scand J Prim Health Care 2014;32:62-66 [T,I]

24779455             R/C

MÉTODO PARA LA DETECCIÓN DOMICILIARIA DE TOLERANCIA ALTERADA A LA GLUCOSA EN PACIENTES HIPERTENSOS EN ATENCIÓN PRIMARIA

 

Kujanpää T, Ylisaukko-Oja T, Jokelainen J, Hirsikangas S, Kanste O, Kyngäs H, et al. Prevalence of anxiety disorders among Finnish primary care high utilizers and validation of Finnish translation of GAD-7 and GAD-2 screening tools. Scand J Prim Health Care 2014;32:78-83 [T,I]

24920316             R/C

PREVALENCIA DE TRASTORNOS DE ANSIEDAD ENTRE HIPERUTILIZADORES FINESES DE ATENCIÓN PRIMARIA Y VALIDACIÓN DE LA TRADUCCIÓN FINESA DE LAS HERRAMIENTAS DE CRIBAJE GAD-7 Y GAD-2

 

Nevalainen M, Kuikka L, Pitkälä K. Medical errors and uncertainty in primary healthcare: A comparative study of coping strategies among young and experienced GPs. Scand J Prim Health Care 2014;32:84-89 [T,II]

24914458             R/C

ERRORES MÉDICOS E INCERTIDUMBRE EN ATENCIÓN PRIMARIA DE SALUD: ESTUDIO COMPARATIVO DE ESTRATEGIAS DE SUPERACIÓN ENTRE MÉDICOS GENERALES TANTO JÓVENES COMO EXPERIMENTADOS

 

Koffeman AR, Valkhoff VE, Jong GW, Warlé-van Herwaarden MF, Bindels PJ, Sturkenboom MC, et al. Ischaemic cardiovascular risk and prescription of non-steroidal anti-inflammatory drugs for musculoskeletal complaints. Scand J Prim Health Care 2014;32:90-98 [S,I]

24931511             R/C

RIESGO CARDIOVASCULAR ISQUÉMICO Y PRESCRIPCIÓN DE AINE PARA LAS MOLESTIAS OSTEOMUSCULARES

 

THE LANCET

 

Hypertension: an urgent need for global control and prevention. Lancet 2014;383:1861 [AO,I]

24881973

HIPERTENSIÓN: NECESIDAD URGENTE DE CONTROL Y PREVENCIÓN MUNDIALES

 

Polio eradication: the CIA and their unintended victims. Lancet 2014;383:1862 [AO,I]

24881975

ERRADICACIÓN DE LA POLIO: LA CÍA Y SUS VÍCTIMAS NO INTENCIONADAS

 

Waeber B, Feihl F. Nebivolol and valsartan: useful treatment for hypertension? Lancet 2014;383:1864-1866 [AO,I]

24881977

NEBIVOLOL Y VALSARTAN: TRATAMIENTO ÚTIL PARA LA HIPERTENSIÓN

 

Kahan T. Focus on blood pressure as a major risk factor. Lancet 2014;383:1866-1868.[AO,I]

24881978

CONCENTRARSE EN LA TENSIÓN ARTERIAL COMO FACTOR DE RIESGO DE PRIMER ORDEN

 

McManus RJ, Mant J. The drugs do work: blood pressure improvement in England. Lancet 2014;383:1868-1869 [AO,I]

24881979

LAS MEDICINAS FUNCIONAN: MEJORÍA DE LA TENSIÓN ARTERIAL EN INGLATERRA

 

Giles TD, Weber MA, Basile J, Gradman AH, Bharucha DB, Chen W, et al; NAC-MD-01 Study Investigators. Efficacy and safety of nebivolol and valsartan as fixed-dose combination in hypertension: a randomised, multicentre study. Lancet 2014;383:1889-1898 [EC,I]

24881993             R/C

EFICACIA Y SEGURIDAD DEL NEBIVOLOL Y EL VALSARTAN COMO COMBINACIÓN A DOSIS FIJA EN LA HIPERTENSIÓN: ESTUDIO ALEATORIZADO MULTICÉNTRICO

 

Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. Lancet 2014;383:1899-1911 [S,II]

24881994             R/C

TENSIÓN ARTERIAL E INCIDENCIA DE DOCE ENFERMEDADES CARDIOVASCULARES: RIESGOS A LO LARGO DE LA VIDA, AÑOS DE VIDA SANA PERDIDOS Y ASOCIACIONES ESPECÍFICAS POR EDAD EN 1,25 MILLONES DE PERSONAS

 

Falaschetti E, Mindell J, Knott C, Poulter N. Hypertension management in England: a serial cross-sectional study from 1994 to 2011. Lancet 2014;383:1912-1919 [T,I]

24881995             R/C

MANEJO DE LA HIPERTENSIÓN EN INGLATERRA: ESTUDIO TRANSVERSAL SERIADO DESDE 1994 A 2011

 

Back to basics for diabetes. Lancet 2014;383:1945 [AO,I]

24910218

VUELTA A LOS PRINCIPIOS EN LA DIABETES

 

Shi Y, Hu FB. The global implications of diabetes and cancer. Lancet 2014;383:1947-1948 [AO,I]

24910221

IMPLICACIONES MUNDIALES DE LA DIABETES Y EL CÁNCER

 

Ji L. Sex disparity in the risk of diabetes-associated stroke. Lancet 2014;383:1948-1950 [AO,I]

24613027

DISPARIDAD ENTRE SEXOS EN EL RIESGO DE ICTUS ASOCIADO A LA DIABETES

 

Peters SA, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775,385 individuals and 12,539 strokes. Lancet 2014;383:1973-1980 [M,II]

24613026             R/C

DIABETES COMO FACTOR DE RIESGO PARA EL ICTUS EN MUJERES COMPARADAS CON HOMBRES: REVISIÓN SISTEMÁTICA Y METAANÁLISIS DE 64 COHORTES QUE INCLUYEN A 775.385 INDIVIDUOS Y 12.539 ICTUS

 

Dick KJ, Nelson CP, Tsaprouni L, Sandling JK, Aïssi D, Wahl S, et al. DNA methylation and body-mass index: a genome-wide analysis. Lancet 2014;383:1990-1998 [S,II]

24630777             R/C

METILACIÓN DE ADN E ÍNDICE DE MASA CORPORAL: ANÁLISIS GENÓMICO AMPLIO

 

Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet 2014;383:1999-2007 [R,I]

24910231             R/C

PREVENCIÓN Y MANEJO DE LA DIABETES TIPO 2: COMPONENTES DIETÉTICOS Y ESTRATEGIAS NUTRICIONALES

 

The World (fizzy drink) Cup 2014. Lancet 2014;383:2020 [AO,I]

24931680

LA COPA MUNDIAL 2014 (DE BEBIDA GASEOSA)

 

Migliori GB, Sotgiu G. Measuring the effect of tuberculosis control: a step forward. Lancet 2014;383:2026-2028 [AO,I]

24650956

MEDIR EL EFECTO DEL CONTROL DE LA TUBERCULOSIS: UN PASO ADELANTE

 

THE NEW ENGLAND JOURNAL OF MEDICINE

 

Boucher HW, Wilcox M, Talbot GH, Puttagunta S, Das AF, Dunne MW. Once-weekly dalbavancin versus daily conventional therapy for skin infection. N Engl J Med 2014;370:2169-2179 [EC,I]

24897082             R/C

DALBAVACINA UNA VEZ A LA SEMANA FRENTE AL TRATAMIENTO DIARIO CONVENCIONAL PARA LAS INFECCIONES DE LA PIEL

 

Corey GR, Kabler H, Mehra P, Gupta S, Overcash JS, Porwal A, et al; SOLO I Investigators. Single-dose oritavancin in the treatment of acute bacterial skin infections. N Engl J Med 2014;370:2180-2190 [EC,I]

24897083             R/C

ORITAVACINA EN DOSIS SIMPLE EN EL TRATAMIENTO DE LAS INFECCIONES DÉRMICAS AGUDAS BACTERIANAS

 

Chirinos JA, Gurubhagavatula I, Teff K, Rader DJ, Wadden TA, Townsend R, et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med 2014;370:2265-2275 [EC,I]

24918371             R/C

CPAP, PÉRDIDA DE PESO O AMBAS EN LA APNEA OBSTRUCTIVA DEL SUEÑO

 

Gottlieb DJ, Punjabi NM, Mehra R, Patel SR, Quan SF, Babineau DC, et al. CPAP versus oxygen in obstructive sleep apnea. N Engl J Med 2014;370:2276-2285 [EC,I]

24918372             R/C

CPAP FRENTE A OXÍGENO EN LA APNEA OBSTRUCTIVA DEL SUEÑO

 

Ingelfinger JR. Clinical practice. The child or adolescent with elevated blood pressure. N Engl J Med 2014;370:2316-2325 [R,I]

24918374

PRÁCTICA CLÍNICA. EL NIÑO O ADOLESCENTE CON TENSIÓN ARTERIAL ELEVADA

 

Macaraig M, Burzynski J, Varma JK. Tuberculosis control in New York City--a changing landscape. N Engl J Med 2014;370:2362-2365 [AO,I]

24941176

CONTROL DE LA TUBERCULOSIS EN LA CIUDAD DE NUEVA YORK-UN PAISAJE CAMBIANTE

 

Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, Pohl HG, et al; RIVUR Trial Investigators. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med 2014;370:2367-2376 [EC,I]

24795142             R/C

PROFILAXIS ANTIMICROBIANA EN NIÑOS CON REFLUJO VESICOURETERAL

 

Chey WD, Webster L, Sostek M, Lappalainen J, Barker PN, Tack J. Naloxegol for opioid-induced constipation in patients with noncancer pain. N Engl J Med 2014;370:2387-2396 [EC,I]

24896818             R/C

NALOXEGOL PARA EL ESTREÑIMIENTO INDUCIDO POR OPIOIDES EN PACIENTES CON DOLOR NO ONCOLÓGICO

 

Huybrechts KF, Palmsten K, Avorn J, Cohen LS, Holmes LB, Franklin JM, et al. Antidepressant use in pregnancy and the risk of cardiac defects. N Engl J Med 2014;370:2397-2407 [S,II]

24941178             R/C

USO DE ANTIDEPRESIVOS EN EL EMBARAZO Y RIESGO DE DEFECTOS CARDIACOS

 

Biesecker LG, Green RC. Diagnostic clinical genome and exome sequencing. N Engl J Med 2014;370:2418-2425 [R,I]

24941179

GENOMA DIAGNÓSTICO CLÍNICO Y SECUENCIACIÓN DE EXOMA

 

Ingelfinger JR, Stapleton FB. Antibiotic prophylaxis for vesicoureteral reflux--answers, yet questions. N Engl J Med 2014;370:2440-2441 [AO,I]

24795143

PROFILAXIS ANTIBIÓTICA EN EL REFLUJO VESICOURETERAL--RESPUESTAS, PERO TODAVÍA PREGUNTAS

 

Hwang TJ, Bourgeois FT, Seeger JD. Drug safety in the digital age. N Engl J Med 2014;370:2460-2462 [AO,I]

24963564

SEGURIDAD FARMACOLÓGICA EN LA ERA DIGITAL

 

Connors JM. Prophylaxis against venous thromboembolism in ambulatory patients with cancer. N Engl J Med 2014;370:2515-2519 [R,I]

24963570

PROFILAXIS CONTRA EL TROMBOEMBOLISMO VENOSO EN PACIENTES AMBULATORIOS CON CÁNCER

 

Cardiovascular morbidity and obstructive sleep apnea. N Engl J Med 2014 [Epub ahead of print] [AO,I]

24918956

MORBILIDAD CARDIOVASCULAR Y APNEA OBSTRUCTIVA DEL SUEÑO

 

 

ACADEMIC MEDICINE

 

S24662199

All physicians take a leadership role at some point in their career-some exert influence in their practices and communities as informal leaders, and others hold formal leadership roles to which they are appointed or elected. These formal leadership roles convey power to those individuals who hold such positions. Formal leadership, however, is limited in its influence unless it is accompanied by a series of personal and interpersonal competencies that characterize both formal and informal leaders.Many physicians who do not hold formal leadership roles will be called on to provide (or will wish to provide) informal leadership at various times in their careers. Both formal and informal leaders should be trained in the personal and interpersonal competencies necessary for effective leadership to advance the principles-driven and values-oriented goals inherent in the health care enterprise.In this article, the author defines leadership and describes the characteristics of formal and informal leaders, then discusses the types of leadership and the power derived from different leadership roles. He concludes by arguing in favor of expanding the scope of leadership training to include informal as well as formal leaders.

S24871243

Findings suggest that important predictors of physician performance on competence assessment include personal characteristics, practice context, and reasons for assessment referral. These findings have implications for development of policies and programs designed to assess risk of poor physician performance and quality of care improvement efforts through organizational/practice design or remedial education.

 

ANNALS OF INTERNAL MEDICINE

 

S24862434

Prenatal HBV screening followed by postnatal prophylaxis is highly effective in preventing vertical transmission of HBV. A negative e antigen status or a viral load less than 5 × 107 IU/mL (90.9% of women tested) identifies women at extremely low risk for transmission after immunoprophylaxis who are unlikely to benefit from further interventions.

S24935489

This synopsis of the guideline summarizes the evidence about risk factors for stroke in women and suggests prevention strategies. It also describes the new recommendations relevant to identifying and treating hypertensive disorders in pregnancy that increase risk for stroke.

S24887617 

Pharmacologic rate- and rhythm-control strategies have comparable efficacy across outcomes in primarily older patients with mild AF symptoms. Pulmonary vein isolation is better than antiarrhythmic medications at reducing recurrences of AF in younger patients with paroxysmal AF and mild structural heart disease. Future research should address uncertainties related to subgroups of interest and the effect of different therapies on long-term clinical outcomes.

S24887616

In unscreened elderly persons CRC screening should be considered well beyond age 75 years. A colonoscopy is indicated at most ages.

S24663815

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment. (I statement).

 

ARCHIVOS DE BRONCONEUMOLOGIA

 

S24387877

En estudios recientes ha quedando quedado perfectamente establecido que el tabaco incrementa la susceptibilidad a la infección bacteriana pulmonar, incluso en fumadores pasivos. Este efecto muestra también dosis-respuesta, ya que disminuye espectacularmente el riesgo 10 años después de abandonar el hábito tabáquico, situándose a niveles de no fumadores.

Streptococcus pneumoniae es el microorganismo causante de neumonía adquirida en la comunidad (NAC) que más se ha relacionado con el tabaquismo, especialmente en situaciones de enfermedad neumocócica invasiva y shock séptico.

Su influencia sobre la evolución de la neumonía no parece clara, aunque existen evidencias que sugieren un peor pronóstico de la neumonía neumocócica.

En NAC causadas por Legionella pneumophila también se ha observado que el hábito tabáquico es el factor de riesgo más remarcable, ya que puede suponer un aumento del riesgo del 121% por cada paquete diario de cigarrillos consumidos.

Por otro lado, el consumo de tabaco puede también favorecer la presencia de enfermedades que a su vez son factores de riesgo conocidos de NAC, como enfermedades periodontales e infecciones víricas de la vía aérea superior.

Como medida preventiva, si bien cabe proponer el abandono del tabaco, también es recomendable la vacuna neumocócica, independientemente de la presencia de comorbilidad.

 

ATENCION PRIMARIA

 

S24768654

A pesar de la accesibilidad a la EF deben realizarse esfuerzos para estandarizar la formación, incrementar el número de exploraciones y promover el control de calidad sistemático.

S24768653

El grado de satisfacción de los pacientes de atención primaria domiciliaria parece depender de las características propias de cada modelo organizativo, siendo el modelo dispensarizado el que presenta un mayor grado de satisfacción o calidad asistencial percibida. Se debería realizar un mayor número de estudios para generalizar estos resultados a otros centros de atención primaria pertenecientes a otras instituciones.

S24704194

El cigarrillo electrónico (e-cig) es un dispositivo con forma de cigarrillo convencional que libera determinadas dosis de vapores de nicotina a través de un proceso de calentamiento electrónico.

Los cartuchos de nicotina tienen mucha variabilidad en la cantidad de nicotina liberada, incluso dentro de la misma marca. No todas las marcas admiten que contienen nicotina, pero esta se detecta en la mayoría de unidades analizadas. El e-cig contiene habitualmente propelentes como el propilenglicol, que es un producto irritante pulmonar. El efecto respiratorio a corto plazo del vapor de un e-cig es similar al causado por el humo del cigarrillo y es causa de broncoconstricción. La mayoría de marcas contienen glicerina, y se ha detectado al menos un caso de neumonía lipoidea por esta sustancia. Muchas marcas contienen trazas de N-nitrosaminas, metales pesados y otros productos que se encuentran en el humo de los cigarrillos convencionales en mucha mayor proporción. Actualmente no se dispone de evidencia científica de que sea un dispositivo eficaz para dejar de fumar, por lo que no debe recomendarse de forma proactiva para este fin y puede interferir en el uso de tratamientos de evidencia científica demostrada para dejar de fumar. Puede tener un efecto indeseable al promover el inicio del consumo en adolescentes o retener a fumadores adultos en el consumo de nicotina y en la dependencia gestual. No se conoce bien la toxicidad de los vapores pero se sabe que no son inocuos, por lo que no deberían utilizarse en espacios públicos cerrados.

S24661973

La prescripción inapropiada en mayores es frecuente y está relacionada con el uso de benzodiacepinas de vida media larga. Existen diabéticos con factores de riesgo cardiovascular en los que se omiten las estatinas. La polimedicación juega un papel importante en las PPI y OP.

S24703389

El EAT-26 modificado y abreviado es un instrumento multidimensional, con excelentes valores de confiabilidad y sensibilidad, y con un adecuado valor de especificidad, apropiado para el cribado de posible TCA en población de riesgo y útil en atención primaria para su detección temprana en mujeres jóvenes.

 

BRITISH MEDICAL JOURNAL

 

S24865600

Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer.

WINDECKER

Among patients with stable coronary artery disease, coronary artery bypass grafting reduces the risk of death, myocardial infarction, and subsequent revascularisation compared with medical treatment. All stent based coronary revascularisation technologies reduce the need for revascularisation to a variable degree. Our results provide evidence for improved survival with new generation drug eluting stents but no other percutaneous revascularisation technology compared with medical treatment.

REES

Lower urinary tract symptoms (LUTS) in men have many causes and are often multifactorial

A full assessment helps in making a diagnosis and avoids the assumption that LUTS in all men are due to benign prostatic hyperplasia (BPH)

Frequency volume charts are underused but often provide important diagnostic clues

Lifestyle measures, in particular altering fluid intake, can be useful for men with LUTS

a blockers are the usual treatment for LUTS due to BPH, and antimuscarinics for overactive bladder

5 a reductase inhibitors reduce the risk of clinical progression and should be targeted at those at high risk of clinical progression

A range of surgical options are available for men who fail initial medical management

Lower urinary tract symptoms (LUTS) are common in men and increase in frequency and severity with age. Over one third of men aged 50 or more are living with moderate to severe symptoms, equating to 3.4 million men in the United Kingdom alone and 24 million in countries of the European Union.1 Most men with LUTS can be managed effectively in primary care, with either conservative lifestyle measures or medical treatment.2 We discuss the causes of LUTS in men and summarise the current evidence on assessment and management of patients

S24874977

Higher potency statin use is associated with a moderate increase in the risk of new onset diabetes compared with lower potency statins in patients treated for secondary prevention of cardiovascular disease. Clinicians should consider this risk when prescribing higher potency statins in secondary prevention patients.

S24906901

Community based specialist palliative care teams, despite variation in team composition and geographies, were effective at reducing acute care use and hospital deaths at the end of life.

S24879819

The effectiveness of thrombolytic therapy in daily clinical practice might be comparable with the effectiveness shown in randomised clinical trials and pooled analysis. Early treatment was associated with favourable outcome in daily clinical practice, which underlines the importance of speeding up the process for thrombolytic therapy in hospital and before admission to achieve shorter time from door to needle and from onset to treatment for thrombolytic therapy.

S24938302

Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.

S24899650

Clinical study reports contained extensive data on major harms that were unavailable in journal articles and in trial registry reports. There were inconsistencies between protocols and clinical study reports and within clinical study reports. Clinical study reports should be used as the data source for systematic reviews of drugs, but they should first be checked against protocols and within themselves for accuracy and consistency.

S24942789

Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting.

S24942388

This study found no evidence for a positive association between the use of drug treatments for ADHD and the risk of concomitant suicidal behaviour among patients with ADHD. If anything, the results pointed to a potential protective effect of drugs for ADHD on suicidal behaviour, particularly for stimulant drugs. The study highlights the importance of using within patient designs to control for confounding in future pharmacoepidemiological studies.

S24868083

Among this well treated primary care population, fixed dose combination treatment improved adherence to the combination of all recommended drugs but improvements in clinical risk factors were small and did not reach statistical significance. Acceptability was high for both general practitioners and patients, although the discontinuation rate was high.

S24912589

A community based, individually tailored intervention programme with screening for risk of ischaemic heart disease and repeated lifestyle intervention over five years had no effect on ischaemic heart disease, stroke, or mortality at the population level after 10 years.Trial registration Clinical trials NCT00289237.

S24951459

Invitation to modern mammography screening may reduce deaths from breast cancer by about 28%.

 

BRITISH JOURNAL OF PSYCHIATRY

 

S24676963

Continuing CST improves quality of life; and improves cognition for those taking AChEIs.

S24676966

High levels of early childhood conduct problems are particularly associated with increased health, social care and criminal justice costs in adulthood.

S24578445

Suicide risk in physically ill people varies substantially by presence of psychiatric comorbidity, particularly the relative timing of onset of the two types of illness. Closer collaboration between general and mental health services should be an essential component of suicide prevention strategies.

S24526745

Both interventions led to significant reductions in long-term benzodiazepine use in patients without severe comorbidity. A structured intervention with a written individualised stepped-dose reduction is less time-consuming and as effective in primary care as a more complex intervention involving follow-up visits.

 

 

CANADIAN MEDICAL ASSOCIATION JOURNAL

 

S24664649

In this trial, the rate of successful radial-head subluxation performed by nurses was inferior to the physician success rate. Although the success rate in the nurse-initiated care group did not meet the non-inferiority margin, nurses were able to reduce radial head subluxation for almost 85% of children who presented with probable radial-head subluxation. Trial registration: Clinical Trials.gov, no. NCT00993954.

S24756625

We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.

 

CIRCULATION

 

S24842943

Hospitalization rates for AF have increased exponentially among US adults from 2000 to 2010. The proportion of comorbid chronic diseases has also increased significantly. The last decade has witnessed an overall decline in hospital mortality; however, the hospitalization cost has significantly increased.

S24799511

A well-established body of scientific research shows that there is a strong relationship between excess sodium intake and high blood pressure and other adverse health outcomes. With Americans getting >75% of their sodium from processed and restaurant food, this evidence creates mounting pressure for less sodium in the food supply. The reduction of sodium in the food supply is a complex issue that involves multiple stakeholders. The success of new technological approaches for reducing sodium will depend on product availability, health effects (both intended and unintended), research and development investments, quality and taste of reformulated foods, supply chain management, operational modifications, consumer acceptance, and cost. The conference facilitated an exchange of ideas and set the stage for potential collaboration opportunities among stakeholders with mutual interest in reducing sodium in the food supply and in Americans' diets. Population-wide sodium reduction remains a critically important component of public health efforts to promote cardiovascular health and prevent cardiovascular disease and will remain a priority for the American Heart Association.

 

DIABETES CARE

 

S24855154

Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in such people. The group was aware of evidence that the benefits of insulin therapy are still usually offered late, and thus the aim of the discussion was how to define the optimal timing and basis for decisions regarding insulin and to apply these concepts in practice. It was noted that recent evidence had built upon that of the previous decades, together confirming the benefits and safety of insulin therapy, albeit with concerns about the potential for hypoglycemia and gain in body weight. Insulin offers a unique ability to control hyperglycemia, being used from the time of diagnosis in some circumstances, when metabolic control is disturbed by medical illness, procedures, or therapy, as well as in the longer term in ambulatory care. For those previously starting insulin, various other forms of therapy can be added later, which offer complementary effects appropriate to individual needs. Here we review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and tactics for glycemic control in type 2 diabetes.

S24595629

In the ACCORD BP trial, compared with combined standard treatment, intensive BP or intensive glycemia treatment alone improved major CVD outcomes, without additional benefit from combining the two. In the ACCORD lipid trial, neither intensive lipid nor glycemia treatment produced an overall benefit, but intensive glycemia treatment increased mortality.

S24705610

The presence of a minor lesion was clearly the strongest predictor, while recommended use of adequately offloading footwear was a strong protector against ulcer recurrence from unrecognized repetitive trauma. These outcomes define clear targets for diabetic foot screening and ulcer prevention.

S24667462

Although measuring SMB is difficult and the used operationalization might be limited, our results give some indication that a high level of SMB is associated with prolonged life expectancy in patients with type 2 diabetes and highlight the potential impact of the patients' active contribution on the long-term trajectory of the disease. We assume that the used proxy for SMB is associated with unmeasured, but important, dimensions of health behavior.

S24705609

The incidence of both GDM and pre-GDM in pregnancy has doubled over the last 14 years, and the overall burden of diabetes in pregnancy on society is growing. Although congenital anomaly rates have declined in women with diabetes, perinatal mortality rates remain unchanged, and the risk of both remains significantly elevated compared with nondiabetic women. Increased efforts are needed to reduce these adverse outcomes.

S24855158

Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control, and this effect was larger in the mobile phone subgroup. There was no evidence of benefit for other biological, cognitive, behavioral, or emotional outcomes.

S24722494

Empagliflozin 10 and 25 mg for 24 weeks as add-on to metformin therapy significantly improved glycemic control, weight, and BP, and were well-tolerated.

S24855159

The availability of insulin analogs has offered insulin replacement strategies that are proposed to more closely mimic normal human physiology. Specifically, there are a considerable number of reports demonstrating that prandial insulin analogs (lispro, aspart, glulisine) have pharmacokinetic and pharmacodynamic profiles closer to normal, with resulting faster onset and offset of insulin effect when compared with regular human insulin. In addition, basal insulin analogs (glargine, detemir) have been reported to offer longer duration of action, less variability, more predictability, less hypoglycemia (especially nocturnal), and a favorable effect on weight. However, an argument against use of analog insulins as compared with use of regular or NPH insulin is one that states that the effectiveness and risk of hypoglycemia are the only two valid clinical outcomes that should be used to compare the analog and human insulins. Thus, there remains a debate in some circles that analog insulins are no more effective than human insulins, yet at a much higher financial cost. To provide an in-depth understanding of both sides of the argument, we provide a discussion of this topic as part of this two-part point-counterpoint narrative. In the counterpoint narrative, Dr. Davidson provides his argument and defends his opinion that outside of a few exceptions, analog insulins provide no clinical benefit compared with human insulins but cost much more. In the point narrative presented here, Dr. Grunberger provides a defense of analog insulins and their value in clinical management and suggests that when evaluating the "cost" of therapy, a much more global assessment is needed.-William T. CefaluEditor in Chief, Diabetes Care.

S24855160

The availability of insulin analogs has offered insulin replacement strategies that are proposed to more closely mimic normal human physiology. Specifically, there are a considerable number of reports demonstrating that prandial insulin analogs (lispro, aspart, glulisine) have pharmacokinetic and pharmacodynamic profiles closer to normal, with resulting faster onset and offset of insulin effect when compared with regular human insulin. In addition, basal insulin analogs (glargine, detemir) have been reported to offer longer duration of action, less variability, more predictability, less hypoglycemia (especially nocturnal), and a favorable effect on weight. However, an argument against use of analog insulins as compared with use of regular or NPH insulin is one that states that the effectiveness and risk of hypoglycemia are the only two valid clinical outcomes that should be used to compare the analog and human insulins. Thus, there remains a debate in some circles that analog insulins are no more effective than human insulins, yet at a much higher financial cost. To provide an in-depth understanding of both sides of the argument, we provide a discussion of this topic as part of this two-part point-counterpoint narrative. In the counterpoint narrative presented here, Dr. Davidson provides his argument and defends his opinion that outside of a few exceptions, analog insulins provide no clinical benefit compared with human insulins but cost much more. In the preceding point narrative, Dr. Grunberger provides a defense of analog insulins and their value in clinical management and suggests that when evaluating the "cost" of therapy, a much more global assessment is needed.-William T. CefaluEditor in Chief, Diabetes Care.

 

DRUGS

 

S24825489

Recent high-quality studies have confirmed the central role of lithium in the treatment of bipolar disorder and have established lithium as the drug of first choice for long-term prophylaxis in this condition. However, several indications for its use in unipolar major depression are also based on sound evidence. This includes lithium augmentation as a main strategy for depressed patients not responding to an antidepressant, lithium prophylaxis for recurrent unipolar depression as an alternative to prophylaxis with an antidepressant, and lithium's unique anti-suicidal properties. Lithium monotherapy, on the other hand, is not established for acute treatment of depression. Lithium therapy should be a core competency of every psychiatrist, enabling the safe use of lithium, to the benefit of our patients.

S24866023

The epoch-making discovery of insulin heralded a new dawn in the management of diabetes. However, the earliest, unmodified soluble insulin preparations were limited by their short duration of action, necessitating multiple daily injections. Initial attempts to protract the duration of action of insulin involved the use of various additives, including vasoconstrictor substances, which met with limited success. The subsequent elucidation of the chemical and three-dimensional structure of insulin and its chemical synthesis and biosynthesis allowed modification of the insulin molecule itself, resulting in insulin analogs that are designed to mimic normal endogenous insulin secretion during both fasting and prandial conditions. Insulin glargine was the first once-daily, long-acting insulin analog to be introduced into clinical practice more than 10 years ago and is specifically designed to provide basal insulin requirements. It has a prolonged duration of action and no distinct insulin peak, making it suitable for once-daily administration and reducing the risk of nocturnal hypoglycemia that is seen with intermediate-acting insulins. Insulin glargine can be used in combination with prandial insulin preparations and non-insulin anti-diabetic agents according to individual requirements.

S24846578

Tuberculosis (TB) is the world's second leading infectious killer. Cases of multidrug-resistant (MDR-TB) and extremely drug-resistant (XDR-TB) have increased globally. Therapeutic drug monitoring (TDM) remains a standard clinical technique for using plasma drug concentrations to determine dose. For TB patients, TDM provides objective information for the clinician to make informed dosing decisions. Some patients are slow to respond to treatment, and TDM can shorten the time to response and to treatment completion. Normal plasma concentration ranges for the TB drugs have been defined. For practical reasons, only one or two samples are collected post-dose. A 2-h post-dose sample approximates the peak serum drug concentration (Cmax) for most TB drugs. Adding a 6-h sample allows the clinician to distinguish between delayed absorption and malabsorption. TDM requires that samples are promptly centrifuged, and that the serum is promptly harvested and frozen. Isoniazid and ethionamide, in particular, are not stable in human serum at room temperature. Rifampicin is stable for more than 6 h under these conditions. Since our 2002 review, several papers regarding TB drug pharmacokinetics, pharmacodynamics, and TDM have been published. Thus, we have better information regarding the concentrations required for effective TB therapy. In vitro and animal model data clearly show concentration responses for most TB drugs. Recent studies emphasize the importance of rifamycins and pyrazinamide as sterilizing agents. A strong argument can be made for maximizing patient exposure to these drugs, short of toxicity. Further, the very concept behind 'minimal inhibitory concentration' (MIC) implies that one should achieve concentrations above the minimum in order to maximize response. Some, but not all clinical data are consistent with the utility of this approach. The low ends of the TB drug normal ranges set reasonable 'floors' above which plasma concentrations should be maintained. Patients with diabetes and those infected with HIV have a particular risk for poor drug absorption, and for drug-drug interactions. Published guidelines typically describe interactions between two drugs, whereas the clinical situation often is considerably more complex. Under 'real-life' circumstances, TDM often is the best available tool for sorting out these multi-drug interactions, and for providing the patient safe and adequate doses. Plasma concentrations cannot explain all of the variability in patient responses to TB treatment, and cannot guarantee patient outcomes. However, combined with clinical and bacteriological data, TDM can be a decisive tool, allowing clinicians to successfully treat even the most complicated TB patients.

S24902800

Trimetazidine is a cytoprotective drug whose cardiovascular effectiveness, especially in patients with stable ischemic heart disease, has been the source of much controversy in recent years; some have gone so far as to treat the medication as a 'placebo drug' whose new side effects, such as Parkinsonian symptoms, outweigh its benefits. This article is an attempt to present the recent key studies, including meta-analyses, on the use of trimetazidine in chronic heart failure, also in patients with diabetes mellitus and arrhythmia, as well as in peripheral artery disease. This paper also includes the most recent European Society of Cardiology guidelines, including those of 2013, on the use of trimetazidine in cardiovascular disease.

S24866024

Approximately 30 % of HIV-infected patients are co-infected with hepatitis C virus (HCV). After the release of highly active antiretroviral therapy, liver disease has become the leading cause of morbidity and mortality in HIV patients. Prior to 2011, HCV treatment with pegylated-interferon and ribavirin in HCV/HIV co-infected patients only allowed 14-38 % of patients with HCV genotype 1 to achieve a sustained virologic response (SVR). Additionally, treatment was commonly discontinued as a result of adverse events. Recently, simeprevir and sofosbuvir have been approved by the US Food and Drug Administration (FDA) for HCV mono-infection. Sofosbuvir has been given FDA approval in co-infected patients offering unprecedented SVR rates and the potential for interferon-free therapy. HCV therapies that are in the pipeline offer improved treatment times, safety profiles, and rates of SVR. Despite these improvements, several new issues including adherence, drug-drug interactions with antiretroviral therapies, adverse events, resistance, and patient selection may complicate therapy. This article reviews the current status of direct-acting antivirals (DAA)-containing regimens for HIV/HCV co-infected patients in the USA. New results investigating telaprevir and boceprevir are also discussed as they are relevant for locations where new DAAs are not available. The impact future interferon-free therapies may have on co-infected patients is also discussed.

 

EUROPEAN HEART JOURNAL

 

S24057077

Self-reported symptoms of depression and anxiety, especially if recurrent, were moderately associated with the risk of incident AMI. We had some indications that these associations might partly reflect reverse causation or confounding from common chronic diseases.

S24639425

Atrial fibrillation (AF) is the most common arrhythmia and has gained increasingly more attention due to new treatment options, particularly catheter ablation. Growing experience with this technique and better AF suppression compared with antiarrhythmic medication have paved the way for its extended use and indication. At this point, it is recommended for symptomatic patients if antiarrhythmic drugs failed and in selected young symptomatic patients as first line therapy. It is a tempting concept to improve prognosis in young AF patients by rhythm control irrespective of symptoms. In this review, we summarize epidemiological data on young AF, efficacy, and limitations of rate and rhythm control by means of medication and catheter ablation in young patients, information on arrhythmia progression and outcome, and the consequences of these data for AF treatment in young, asymptomatic patients.

S24282187

Cardiovascular disease (CVD) and depression are common. Patients with CVD have more depression than the general population. Persons with depression are more likely to eventually develop CVD and also have a higher mortality rate than the general population. Patients with CVD, who are also depressed, have a worse outcome than those patients who are not depressed. There is a graded relationship: the more severe the depression, the higher the subsequent risk of mortality and other cardiovascular events. It is possible that depression is only a marker for more severe CVD which so far cannot be detected using our currently available investigations. However, given the increased prevalence of depression in patients with CVD, a causal relationship with either CVD causing more depression or depression causing more CVD and a worse prognosis for CVD is probable. There are many possible pathogenetic mechanisms that have been described, which are plausible and that might well be important. However, whether or not there is a causal relationship, depression is the main driver of quality of life and requires prevention, detection, and management in its own right. Depression after an acute cardiac event is commonly an adjustment disorder than can improve spontaneously with comprehensive cardiac management. Additional management strategies for depressed cardiac patients include cardiac rehabilitation and exercise programmes, general support, cognitive behavioural therapy, antidepressant medication, combined approaches, and probably disease management programmes.

S24536084

Atrial fibrillation (AF) is generally considered a progressive disease, typically evolving from paroxysmal through persistent to 'permanent' forms, a process attributed to electrical and structural remodelling related to both the underlying disease and AF itself. Medical treatment has yet to demonstrate clinical efficacy in preventing progression. Large clinical trials performed to date have failed to show benefit of rhythm control compared with rate control, but these trials primarily included patients at late stages in the disease process. One possible explanation is that intervention at only an early stage of progression may improve prognosis. Evolving observations about the progressive nature of AF, along with the occurrences of major complications such as strokes upon AF presentation, led to the notion that earlier and more active approaches to AF detection, rhythm-reversion, and maintenance of sinus rhythm may be a useful strategy in AF management. Approaches to early and sustained rhythm control include measures that prevent development of the AF substrate, earlier catheter ablation, and novel antiarrhythmic drugs. Improved classifications of AF mechanism, pathogenesis, and remodelling may be helpful to enable patient-specific pathophysiological diagnosis and therapy. Potential novel therapeutic options under development include microRNA-modulation, heatshock protein inducers, agents that influence Ca2+ handling, vagal stimulators, and more aggressive mechanism-based ablation strategies. In this review, of research into the basis and management of AF in acute and early settings, it is proposed that progression from paroxysmal to persistent AF can be interrupted, with potentially favourable prognostic impact.

S24591550

There is a higher risk of cardiovascular events shortly after outbursts of anger.

 

FAMILY MEDICINE

 

S24911300

Our findings show that primary care hypertension patients who use a lipophilic beta-blocker are more likely to have higher depression scores than those who do not use a lipophilic beta-blocker.

S24911299

Successful implementation of innovative PCMH curricula is key to preparing a workforce ready to practice in a new model of health care delivery. This qualitative study demonstrates that an experiential PCMH curriculum can enhance third-year medical student self-assessed knowledge of and attitudes toward the PCMH and may improve perceptions of a career in primary care.

S24911296

Despite increased emphasis on quality improvement activities in practice, most family medicine clerkships do not currently offer PBLI curricula. Additionally, less than one in four family medicine clerkships plan on increasing the amount of PBLI curricula in the next 12 months. Continued research in this area is needed to identify successful models for PBLI curricular offerings.

S24911298

A successful curriculum redesign requires considerable planning and coordination. We designed and implemented a comprehensive CSC that was both well received and effective. Peer teaching programs can provide medical education leadership experiences with benefits for learners, teachers, and medical educators.

 

FAMILY PRACTICE

 

S24435069

Based on a literature search and expert opinion, we have developed an information leaflet for GPs to provide as a supplement to oral shoe advice. Women using this leaflet were able to select shoes of better quality and better fit than women selecting shoes without using the leaflet.

S24639564

The data showed high levels of involvement by German PCPs in CVD prevention and dietary counselling. The rather low perceived success of dietary intervention and differences with respect to patients' health insurance status indicate a need to address both communication skills in medical training and appropriate reimbursement of preventive services.

S24736294

Although the findings are in favour of purposeful selection, observed differences in detected problems between the two selection procedures are relatively small. GPs should at least target older people with =2 chronic conditions, using =5 medications, being female, of an older age, living alone and the less educated.

S24728774

Stroke risk profiles of patients detected via opportunistic and systematic screenings were similar. Data derived from the SAFE study suggest that active screening for AF in patients aged =65 years in primary care is a useful screening programme with 78-83% of patients identified eligible for anticoagulation treatment according to the CHADS2 criteria.

S24736295

This study has elucidated specific costs, benefits and ethical barriers to placebo use as perceived by a large sample of UK GPs. Stand-alone qualitative work would provide a more in-depth understanding of GPs' views. Continuing education and professional guidance could help GPs update and contextualize their understanding of placebos and their clinical effects.

S24532609

Our study shows a high burden of care for fall-related injuries in older general practice patients and provides baseline data for its future monitoring.

S24367069

The use of implementation strategies for the distribution of guidelines on CVD can be convincingly effective on physician adherence, regardless whether based on a unimodal or multimodal design. Three distinct strategies should be well considered in such an attempt: organizational changes in the primary care team, patient education and provider education.

S24473676

The Stepping Up model allowed technical care to be embedded within generalist whole-person care, supported clinicians and practice system to overcome clinical inertia and supported patients to make the timely transition to insulin. Testing of the model's effectiveness is now underway.

S24621557

Clear, comprehensive criteria, particularly with regards to comorbidities, are required for GPs to confidently screen patients for potential participation in research. Future studies should promote inclusivity and encourage GPs to adopt a liberal approach when screening patient lists. This would enhance the validity and generalizability of primary care research and encourage greater patient autonomy.

 

JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

 

S24915260

Among patients with diabetes who were receiving metformin, the addition of insulin vs a sulfonylurea was associated with an increased risk of a composite of nonfatal cardiovascular outcomes and all-cause mortality. These findings require further investigation to understand risks associated with insulin use in these patients.

S24915263

Insulin can help achieve ideal hemoglobin A1c goals for patients with type 2 diabetes. Barriers such as adherence, patient preferences, clinician preferences, and resource allocation must be addressed.

S24893088

Among Medicare beneficiaries hospitalized for heart failure and with an LVEF between 30% and 35% and less than 30%, survival at 3 years was better in patients who received a prophylactic ICD than in comparable patients with no ICD. These findings support guideline recommendations to implant prophylactic ICDs in eligible patients with an LVEF of 35% or less.

S24893087

Among older patients hospitalized with pneumonia, treatment that included azithromycin compared with other antibiotics was associated with a lower risk of 90-day mortality and a smaller increased risk of myocardial infarction. These findings are consistent with a net benefit associated with azithromycin use.

S24892770

Declines in estimated GFR smaller than a doubling of serum creatinine concentration occurred more commonly and were strongly and consistently associated with the risk of ESRD and mortality, supporting consideration of lesser declines in estimated GFR (such as a 30% reduction over 2 years) as an alternative end point for CKD progression.

S24866862

A structured, moderate-intensity physical activity program compared with a health education program reduced major mobility disability over 2.6 years among older adults at risk for disability. These findings suggest mobility benefit from such a program in vulnerable older adults.

S24938566

CLINICAL QUESTION:

Is exercise an effective treatment for depression?

BOTTOM LINE:

Exercise is associated with a greater reduction in depression symptoms compared with no treatment, placebo, or active control interventions, such as relaxation or meditation. However, analysis of high-quality studies alone suggests only small benefits.

S24893090

CLINICAL QUESTION Is prophylactic antibiotic treatment associated with fewer exacerbations or improved health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)? BOTTOM LINE Continuous macrolide antibiotic use for prophylaxis was associated with a clinically significant reduction in COPD exacerbations. Pulsed antibiotic use was not associated with benefit. Continuous and pulsed antibiotics were associated with improved HRQOL, but this was not clinically significant.

S24893089

Resistant hypertension-uncontrolled hypertension with 3 or more antihypertensive agents-is increasingly common in clinical practice. Clinicians should exclude pseudoresistant hypertension, which results from nonadherence to medications or from elevated blood pressure related to the white coat syndrome. In patients with truly resistant hypertension, thiazide diuretics, particularly chlorthalidone, should be considered as one of the initial agents. The other 2 agents should include calcium channel blockers and angiotensin-converting enzyme inhibitors for cardiovascular protection. An increasing body of evidence has suggested benefits of mineralocorticoid receptor antagonists, such as eplerenone and spironolactone, in improving blood pressure control in patients with resistant hypertension, regardless of circulating aldosterone levels. Thus, this class of drugs should be considered for patients whose blood pressure remains elevated after treatment with a 3-drug regimen to maximal or near maximal doses. Resistant hypertension may be associated with secondary causes of hypertension including obstructive sleep apnea or primary aldosteronism. Treating these disorders can significantly improve blood pressure beyond medical therapy alone. The role of device therapy for treating the typical patient with resistant hypertension remains unclear.

OMEARA

Clinical Question:  Is treatment with topical or systemic antimicrobial agents associated with better venous leg ulcer healing compared with usual care (dressings and bandages without antimicrobials) or an alternative topical or systemic antimicrobial agent?

Bottom Line:  Available evidence, from underpowered pooled data, neither supports nor refutes an association of systemic antibiotic therapy with improved venous leg ulcer healing. Among topical antimicrobials, cadexomer iodine may be associated with better healing compared with usual care.

PISANO

Another spirited debate has ensued over the benefits of breast cancer screening,1 freshly stimulated by the recent publication of the 25-year follow-up results of the Canadian National Breast Screening Study (CNBSS) that showed no difference in breast cancer–related mortality in screened women vs controls.2 This latest controversy developed even though the CNBSS is the only one of 8 randomized clinical trials of screening mammography that failed to find a reduction in mortality,3 and despite substantial and well-described limitations in the CNBSS methods,4 including poor image quality and problems in the randomization schema that created a screened cohort with more large palpable cancers than the control group. Fourteen more recent studies published between 2001 and 2010 using more modern technology have shown a 25% to 50% reduction in breast cancer–related mortality for women aged 40 to 74 years.5 In the interval since the randomized trials of screening and with the demonstration of improved diagnostic accuracy for women with dense breasts,6 digital mammography has supplanted film mammography as the screening technology of choice,7 and treatment of breast cancer has improved substantially.8

FRIEDEWALD

Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes

 

JAMA INTERNAL MEDICINE

 

S24733354

Direct-to-consumer education effectively elicits shared decision making around the overuse of medications that increase the risk of harm in older adults. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01148186.

S24756610

False-positive mammograms were associated with increased short-term anxiety but not long-term anxiety, and there was no measurable health utility decrement. False-positive mammograms increased women's intention to undergo future breast cancer screening and did not increase their stated willingness to travel to avoid a false-positive result. Our finding of time-limited harm after false-positive screening mammograms is relevant for clinicians who counsel women on mammographic screening and for screening guideline development groups.

S24710960

Sildenafil use may be associated with an increased risk of developing melanoma. Although this study is insufficient to alter clinical recommendations, we support a need for continued investigation of this association.

S24733277

A novel telephone-based, low-intensity model to concurrently manage cardiac patients with depression and/or anxiety disorders was effective for improving mental health-related quality of life in a 24-week trial. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01201967.

 

JAMA PSYCHIATRY

 

S24789675

Many pharmacotherapies and psychotherapies are effective, but there is a lot of room for improvement. Because of the multiple differences in the methods used in pharmacotherapy and psychotherapy trials, indirect comparisons of their effect sizes compared with placebo or no treatment are problematic. Well-designed direct comparisons, which are scarce, need public funding. Because patients often benefit from both forms of therapy, research should also focus on how both modalities can be best combined to maximize synergy rather than debate the use of one treatment over the other.

 

MEDICINA CLINICA

 

S24387955

La comorbilidad FM empeora los parámetros clínicos, la fatiga y la percepción de la calidad de vida en los pacientes con SFC.

S23622897

Aproximadamente la mitad de los pacientes con DM2 no insulinizados y en tratamiento con HO presenta ICP. Cuatro de cada 10 pacientes cumplen adecuadamente el tratamiento con HO. El sexo femenino y una menor duración de la DM2 se asocian independientemente a ICP.

S24183117

El exceso de peso es un grave problema de salud pública, con una importante mortalidad asociada. El análisis de los fallecimientos atribuibles es una útil herramienta para conocer la situación real y la monitorización de las medidas encaminadas a su control.

S23683969

La DM2 se asocia a sobrepeso y obesidad y aumenta con el grado de IMC. Dislipidemia, hipertensión y sedentarismo en DM2 se incrementan con el aumento del IMC. Los pacientes con peor control metabólico se asocian a mayor grado de obesidad.

S24480288

La encefalopatía hepática (EH) es una complicación frecuente de la cirrosis, con un gran impacto social, que deteriora la calidad de vida del paciente y se considera un signo de enfermedad hepática avanzada y, por tanto, una indicación clínica para la evaluación de trasplante hepático.

Los pacientes que han presentado episodios de EH tienen un elevado riesgo de recurrencia, por lo que una vez superado el episodio de EH se recomienda el control y la prevención de factores precipitantes (hemorragia digestiva, peritonitis bacteriana espontánea, uso de los diuréticos con precaución, evitar medicación depresora del sistema nervioso), la administración continuada de disacáridos no absorbibles, como lactitol o lactulosa, o de antibióticos poco o no absorbibles como rifaximina, y la valoración de la necesidad de un trasplante hepático, dado que la presencia de un episodio de EH conlleva un mal pronóstico en la cirrosis.

S24216018

El déficit de vitamina D y el síndrome metabólico son 2 entidades muy frecuentes en población española. Se ha sugerido que los pacientes con síndrome metabólico pueden tener déficit de vitamina D con mayor frecuencia que los sujetos sin él, y que unos valores bajos de vitamina D pueden predisponer al desarrollo de síndrome metabólico. No obstante, los resultados de estudios prospectivos y de intervención han sido diversos, sin que se haya aclarado por el momento si existe esta relación. El objetivo de este trabajo fue evaluar la relación entre los valores de 25-hidroxivitamina D y la prevalencia e incidencia del síndrome metabólico.

 

REVISTA ESPAÑOLA DE CARDIOLOGIA

 

S24863590

La aparición de los nuevos anticoagulantes orales como tratamiento de prevención de fenómenos de tromboembolia en la fibrilación auricular no valvular ha supuesto sin duda un significativo avance. Se ha estudiado la eficacia y la seguridad de los tres nuevos fármacos en ECA de no inferioridad (hipótesis principal), en los que también se analizaban hipótesis de superioridad. Aunque existe un lógico entusiasmo por conocer qué fármaco es más eficaz, efectivo y eficiente, sin las pertinentes comparaciones directas no se podrá obtener de manera fiable esa información. En todo caso, resulta razonable pensar que, conforme vaya pasando el tiempo y se tenga más datos de estudios observacionales, se irán definiendo las características de la enfermedad —pero, sobre todo, del paciente (comorbilidades, riesgo hemorrágico, factores psicosociales, etc.)— y del entorno que definirán las indicaciones precisas de cada fármaco para grupos de pacientes concretos.

S24863597

Actualmente está bien establecido que la alta reactividad plaquetaria a la adenosina difosfato durante el tratamiento con clopidogrel es un factor independiente predictivo del riesgo de eventos isquémicos en pacientes a los que se ha practicado una intervención coronaria percutánea. Sin embargo, el papel exacto de las pruebas de la función plaquetaria sigue siendo objeto de controversia. Las pruebas de la función plaquetaria para asegurar una inhibición plaquetaria óptima han sido recomendadas por algunos autores para mejorar los resultados en los pacientes tratados con clopidogrel. En ensayos prospectivos y aleatorizados recientes sobre tratamiento antiagregante plaquetario personalizado, no se ha podido demostrar un efecto favorable de las pruebas de la función plaquetaria en cuanto a mejora de los resultados clínicos. En este artículo se analizan los mecanismos de la falta de respuesta a clopidogrel, los ensayos recientes de las pruebas de la función plaquetaria y otros nuevos avances en el campo del tratamiento antiagregante plaquetario personalizado.

S24863592

Este estudio aporta información desde una perspectiva nacional y muestra una prevalencia de factores de riesgo cardiovascular superior en el sur de España, con estrecha correlación con la obesidad, el estilo de vida sedentario e indicadores de una situación socioeconómica desfavorecida.

 

SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE

 

S24914458

Experienced GPs seem to better tolerate uncertainty and also seem to fear medical errors less than their young colleagues. Young and more experienced GPs use different coping strategies for dealing with medical errors. Implications. When GPs become more experienced, they seem to get better at coping with medical errors. Means to support these skills should be studied in future research.

S24920316

GAD is rather common among high utilizers of primary care, although the prevalence of 4% is lower than that previously reported. GAD-7 is a valid and useful tool for detecting GAD among primary health care patients.

S24779455

OGTTh may be a useful screening method for IGT in risk groups such as hypertensive patients.

S24931511

Overall, patients with a high CV risk were less likely to be prescribed an NSAID for musculoskeletal complaints than patients with a low CV risk. Nevertheless, one in five high CV risk patients received an NSAID, indicating that there is still room for improvement.

 

THE LANCET

 

S24613026

The excess risk of stroke associated with diabetes is significantly higher in women than men, independent of sex differences in other major cardiovascular risk factors. These data add to the existing evidence that men and women experience diabetes-related diseases differently and suggest the need for further work to clarify the biological, behavioural, or social mechanisms involved.

S24881994

The widely held assumptions that blood pressure has strong associations with the occurrence of all cardiovascular diseases across a wide age range, and that diastolic and systolic associations are concordant, are not supported by the findings of this high-resolution study. Despite modern treatments, the lifetime burden of hypertension is substantial. These findings emphasise the need for new blood pressure-lowering strategies, and will help to inform the design of randomised trials to assess them.

S24630777

Increased BMI in adults of European origin is associated with increased methylation at the HIF3A locus in blood cells and in adipose tissue. Our findings suggest that perturbation of hypoxia inducible transcription factor pathways could have an important role in the response to increased weight in people.

S24881995

If the same systematic improvement in all aspects of hypertension management continues until 2022, 80% of patients with treated hypertension will have controlled blood pressure levels with a potential annual saving of about 50,000 major cardiovascular events.

S24881993

Nebivolol and valsartan fixed-dose combination is an effective and well-tolerated treatment option for patients with hypertension.

S24910231

In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than is the quantity of these macronutrients. Diets rich in wholegrains, fruits, vegetables, legumes, and nuts; moderate in alcohol consumption; and lower in refined grains, red or processed meats, and sugar-sweetened beverages have been shown to reduce the risk of diabetes and improve glycaemic control and blood lipids in patients with diabetes. With an emphasis on overall diet quality, several dietary patterns such as Mediterranean, low glycaemic index, moderately low carbohydrate, and vegetarian diets can be tailored to personal and cultural food preferences and appropriate calorie needs for weight control and diabetes prevention and management. Although much progress has been made in development and implementation of evidence-based nutrition recommendations in developed countries, concerted worldwide efforts and policies are warranted to alleviate regional disparities.

 

THE NEW ENGLAND JOURNAL OF MEDICINE

 

S24795142

Among children with vesicoureteral reflux after urinary tract infection, antimicrobial prophylaxis was associated with a substantially reduced risk of recurrence but not of renal scarring. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; RIVUR ClinicalTrials.gov number, NCT00405704.).

S24941178

The results of this large, population-based cohort study suggested no substantial increase in the risk of cardiac malformations attributable to antidepressant use during the first trimester. (Funded by the Agency for Healthcare Research and Quality and the National Institutes of Health.).

S24918371

In adults with obesity and obstructive sleep apnea, CPAP combined with a weight-loss intervention did not reduce CRP levels more than either intervention alone. In secondary analyses, weight loss provided an incremental reduction in insulin resistance and serum triglyceride levels when combined with CPAP. In addition, adherence to a regimen of weight loss and CPAP may result in incremental reductions in blood pressure as compared with either intervention alone. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT0371293 .).

S24918372

In patients with cardiovascular disease or multiple cardiovascular risk factors, the treatment of obstructive sleep apnea with CPAP, but not nocturnal supplemental oxygen, resulted in a significant reduction in blood pressure. (Funded by the National Heart, Lung, and Blood Institute and others; HeartBEAT ClinicalTrials.gov number, NCT01086800 .).

S24897082

Once-weekly intravenous dalbavancin was not inferior to twice-daily intravenous vancomycin followed by oral linezolid for the treatment of acute bacterial skin and skin-structure infection. (Funded by Durata Therapeutics; DISCOVER 1 and DISCOVER 2 ClinicalTrials.gov numbers, NCT01339091 and NCT01431339.).

S24896818

Treatment with naloxegol, as compared with placebo, resulted in a significantly higher rate of treatment response, without reducing opioid-mediated analgesia. (Funded by AstraZeneca; KODIAC-04 and KODIAC-05 ClinicalTrials.gov numbers, NCT01309841 and NCT01323790, respectively.).

S24897083

A single dose of oritavancin was noninferior to twice-daily vancomycin administered for 7 to 10 days for the treatment of acute bacterial skin and skin-structure infections caused by gram-positive pathogens. (Funded by the Medicines Company; SOLO I ClinicalTrials.gov number, NCT01252719.).

 

 

 

 

 

                      

XXVIII Congreso de Comunicación y Salud

 

 

21 Jor. Residentes y Tutores semFYC

 


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