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Septiembre 2014 PDF Imprimir E-mail
Lunes, 06 de Octubre 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
 
 
Gaglani SM, Topol EJ. iMedEd: the role of mobile health technologies in medical education. Acad Med. 2014;89:1207-1209 [AO,I]
24892404             R/C
iMedEd: EL PAPEL DE LAS TECNOLOGÍAS MÓVILES DE SALUD EN LA FORMACIÓN MÉDICA
 
 
Bronfort G, Hondras MA, Schulz CA, Evans RL, Long CR, Grimm R. Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation. Ann Intern Med. 2014;161:381-391 [EC,II]
25222385             R/C
MANIPULACIÓN VERTEBRAL Y EJERCICIOS CASEROS CON CONSEJOS EN EL DOLOR DE PIERNA SUBAGUDO Y CRÓNICO RELACIONADO CON LA ESPALDA: ENSAYO CON ASIGNACIÓN FLEXIBLE
 
Gagne JJ, Choudhry NK, Kesselheim AS, Polinski JM, Hutchins D, Matlin OS, et al. Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Ann Intern Med. 2014;161:400-407 [T,II]
25222387             R/C
EFECTO COMPARADO DE LAS ESTATINAS GENÉRICAS Y DE MARCA SOBRE LOS RESULTADOS EN LOS PACIENTES: ESTUDIO DE COHORTE
 
Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161:429-440 [M,II]
25222388             R/C
TRATAMIENTO NO QUIRÚRGICO DE LA INCONTINENCIA URINARIA EN MUJERES: GUÍA DE PRÁCTICA CLÍNICA DEL AMERICAN COLLEGE OF PHYSICIANS
 
Vickers AJ, Edwards K, Cooperberg MR, Mushlin AI. A simple schema for informed decision making about prostate cancer screening. Ann Intern Med. 2014;161:441-442 [AO,I]
ESQUEMA SENCILLO PARA LA TOMA INFORMADA DE DECISIONES RESPECTO AL CRIBAJE DE CÁNCER DE PRÓSTATA
 
Cullen W, Murray P, Harnett A. Generic statins: effectiveness, affordability, and patient adherence. Ann Intern Med. 2014;161:447-448 [AO,I]
ESTATINAS GENÉRICAS: EFECTIVIDAD, ASEQUIBILIDAD Y CUMPLIMIENTO POR EL PACIENTE
 
 
Ruiz Manzano J, Vilaplana C ¿Trataremos la tuberculosis con vacunas en el siglo XXI? Arch Bronconeumol. 2014;50:373-374 [AO,I]
¿TRATAREMOS LA TUBERCULOSIS CON VACUNAS EN EL SIGLO XXI?
 
 
Dworzynski K, Ardern-Jones M, Nasser S; Guideline Development Group (GDG). Diagnosis and management of drug allergy in adults, children and young people: summary of NICE guidance. BMJ. 2014;349:g485 [M,III]
DIAGNÓSTICO Y TRATAMIENTO DE LAS ALERGIAS MEDICAMENTOSAS EN ADULTOS, NIÑOS Y JÓVENES: RESUMEN DE LA GUÍA NICE
 
Billioti S, Moride Y, Ducruet T, Kurth T, Verdoux H, Tournier M, et al. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ. 2014;349:g520 [CC,I]
25208536             R/C
USO DE BENZODIACEPINAS Y ENFERMEDAD DE ALZHEIMER. ESTUDIO CASO-CONTROL
 
Eisman S, Sinclair R. Fungal nail infection: diagnosis and management. BMJ. 2014;348:g1800 [R,I]
INFECCIÓN MICÓTICA DE LA UÑA: DIAGNÓSTICO Y TRATAMIENTO
 
Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ. 2014;349:g3961 [R,II]
25164369             R/C
CIRUGÍA BARIÁTRICA PARA LA OBESIDAD Y LOS PROBLEMAS METABÓLICOS EN ADULTOS
 
Bech BH, Kjaersgaard MI, Pedersen HS, Howards PP, Sørensen MJ, Olsen J, et al. Use of antiepileptic drugs during pregnancy and risk of spontaneous abortion and stillbirth: population based cohort study. BMJ. 2014;349:g5159 [S,I]
25150301             R/C
USO DE FÁRMACOS ANTIEPILÉPTICOS DURANTE EL EMBARAZO Y RIESGO DE ABORTO ESPONTÁNEO Y MORTINATALIDAD: ESTUDIO DE COHORTE POBLACIONAL
 
Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ. 2014;349:g5226 [R,II]
25189324             R/C
DEFICIENCIA DE VITAMINA B12
 
Cragan JD. Medication use during pregnancy. BMJ. 2014;349:g5252 [AO,I]
USO DE MEDICACIÓN DURANTE EL EMBARAZO
 
McCartney M. Adrenaline in cardiac arrest: it's unethical for patients not to know. BMJ. 2014;349:g5258 [AO,I]
ADRENALINA EN LA PARADA CARDIACA: NO ES ÉTICO QUE LOS PACIENTES NO SEPAN
 
Pathak N, Dodds J, Zamora J, Khan K. Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis. BMJ. 2014;349:g5264 [M,II]
25232064             R/C
EXACTITUD DE LA PRUEBA DEL VPH EN ORINA PARA LA PRESENCIA DE VPH EN CÉRVIX: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
Yaffe K, Boustani M. Benzodiazepines and risk of Alzheimer's disease. BMJ. 2014;349:g5312 [AO,I]
BENZODIACEPINAS Y ENFERMEDAD DE ALZHEIMER
 
Gunning E, Richards E. Should patients be able to email their general practitioner? BMJ. 2014;349:g5338 [AO,I]
¿DEBERÍAN LOS PACIENTES PODER COMUNICARSE POR CORREO ELECTRÓNICO CON SU MÉDICO GENERAL?
 
Crawford MJ, MacLaren T, Reilly JG. Are mood stabilisers helpful in treatment of borderline personality disorder? BMJ. 2014;349:g5378 [R,I]
¿SIRVEN DE AYUDA LOS ESTABILIZADORES DEL ÁNIMO EN EL TRATAMIENTO DEL TRASTORNO LIMÍTROFE DE LA PERSONALIDAD?
 
Kruis AL, Boland MR, Assendelft WJ, Gussekloo J, Tsiachristas A, Stijnen T, et al. Effectiveness of integrated disease management for primary care chronic obstructive pulmonary disease patients: results of cluster randomised trial. BMJ. 2014;349:g5392 [EC,I]
25209620             R/C
EFECTIVIDAD DEL MANEJO INTEGRADO DE LA ENFERMEDAD EN LA ATENCIÓN PRIMARIA DE PACIENTES DE EPOC: RESULTADOS DE UN ENSAYO ALEATORIZADO POR GRUPOS
 
de Glas NA, de Craen AJ, Bastiaannet E, Op 't Land EG, Kiderlen M, van de Water W, et al. Effect of implementation of the mass breast cancer screening programme in older women in the Netherlands: population based study. BMJ. 2014;349:g5410 [S,II]
25224469             R/C
EFECTO DE LA PUESTA EN MARCHA DEL PROGRAMA DE CRIBADO DE CÁNCER DE MAMA EN MUJERES MAYORES EN HOLANDA: ESTUDIO POBLACIONAL
 
Martin SA, Boucher M, Wright JM, Saini V. Mild hypertension in people at low risk. BMJ. 2014;349:g5432 [R,III]
25224509             R/C
HIPERTENSIÓN MODERADA EN PERSONAS DE BAJO RIESGO
 
Godlee F. How guidelines can fail us. BMJ. 2014;349:g5448 [AO,I]
CÓMO NOS PUEDEN FALLAR LAS GUÍAS
 
Ashton JR. Regulation of electronic cigarettes. BMJ. 2014;349:g5484 [AO,I]
REGULACIÓN DE LOS CIGARRILLOS ELECTRÓNICOS
 
Kitchener HC, Owens GL. Urine testing for HPV. BMJ. 2014;349:g5542 [AO,I]
PRUEBA DE ORINA PARA EL VPH
 
Meltzer SJ. Unhealthy lifestyles and gestational diabetes. BMJ. 2014;349:g5549 [AO,I]
FORMAS DE VIDA POCO SALUDABLES Y DIABETES GESTACIONAL
 
Tomori O. Ebola in an unprepared Africa. BMJ. 2014;349:g5597 [AO,I]
EL ÉBOLA EN UNA ÁFRICA NO PREPARADA
 
Adams BD, Benger J. Should we take patients to hospital in cardiac arrest? BMJ. 2014;349:g5659 [AO,I]
¿DEBERÍAMOS LLEVAR A LOS PACIENTES CON PARADA CARDIACA AL HOSPITAL?
 
Kendall T, Morriss R, Mayo-Wilson E, Marcus E; Guideline Development Group. Assessment and management of bipolar disorder: summary of updated NICE guidance. BMJ. 2014;349:g5673 [M,II]
VALORACIÓN Y MANEJO DEL TRASTORNO BIPOLAR: RESUMEN DE LA GUÍA NICE ACTUALIZADA
 
Bourbeau J. Integrated disease management for adults with chronic obstructive pulmonary disease. BMJ. 2014;349:g5675 [AO,I]
MANEJO INTEGRAL DE LA ENFERMEDAD EN ADULTOS CON EPOC
 
 
Tully J, Hearn D, Fahy T. Can electronic monitoring (GPS 'tracking') enhance risk management in psychiatry? Br J Psychiatry. 2014;205:83-85 [AO,I]
25252314             R/C
¿PUEDE REFORZAR EL MANEJO DEL RIESGO EN PSIQUIATRÍA EL SEGUIMIENTO ELECTRÓNICO (RASTREO POR GPS)?
 
El Marroun H, White TJ, van der Knaap NJ, Homberg JR, Fernández G, Schoemaker NK, et al. Prenatal exposure to selective serotonin reuptake inhibitors and social responsiveness symptoms of autism: population-based study of young children. Br J Psychiatry. 2014;205:95-102 [S,I]
25252317             R/C
EXPOSICIÓN PRENATAL A LOS ISRS Y SÍNTOMAS DE REACTIVIDAD SOCIAL DEL AUTISMO: ESTUDIO POBLACIONAL EN NIÑOS
 
Jones I, McDonald L. Living with uncertainty: antidepressants and pregnancy. Br J Psychiatry. 2014;205:103-104 [AO,I]
25252318             R/C
VIVIR CON LA INCERTIDUMBRE: ANTIDEPRESIVOS Y EMBARAZO
 
Petersen I, Evans S, Nazareth I. Prenatal exposure to selective serotonin reuptake inhibitors and autistic symptoms in young children: another red herring? Br J Psychiatry. 2014;205:105-106 [AO,I]
25252319             R/C
ESPOSICIÓN PRENATAL A LOS ISRS Y SÍNTOMAS AUTISTAS EN NIÑOS: ¿OTRA PISTA FALSA?
 
Séguin M, Beauchamp G, Robert M, Dimambro M, Turecki G. Developmental model of suicide trajectories. Br J Psychiatry. 2014 [Epub ahead of print] [T,I]
24809398             R/C
MODELO DE DESARROLLO DE LAS TRAYECTORIAS SUICIDAS
 
 
Jette N, Reid AY, Wiebe S. Surgical management of epilepsy. CMAJ. 2014;186:997-1004 [R,I]
TRATAMIENTO QUIRÚRGICO DE LA EPILEPSIA
 
 
Mays RJ, Regensteiner JG. Therapy for peripheral artery disease: gaps in treating patients with claudication. Circulation. 2014;130:929-931 [AO,I]
TRATAMIENTO DE LA ENFERMEDAD ARTERIAL PERIFÉRICA: LAGUNAS EN EL TRATAMIENTO DE LOS PACIENTES CON CLAUDICACIÓN
 
Levine BD. Can intensive exercise harm the heart? The benefits of competitive endurance training for cardiovascular structure and function. Circulation. 2014;130:987-991 [R,I]
¿PUEDE DAÑAR AL CORAZÓN EL EJERCICIO INTENSIVO? BENEFICIOS DEL ENTRENAMIENTO COMPETITIVO DE RESISTENCIA PARA LA ESTRUCTURA Y LA FUNCIÓN CARDIOVASCULARES
 
La Gerche A, Heidbuchel H. Can intensive exercise harm the heart? You can get too much of a good thing. Circulation 2014;130:992-1002 [R,I]
¿PUEDE DAÑAR AL CORAZÓN EL EJERCICIO INTENSIVO? PUEDES EXCEDERTE CON ALGO BUENO
 
Wakefield TW, Obi AT, Henke PK. An aspirin a day to keep the clots away: can aspirin prevent recurrent thrombosis in extended treatment for venous thromboembolism? Circulation. 2014;130:1031-1033 [AO,I]
UNA ASPIRINA AL DÍA MANTIENE LOS COÁGULOS ALEJADOS: ¿PUEDE PREVENIR LA ASPIRINA LA TROMBOSIS RECURRENTE EN EL TRATAMIENTO AMPLIADO DEL TROMBOEMBOLISMO VENOSO?
 
Simes J, Becattini C, Agnelli G, Eikelboom JW, Kirby AC, Mister R, et al; INSPIRE Study Investigators* (International Collaboration of Aspirin Trials for Recurrent Venous Thromboembolism). Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration. Circulation. 2014;130:1062-1071 [EC,II]
25156992             R/C
ASPIRINA EN LA PREVENCIÓN DEL TROMBOEMBOLISMO VENOSO RECURRENTE: COLABORACIÓN INSPIRE
 
 
Raz I, Bhatt DL, Hirshberg B, Mosenzon O, Scirica BM, Umez-Eronini A, et al. Incidence of pancreatitis and pancreatic cancer in a randomized controlled multicenter trial (SAVOR-TIMI 53) of the dipeptidyl peptidase-4 inhibitor saxagliptin. Diabetes Care. 2014;37:2435-2441 [EC,I]
24914244             R/C
INCIDENCIA DE PANCREATITIS Y CÁNCER DE PÁNCREAS EN UN ENSAYO ALEATORIZADO CONTROLADO MULTICÉNTRICO (SAVOR-TIMI 53) DEL INHIBIDOR DE LA DPP-4 SAXAGLIPTINA
 
Gudipaty L, Rosenfeld NK, Fuller CS, Gallop R, Schutta MH, Rickels MR. Effect of exenatide, sitagliptin, or glimepiride on ß-cell secretory capacity in early type 2 diabetes. Diabetes Care. 2014;37:2451-2458 [EC,I]
24969577             R/C
EFECTO DE LA EXENATIDA, SITAGLIPTINA O GLIMEPIRIDA SOBRE LA CAPACIDAD SECRETORA DE LA CÉLULA ß EN LA DIABETES TIPO 2 INICIAL
 
Tsilidis KK, Capothanassi D, Allen NE, Rizos EC, Lopez DS, van Veldhoven K, et al. Metformin does not affect cancer risk: a cohort study in the U.K. Clinical Practice Research Datalink analyzed like an intention-to-treat trial. Diabetes Care. 2014;37:2522-2532 [S,I]
24898303             R/C
LA METFORMINA NO AFECTA AL RIESGO DE CÁNCER: ESTUDIO DE COHORTE EN EL UK CLINICAL PRACTICE RESEARCH DATALINK COMO UN ENSAYO POR INTENCIÓN DE TRATAR
 
Zhuo X, Zhang P, Barker L, Albright A, Thompson TJ, Gregg E. The lifetime cost of diabetes and its implications for diabetes prevention. Diabetes Care. 2014;37:2557-2564 [T,I]
25147254             R/C
COSTE DE LA DIABETES A LO LARGO DE LA VIDA Y SUS IMPLICACIONES EN LA PREVENCIÓN DE LA DIABETES
 
Perreault L, Temprosa M, Mather KJ, Horton E, Kitabchi A, Larkin M, et al; Diabetes Prevention Program Research Group. Regression from prediabetes to normal glucose regulation is associated with reduction in cardiovascular risk: results from the diabetes prevention program outcomes study.
Diabetes Care. 2014;37:2622-2631 [S,I]
24969574             R/C
LA REGRESIÓN DESDE LA PREDIABETES A LA REGULACIÓN NORMAL DE LA GLUCOSA ESTÁ ASOCIADA A UNA REDUCCIÓN DEL RIESGO CARDIOVASCULAR: RESULTADOS DEL ESTUDIO DEL PROGRAMA DE PREVENCIÓN DE LA DIABETES
 
Bacha F, Edmundowicz D, Sutton-Tyrell K, Lee S, Tfayli H, Arslanian SA. Coronary artery calcification in obese youth: what are the phenotypic and metabolic determinants?
Diabetes Care. 2014;37:2632-2639 [T,I]
25147256             R/C
CALCIFICACIÓN ARTERIAL CORONARIA EN JÓVENES OBESOS: ¿CUÁLES SON LOS DETERMINANTES METABÓLICOS Y FENOTÍPICOS?
 
Cefalu WT, Buse JB, Del Prato S, Home PD, LeRoith D, Nauck MA, et al. Beyond metformin: safety considerations in the decision-making process for selecting a second medication for type 2 diabetes management: reflections from a diabetes care editors' expert forum. Diabetes Care. 2014;37:2647-2659 [R,II]
25147257             R/C
MÁS ALLÁ DE LA METFORMINA: CONSIDERACIONES DE SEGURIDAD EN EL PROCESO DE TOMA DE DECISIONES PARA SELECCIONAR UNA SEGUNDA MEDICACIÓN PARA EL MANEJO DE LA DIABETES TIPO 2: REFLEXIONES DE UN FORO DE EXPERTOS EN ATENCIÓN A LA DIABETES
 
 
Moustafa FA, Sandoval LF, Feldman SR. Rosacea: new and emerging treatments. Drugs. 2014;74:1457-1465 [R,I]
25154627             R/C
ROSÁCEA: TRATAMIENTOS NUEVOS Y EMERGENTES
 
Klepser ME. Socioeconomic impact of seasonal (epidemic) influenza and the role of over-the-counter medicines. Drugs. 2014;74:1467-1479 [T,I]
25150045             R/C
IMPACTO SOCIOECONÓMICO DE LA GRIPE ESTACIONAL (EPIDÉMICA) Y EL PAPEL DE LAS MEDICINAS SIN RECETA
 
McKeage K. Fluticasone furoate/vilanterol: a review of its use in chronic obstructive pulmonary disease. Drugs. 2014;74:1509-1522 [R,I]
25074268             R/C
FUROATO DE FLUTICASONA/VILANTEROL: REVISIÓN DE SU USO EN LA EPOC
 
Murphy L, Rennard S, Donohue J, Molimard M, Dahl R, Beeh KM, et al. Turning a molecule into a medicine: the development of indacaterol as a novel once-daily bronchodilator treatment for patients with COPD. Drugs. 2014;74:1635-1657 [R,I]
25212789             R/C
CONVERTIR UNA MOLÉCULA EN UNA MEDICINA: EL DESARROLLO DEL INDACATEROL COMO UN NUEVO TRATAMIENTO BRONCODILATADOR UNA VEZ AL DÍA PARA PACIENTES CON EPOC
 
 
Anderson JL, Antman EM, Harold JG, Jessup M, O'Gara PT, Pinto FJ, et al. Clinical Practice Guidelines on Perioperative Cardiovascular Evaluation: collaborative efforts among the American College of Cardiology, the American Heart Association, and the European Society of Cardiology. Eur Heart J. 2014;35:2342-2343 [AO,I]
GUÍAS DE PRÁCTICA CLÍNICA SOBRE LA EVALUACIÓN CARDIOVASCULAR PERIOPERATORIA: ESFUERZOS DE COLABORACIÓN ENTRE EL AMERICAN COLLEGE OF CARDIOLOGY, LA AMERICAN HEART ASSOCIATION Y LA EUROPEAN SOCIETY OF CARDIOLOGY
 
 
Osorio SN, Abramson E, Pfoh ER, Edwards A, Schottel H, Kaushal R. Risk factors for unexplained medication discrepancies during transitions in care. Fam Med. 2014;46:587-596 [S,I]
25163036             R/C
FACTORES DE RIESGO PARA LAS DISCREPANCIAS NO EXPLICADAS SOBRE MEDICACIÓN DURANTE LAS TRANSICIONES EN LA ATENCIÓN SANITARIA
 
Peterson LE, Blackburn B, King MR. Completing self-assessment modules during residency is associated with better certification exam results. Fam Med. 2014;46:597-602 [T,I]
25163037             R/C
COMPLETAR LOS MÓDULOS DE AUTOVALORACIÓN DURANTE LA RESIDENCIA ESTÁ ASOCIADO CON MEJORES RESULTADOS EN LOS EXÁMENES DE CERTIFICACIÓN
 
Cronholm PF, Singh V, Fogarty CT, Ambuel B. Trends in violence education in family medicine residency curricula. Fam Med. 2014;46:620-625 [T,I]
25163041             R/C
TENDENCIAS EN FORMACIÓN SOBRE LA VIOLENCIA EN LOS CURRÍCULOS DE LA RESIDENCIA DE MEDICINA DE FAMILIA
 
Man C, Nguyen C, Lin S. Effectiveness of a smartphone app for guiding antidepressant drug selection. Fam Med. 2014;46:626-630 [QE,I]
25163042             R/C
EFECTIVIDAD DE UNA APLICACIÓN PARA TELÉFONOS INTELIGENTES PARA GUIAR LA SELECCIÓN DE FÁRMACOS ANTIDEPRESIVOS
 
 
Velasco D, Sánchez M, Egurza M, Arranz E, Aranbarri A, Fano E et al. Evaluación del contexto familiar en un estudio de salud pública. Gac Sanit. 2014;28:356-362 [T,I]
24929614             R/C
EVALUACIÓN DEL CONTEXTO FAMILIAR EN UN ESTUDIO DE SALUD PÚBLICA
 
Arrizabalaga P, Abellana R, Viñas O, Merino A, Ascaso C. Desigualdades de género en la carrera profesional: ¿aún existen barreras a los médicos mujeres en el siglo XXI? Gac Sanit. 2014;28:363-368 [S,I]
24889702             R/C
DESIGUALDADES DE GÉNERO EN LA CARRERA PROFESIONAL: ¿AÚN EXISTEN BARRERAS A LOS MÉDICOS MUJERES EN EL SIGLO XXI?
 
Colell E, Sánchez-Niubò A, Domingo-Salvany A, Delclós J, Benavides F. Prevalencia de consumo de hipnosedantes en población ocupada y factores de estrés laboral asociados. Gac Sanit. 2014;28:369-375 [T,I]
24878258             R/C
PREVALENCIA DE CONSUMO DE HIPNOSEDANTES EN POBLACIÓN OCUPADA Y FACTORES DE ESTRÉS LABORAL ASOCIADOS
 
Díez E, Daban F, Pasarín M, Artazcoz L, Fuertes C, López MJ et al. Evaluación de un programa comunitario para reducir el aislamiento de personas mayores debido a barreras arquitectónicas. Gac Sanit. 2014;28:386-388 [QE,I]
24923205             R/C
EVALUACIÓN DE UN PROGRAMA COMUNITARIO PARA REDUCIR EL AISLAMIENTO DE PERSONAS MAYORES DEBIDO A BARRERAS ARQUITECTÓNICAS
 
Soto-Gordoa M, Arrospide A, Zapiain A, Aiarza A, Abecia LC, Mar J. El coste de la aplicación de la Ley de Dependencia a la enfermedad de Alzheimer. Gac Sanit. 2014;28:389-392 [T,I]
24889701             R/C
EL COSTE DE LA APLICACIÓN DE LA LEY DE DEPENDENCIA A LA ENFERMEDAD DE ALZHEIMER
 
Lima-Serrano M, Lima-Rodríguez JS. Impacto de las intervenciones escolares de promoción de la salud dirigidas a diferentes áreas de conducta: una revisión sistemática. Gac Sanit. 2014;28:411-417 [M,II]
24923204             R/C
IMPACTO DE LAS INTERVENCIONES ESCOLARES DE PROMOCIÓN DE LA SALUD DIRIGIDAS A DIFERENTES ÁREAS DE CONDUCTA: UNA REVISIÓN SISTEMÁTICA
 
Buxó MJ, Casado M. Reflexiones bioéticas sobre el cuidado prematuro desencadenado por el diagnóstico precoz de la enfermedad de Alzheimer. Gac Sanit. 2014;28:426-428 [AO,I]
24852089             R/C
REFLEXIONES BIOÉTICAS SOBRE EL CUIDADO PREMATURO DESENCADENADO POR EL DIAGNÓSTICO PRECOZ DE LA ENFERMEDAD DE ALZHEIMER
 
 
Lu-Yao GL, Albertsen PC, Moore DF, Shih W, Lin Y, DiPaola RS, et al. Fifteen-year survival outcomes following primary androgen-deprivation therapy for localized prostate cancer. JAMA Intern Med. 2014;174:1460-1467 [S,I]
25023796             R/C
RESULTADOS DE SUPERVIVENCIA A LOS 15 AÑOS DESPUÉS DEL TRATAMIENTO PRIMARIO CON DEPRIVACIÓN DE ANDRÓGENOS PARA EL CÁNCER DE PRÓSTATA LOCALIZADO
 
Ross JS, Frazee SG, Garavaglia SB, Levin R, Novshadian H, Jackevicius CA, et al. Trends in use of ezetimibe after the ENHANCE trial, 2007 Through 2010. JAMA Intern Med. 2014;174:1486-1493 [S,I]
25070672             R/C
TENDENCIAS EN EL USO DE EZETIMIBA TRAS EL ENSAYO ENHANCE, DE 2007 A 2010
 
 
Jerant A, Kravitz RL, Fernandez YE, Feldman MD, Cipri C, Nishio D, etal. Potential antidepressant overtreatment associated with office use of brief depression symptom measures. J Am Board Fam Med. 2014;27:611-620 [EC,II]
25201931             R/C
EXCESO DE TRATAMIENTO ANTIDEPRESIVO POTENCIAL ASOCIADO CON EL USO EN LA CONSULTA DE MEDICIONES BREVES DE SÍNTOMAS DE DEPRESIÓN
 
Yalcin BM, Unal M, Pirdal H, Karahan TF. Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial. J Am Board Fam Med. 2014;27:645-660 [EC,I]
25201934             R/C
EFECTOS DE UN PROGRAMA DE MANEJO DE LA IRA Y CONTROL DEL ESTRÉS SOBRE EL ABANDONO TABÁQUICO: ENSAYO CONTROLADO ALEATORIZADO
 
Singh V, Tolman R, Walton M, Chermack S, Cunningham R. Characteristics of men who perpetrate intimate partner violence. J Am Board Fam Med. 2014;27:661-668 [T,II]
25201935             R/C
CARACTERÍSTICAS DE LOS HOMBRES QUE PERPETRAN VIOLENCIA CON LA PAREJA ÍNTIMA
 
 
Thompson IM Jr, Leach RJ, Ankerst DP. Focusing PSA testing on detection of high-risk prostate cancers by incorporating patient preferences into decision making. JAMA. 2014;312:995-996 [AO,I]
CONCENTRAR LA PRUEBA DEL PSA SOBRE LA DETECCIÓN DE LOS CÁNCERES DE PRÓSTATA DE ALTO RIESGO INCORPORANDO LAS PREFERENCIAS DEL PACIENTE A LA TOMA DE DECISIONES
 
King MC, Levy-Lahad E, Lahad A. Population-based screening for BRCA1 and BRCA2: 2014 Lasker Award. JAMA. 2014;312:1091-1092 [AO,II]
CRIBAJE POBLACIONAL PARA BRCA1 Y BRCA2
 
DeLong MR, Benabid AL. Discovery of high-frequency deep brain stimulation for treatment of Parkinson disease: 2014 Lasker Award. JAMA. 2014;312:1093-1094 [AO,I]
DESCUBRIMIENTO DE LA ESTIMULACIÓN CEREBRAL PROFUNDA DE ALTA FRECUENCIA PARA EL TRATAMIENTO DE LA ENFERMEDAD DE PARKINSON
 
Gostin LO, Lucey D, Phelan A. The Ebola epidemic: a global health emergency. JAMA. 2014;312:1095-1096 [AO,I]
LA EPIDEMIA DE ÉBOLA: EMERGENCIA SANITARIA MUNDIAL
 
Calverley PM. Treating COPD in the real world. JAMA. 2014;312:1101-1102 [AO,I]
TRATAR LA EPOC EN EL MUNDO REAL
 
Gershon AS, Campitelli MA, Croxford R, Stanbrook MB, To T, Upshur R, et al. Combination long-acting ß-agonists and inhaled corticosteroids compared with long-acting ß-agonists alone in older adults with chronic obstructive pulmonary disease. JAMA. 2014;312:1114-1121 [S,II]
25226477             R/C
COMBINACIÓN DE LABA Y CORTICOIDES INHALADOS COMPARADA CON LABA SOLOS EN LOS ANCIANOS CON EPOC
 
Castellucci LA, Cameron C, Le Gal G, Rodger MA, Coyle D, Wells PS, et al. Clinical and safety outcomes associated with treatment of acute venous thromboembolism: a systematic review and meta-analysis. JAMA. 2014;312:1122-1135 [M,II]
25226478             R/C
RESULTADOS CLÍNICOS Y DE SEGURIDAD ASOCIADOS CON EL TRATAMIENTO DEL TROMBOEMBOLISMO AGUDO VENOSO: REVISIÓN SISTEMÁTICA Y METAANÁLISIS
 
Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA. 2014;312:1136-1144 [R,II]
25226479             R/C
EVALUACIÓN Y TRATAMIENTO DE LOS PACIENTES MAYORES CON HIPERCOLESTEROLEMIA: REVISIÓN CLÍNICA
 
Herrero R, Parsonnet J, Greenberg ER. Prevention of gastric cancer. JAMA. 2014;312:1197-1198 [AO,I]
PREVENCIÓN DEL CÁNCER GÁSTRICO
 
Parekh AK, Kronick R, Tavenner M. Optimizing health for persons with multiple chronic conditions. JAMA. 2014;312:1199-1200 [AO,I]
OPTIMIZAR LA SALUD DE LAS PERSONAS CON MÚLTIPLES PROBLEMAS CRÓNICOS
 
Dolan SM. Personalized genomic medicine and prenatal genetic testing. JAMA. 2014;312:1203-1205 [AO,I]
MEDICINA GENÓMICA PERSONALIZADA Y PRUEBAS GENÉTICAS PRENATALES
 
Geiss LS, Wang J, Cheng YJ, Thompson TJ, Barker L, Li Y, et al. Prevalence and incidence trends for diagnosed diabetes among adults aged 20 to 79 years, United States, 1980-2012. JAMA. 2014;312:1218-1226 [T,II]
25247518             R/C
TENDENCIAS DE PREVALENCIA E INCIDENCIA DE DIABETES DIAGNOSTICADA EN ADULTOS ENTRE 20 Y 79 AÑOS EN ESTADOS UNIDOS ENTRE 1980 Y 2012
 
Davis AM, Cifu AS. Lung cancer screening. JAMA. 2014;312:1248-1249 [AO,I]
CRIBAJE DEL CÁNCER DE PULMÓN
 
 
Jürschik P, Botigué T, Nuin C, Lavedán A. Asociación entre el Mini Nutritional Assessment y el índice de fragilidad de Fried en las personas mayores que viven en la comunidad. Med Clin (Barc). 2014;143:191-195 [T,I]
24378146             R/C
ASOCIACIÓN ENTRE EL MINI NUTRITIONAL ASSESSMENT Y EL ÍNDICE DE FRAGILIDAD DE FRIED EN LAS PERSONAS MAYORES QUE VIVEN EN LA COMUNIDAD
 
Larrañaga A, Fluiters E, Docet MF, Fernández JL, García-Mayor RV. Estudio comparativo de psicoterapia cognitivo-conductual y terapia nutricional en pacientes con diferentes tipos de trastornos de la conducta alimentaria. Med Clin (Barc). 2014;143:196-200 [S,I]
24035412             R/C
ESTUDIO COMPARATIVO DE PSICOTERAPIA COGNITIVO-CONDUCTUAL Y TERAPIA NUTRICIONAL EN PACIENTES CON DIFERENTES TIPOS DE TRASTORNOS DE LA CONDUCTA ALIMENTARIA
 
Alvarez I, Baón B, Navío M, López-Antón R, Lobo E, Ventura T. Validación española de la entrevista MacArthur Competence Assessment Tool for Treatment para evaluar la capacidad de los pacientes para consentir tratamiento. Med Clin (Barc). 2014;143:201-204 [T,II]
24216012             R/C
VALIDACIÓN ESPAÑOLA DE LA ENTREVISTA MACARTHUR COMPETENCE ASSESSMENT TOOL FOR TREATMENT PARA EVALUAR LA CAPACIDAD DE LOS PACIENTES PARA CONSENTIR TRATAMIENTO
 
Abizanda P. Fragilidad, el nuevo paradigma de atención sanitaria a los mayores. Med Clin (Barc). 2014 ;143:205-206 [AO,I]
FRAGILIDAD, EL NUEVO PARADIGMA DE ATENCIÓN SANITARIA A LOS MAYORES
 
 
Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al; Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC. Human papillomavirus vaccination. MMWR Recomm Rep. 2014;63(RR-05):1-30 [M,III]
25167164             R/C
VACUNACIÓN CONTRA EL PAPILOMA HUMANO
 
 
Naranjo A, Ojeda-Bruno S, Bilbao A, Quevedo JC, Henríquez-Hernández LA, Rodríguez-Lozano C. Resultados de un modelo de prevención secundaria de fractura osteoporótica coordinado por reumatología centrado en la enfermera y el médico de atención primaria. Reumatol Clin. 2014;10:299-303 [T,I]
24553244             R/C
RESULTADOS DE UN MODELO DE PREVENCIÓN SECUNDARIA DE FRACTURA OSTEOPORÓTICA COORDINADO POR REUMATOLOGÍA CENTRADO EN LA ENFERMERA Y EL MÉDICO DE ATENCIÓN PRIMARIA
 
 
Mata P, Alonso R, Pérez-Jiménez F. Detección de la hipercolesterolemia familiar: un modelo de medicina preventiva. Rev Esp Cardiol. 2014;67:685-688 [AO,I]
DETECCIÓN DE LA HIPERCOLESTEROLEMIA FAMILIAR: UN MODELO DE MEDICINA PREVENTIVA
 
Sanz G, Castellano JM, Fuster V. Policomprimido: ¿quimera o realidad? Rev Esp Cardiol. 2014;67:689-692 [AO,II]
POLICOMPRIMIDO: ¿QUIMERA O REALIDAD?
 
Mas-Heredia M, Molés-Moliner E, González-de Paz L, Kostov B, Ortiz-Molina J, Mauri-Vázquez V, et al. Validez y aplicabilidad de un nuevo método de registro para la hipertensión arterial. Rev Esp Cardiol. 2014;67:717-723 [T,I]
25172067             R/C
VALIDEZ Y APLICABILIDAD DE UN NUEVO MÉTODO DE REGISTRO PARA LA HIPERTENSIÓN ARTERIAL
 
Castellano JM, Narula J, Castillo J, Fuster V. Promoción de la salud cardiovascular global: estrategias, retos y oportunidades. Rev Esp Cardiol. 2014;67:724-730 [R,I]
25172068             R/C
PROMOCIÓN DE LA SALUD CARDIOVASCULAR GLOBAL: ESTRATEGIAS, RETOS Y OPORTUNIDADES
 
Castellano JM, Peñalvo JL, Bansilal S, Fuster V. Promoción de la salud cardiovascular en tres etapas de la vida: nunca es demasiado pronto, nunca demasiado tarde. Rev Esp Cardiol. 2014;67:731-737 [R,I]
25172069             R/C
PROMOCIÓN DE LA SALUD CARDIOVASCULAR EN TRES ETAPAS DE LA VIDA: NUNCA ES DEMASIADO PRONTO, NUNCA DEMASIADO TARDE
 
Berciano S, Ordovás JM. Nutrición y salud cardiovascular. Rev Esp Cardiol. 2014;67:738-747 [R,I]
25172532             R/C
NUTRICIÓN Y SALUD CARDIOVASCULAR
 
Cordero A, Masiá MD, Galve E. Ejercicio físico y salud. Rev Esp Cardiol. 2014;67:748-753 [R,I]
25001520             R/C
EJERCICIO FÍSICO Y SALUD
 
 
Murray CJ, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, et al. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:1005-1070 [M,II]
25059949             R/C
INCIDENCIA Y MORTALIDAD MUNDIAL, REGIONAL Y NACIONAL DEL VIH, LA TUBERCULOSIS Y LA MALARIA DURANTE 1990-2013: ANÁLISIS SISTEMÁTICO DEL ESTUDIO GLOBAL BURDEN OF DISEASE 2013
 
Child deaths: inequity and inequality in high-income countries. Lancet. 2014;384:830 [AO,I]
MUERTES INFANTILES: INEQUIDAD Y DESIGUALDAD EN LOS PAÍSES RICOS
 
Saugstad OD. New growth charts for newborn babies. Lancet. 2014;384:833-835 [AO,I]
NUEVAS TABLAS DE CRECIMIENTO PARA RECIÉN NACIDOS
 
McCarthy EA, Walker SP. International fetal growth standards: one size fits all. Lancet. 2014;384:835-836 [AO,I]
ESTÁNDARES INTERNACIONALES DE CRECIMIENTO FETAL: TALLA ÚNICA
 
Villar J, Cheikh Ismail L, Victora CG, Ohuma EO, Bertino E, Altman DG, et al; International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384:857-868 [T,II]
25209487             R/C
ESTÁNDARES INTERNACIONALES DE PESO, LONGITUD Y CIRCUNFERENCIA CEFÁLICA POR EDAD GESTACIONAL Y SEXO: EL ESTUDIO NEWBORN CROSS-SECTIONAL DEL PROYECTO INTERGROWTH 21
 
Papageorghiou AT, Ohuma EO, Altman DG, Todros T, Cheikh Ismail L, Lambert A, et al; International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st). International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014;384:869-879 [S,II]
25209488             R/C
ESTÁNDARES INTERNACIONALES DE CRECIMIENTO FETAL BASADOS EN LAS MEDICIONES DE ECOGRAFÍAS SERIADAS: EL ESTUDIO FETAL GROWTH LONGITUDINAL DEL PROYECTO INTERGROWTH 21
 
Sidebotham P, Fraser J, Covington T, Freemantle J, Petrou S, Pulikottil-Jacob R, et al. Understanding why children die in high-income countries. Lancet. 2014;384:915-927 [R,II]
25209491             R/C
COMPRENDER POR QUÉ MUEREN LOS NIÑOS EN LOS PAÍSES RICOS
 
Sidibé M, Dybul M, Birx D. MDG 6 and beyond: from halting and reversing AIDS to ending the epidemic. Lancet. 2014;384:935-936 [AO,I]
MDG6 Y MÁS ALLÁ: DE DETENER Y REVERTIR EL SIDA A ACABAR CON LA EPIDEMIA
 
Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:957-979 [M,II]
24797572             R/C
NIVELES Y CAUSAS MUNDIALES, REGIONALES Y NACIONALES DE MORTALIDAD NEONATAL, INFANTIL Y POR DEBAJO DE 5 AÑOS DURANTE 1990 A 2013: ANÁLISIS SISTEMÁTICO PARA EL ESTUDIO GLOBAL BURDEN OF DISEASE 2013
 
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:980-1004 [M,II]
24797575             R/C
NIVELES Y CAUSAS MUNDIALES, REGIONALES Y NACIONALES DE MORTALIDAD MATERNA DURANTE 1990 A 2013: ANÁLISIS SISTEMÁTICO PARA EL ESTUDIO GLOBAL BURDEN OF DISEASE 2013
 
Dementia: a false promise. Lancet. 2014;384:1072 [AO,I]
DEMENCIA: PROMESA FALSA
 
The integration of mental and physical health care. Lancet. 2014;384:1072 [AO,I]
LA INTEGRACIÓN DE LA ATENCIÓN SANITARIA FÍSICA Y MENTAL
 
Kompa AR, Krum H. Protein kinases as cardiovascular therapeutic targets. Lancet. 2014;384:1162-1164 [AO,I]
PROTEINQUINASAS COMO DIANAS TERAPÉUTICAS CARDIOVASCULARES
 
Lang AE, Marras C. Initiating dopaminergic treatment in Parkinson's disease. Lancet. 2014;384:1164-1166 [AO,I]
INICIAR EL TRATAMIENTO DOPAMINÉRGICO EN LA ENFERMEDAD DE PARKINSON
 
Hodgins S. Antipsychotics, mood stabilisers, and reductions in violence. Lancet. 2014;384:1167-1168 [AO,I]
ANTIPSICÓTICOS, ESTABILIZADORES DEL ÁNIMOI Y REDUCCIONES EN LA VIOLENCIA
 
Fazel S, Zetterqvist J, Larsson H, Långström N, Lichtenstein P. Antipsychotics, mood stabilisers, and risk of violent crime. Lancet. 2014;384:1206-1214 [S,II]
24816046             R/C
ANTIPSICÓTICOS, ESTABILIZADORES DEL ÁNIMO Y RIESGO DE CRIMEN VIOLENTO
 
 
Sacks CA, Jarcho JA, Curfman GD. Paradigm shifts in heart-failure therapy--a timeline. N Engl J Med. 2014;371:989-991 [AO,I]
CAMBIOS DE PARADIGMA EN EL TRATAMIENTO DE LA INSUFICIENCIA CARDIACA-CRONOLOGÍA
 
Montalescot G, van 't Hof AW, Lapostolle F, Silvain J, Lassen JF, Bolognese L, et al; ATLANTIC Investigators. Prehospital ticagrelor in ST-segment elevation myocardial infarction. N Engl J Med. 2014;371:1016-1027 [EC,II]
25175921             R/C
TICAGRELOR PREHOSPITALARIO EN EL INFARTO DE MIOCARDIO CON ELEVACIÓN DEL SEGMENTO ST
 
Jessup M. Neprilysin inhibition--a novel therapy for heart failure. N Engl J Med. 2014;371:1062-1064 [AO,I]
INHIBICIÓN CON NEPRILYSIN--UNA NUEVA TERAPIA PARA LA INSUFICIENCIA CARDIACA
 
Wolz A. Face to face with Ebola--an emergency care center in Sierra Leone. N Engl J Med. 2014;371:1081-1083 [AO,I]
CARA A CARA CON EL ÉBOLA--UN CENTRO DE ATENCIÓN DE URGENCIAS EN SIERRA LEONA
 
Fauci AS. Ebola--underscoring the global disparities in health care resources. N Engl J Med. 2014;371:1084-1086 [AO,I]
ÉBOLA--SUBRAYADO DE LAS DISPARIDADES MUNDIALES EN RECURSOS DE ATENCIÓN SANITARIA
 
Goodman JL. Studying "secret serums"--toward safe, effective Ebola treatments. N Engl J Med. 2014;371:1086-1089 [AO,I]
ESTUDIO DE LOS "SUEROS SECRETOS"--HACIA TRATAMIENTOS SEGUROS Y EFECTIVOS PARA EL ÉBOLA
 
Smith-Bindman R, Aubin C, Bailitz J, Bengiamin RN, Camargo CA Jr, Corbo J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371:1100-1110 [EC,II]
25229916             R/C
ECOGRAFÍA FRENTE A TOMOGRAFÍA COMPUTADORIZADA EN LA SOSPECHA DE NEFROLITIASIS
 
Lagerqvist B, Fröbert O, Olivecrona GK, Gudnason T, Maeng M, Alström P, et al. Outcomes 1 year after thrombus aspiration for myocardial infarction. N Engl J Med. 2014;371:1111-1120 [EC,II]
25176395             R/C
RESULTADOS DE 1 AÑO TRAS ASPIRACIÓN DE TROMBO EN EL INFARTO DE MIOCARDIO
 
Frieden TR, Damon I, Bell BP, Kenyon T, Nichol S. Ebola 2014--new challenges, new global response and responsibility. N Engl J Med. 2014;371:1177-1180 [AO,II]
ÉBOLA 2014--NUEVOS DESAFÍOS, NUEVAS RESPUESTA Y RESPONSABILIDAD MUNDIALES
 
Briand S, Bertherat E, Cox P, Formenty P, Kieny MP, Myhre JK, et al. The international Ebola emergency. N Engl J Med. 2014;371:1180-1183 [AO,II]
LA EMERGENCIA INTERNACIONAL DEL ÉBOLA
 
Chan M. Ebola virus disease in West Africa--no early end to the outbreak. N Engl J Med. 2014;371:1183-1185 [AO,I]
LA ENFERMEDAD POR EL VIRUS DEL ÉBOLA EN ÁFRICA OCCIDENTAL--SIN FINAL A CORTO PLAZO PARA EL BROTE EPIDÉMICO
 
Brittenden J, Cotton SC, Elders A, Ramsay CR, Norrie J, Burr J, et al. A randomized trial comparing treatments for varicose veins. N Engl J Med. 2014;371:1218-1227 [EC,I]
25251616             R/C
ENSAYO ALEATORIZADO COMPARANDO TRATAMIENTOS PARA VENAS VARICOSAS
 
Taylor WD. Clinical practice. Depression in the elderly. N Engl J Med. 2014;371:1228-1236 [R,I]
PRÁCTICA CLÍNICA. DEPRESIÓN EN LOS MAYORES
 
Nair P. Anti-interleukin-5 monoclonal antibody to treat severe eosinophilic asthma. N Engl J Med. 2014;371:1249-1251 [AO,I]
ANTICUERPO MONOCLONAL ANTI-INTERLEUKINA 5 PARA TRATAR EL ASMA EOSINOFÍLICA GRAVE
 
Kanapathipillai R. Ebola virus disease--current knowledge. N Engl J Med. 2014;371:e18 [R,II]
ENFERMEDAD POR EL VIRUS DEL ÉBOLA--CONOCIMIENTO ACTUAL
 
 
Agusti A. The path to personalised medicine in COPD. Thorax. 2014;69:857-864 [R,I]
24781218             R/C
EL CAMINO HACIA LA MEDICINA PERSONALIZADA EN LA EPOC
 
Young RP, Hopkins RJ, Agusti A. Statins as adjunct therapy in COPD: how do we cope after STATCOPE? Thorax. 2014;69:891-894 [AO,I]
ESTATINAS COMO TERAPIA ADYUVANTE EN LA EPOC: ¿CÓMO SALIMOS ADELANTE TRAS EL STATCOPE?
 
Treasure T, Miloševic M, Fiorentino F, Macbeth F. Pulmonary metastasectomy: what is the practice and where is the evidence for effectiveness? Thorax. 2014;69:946-949 [R,I]
24415715             R/C
METASTASECTOMÍA PULMONAR: ¿CUÁL ES LA PRÁCTICA Y DÓNDE ESTÁ LA EVIDENCIA DE SU EFECTIVIDAD?
 
 
ACADEMIC MEDICINE
 
Mobile health (mHealth) technologies have experienced a recent surge in attention because of their potential to transform the delivery of health care. This enthusiasm is partly due to the near ubiquity of smartphones and tablets among clinicians, as well as to the stream of mobile medical apps and devices being created. While much discussion has been devoted to how these tools will impact the practice of medicine, surprisingly little has been written on the role these technologies will play in medical education. In this commentary the authors describe the opportunities, applications, and challenges of mHealth apps and devices in medical education and argue that medical schools should make efforts to integrate these technologies into their curricula. By not doing so, medical educators risk producing a generation of clinicians underprepared for the changing realities of medical practice brought on by mHealth technologies.
 
ANNALS OF INTRERNAL MEDICINE
 
Compared with those initiating brand-name statins, patients initiating generic statins were more likely to adhere and had a lower rate of a composite clinical outcome.
RECOMMENDATION 1:
ACP recommends first-line treatment with pelvic floor muscle training in women with stress UI. (Grade: strong recommendation, high-quality evidence).
RECOMMENDATION 2:
ACP recommends bladder training in women with urgency UI. (Grade: strong recommendation, moderate-quality evidence).
RECOMMENDATION 3:
ACP recommends pelvic floor muscle training with bladder training in women with mixed UI. (Grade: strong recommendation, moderate-quality evidence).
RECOMMENDATION 4:
ACP recommends against treatment with systemic pharmacologic therapy for stress UI. (Grade: strong recommendation, low-quality evidence).
RECOMMENDATION 5:
ACP recommends pharmacologic treatment in women with urgency UI if bladder training was unsuccessful. Clinicians should base the choice of pharmacologic agents on tolerability, adverse effect profile, ease of use, and cost of medication. (Grade: strong recommendation, high-quality evidence).
RECOMMENDATION 6:
ACP recommends weight loss and exercise for obese women with UI. (Grade: strong recommendation, moderate-quality evidence).
For patients with BRLP, SMT plus HEA was more effective than HEA alone after 12 weeks, but the benefit was sustained only for some secondary outcomes at 52 weeks.
 
BRITISH MEDICAL JOURNAL
 
S25208536
Benzodiazepine use is associated with an increased risk of Alzheimer's disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.
Testing urine for HPV seems to have good accuracy for the detection of cervical HPV, and testing first void urine samples is more accurate than random or midstream sampling. When cervical HPV detection is considered difficult in particular subgroups, urine testing should be regarded as an acceptable alternative.
The extension of the upper age limit to 75 years has only led to a small decrease in incidence of advanced stage breast cancer, while that of early stage tumours has strongly increased.
In this pragmatic study, an integrated disease management approach delivered in primary care showed no additional benefit compared with usual care, except improved level of integrated care and a self reported higher degree of daily activities. The contradictory findings to earlier positive studies could be explained by differences between interventions (provider versus patient targeted), selective reporting of positive trials, or little room for improvement in the already well developed Dutch healthcare system.
Among women with epilepsy and when analysing the risk in antiepileptic drug discordant pregnancies in the same woman, we found no overall association between the use of antiepileptic drugs during pregnancy and spontaneous abortions. Therefore unmeasured confounding may explain the slight increased risk for spontaneous abortion with any antiepileptic drug use (among women both with and without epilepsy). We found no association between antiepileptic drug use during pregnancy and stillbirth, but the statistical precision was low.
This review summarizes recent evidence related to the safety, efficacy, and metabolic outcomes of bariatric surgery to guide clinical decision making. Several short term randomized controlled trials have demonstrated the effectiveness of bariatric procedures for inducing weight loss and initial remission of type 2 diabetes. Observational studies have linked bariatric procedures with long term improvements in body weight, type 2 diabetes, survival, cardiovascular events, incident cancer, and quality of life. Perioperative mortality for the average patient is low but varies greatly across subgroups. The incidence of major complications after surgery also varies widely, and emerging data show that some procedures are associated with a greater risk of substance misuse disorders, suicide, and nutritional deficiencies. More research is needed to enable long term outcomes to be compared across various procedures and subpopulations, and to identify those most likely to benefit from surgical intervention. Given uncertainties about the balance between the risks and benefits of bariatric surgery in the long term, the decision to undergo surgery should be based on a high quality shared decision making process.
Summary box
 Clinical context—Up to 40% of adults worldwide have hypertension, complications of which may account for up to 9.4 million deaths annually from cardiovascular disease
 Diagnostic change—Recommendations for drug treatment have decreased from diastolic pressure of >115 mm Hg to =140/90 mm Hg. A new category, prehypertension (120/80-139/89 mm Hg), has also been introduced
 Rationale for change—Patients with even mildly raised blood pressure may have increased cardiovascular risk
 Leap of faith—Lowering threshold blood pressures will lead to increased diagnosis and treatment, which will decrease mortality
 Impact on prevalence—22% of adults worldwide have mild hypertension (systolic pressure 140-159 mm Hg) and 13.5% have a systolic pressure =160 mm Hg
 Evidence of overdiagnosis—Use of a uniform threshold (140 mm Hg) to mark hypertension risk ignores evidence that risk varies by individual and includes many people who will not benefit from drug treatment
 Harms from overdiagnosis—Studies suggest over half of people with mild hypertension are treated with drugs even though this approach has not been proved to decrease mortality or morbidity. Overemphasis on drug treatment risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level
 Limitations of evidence — Lack of randomised trials that use hard outcomes and compare drugs with lifestyle interventions and placebo in patients with mild hypertension
 Conclusion—Lowering definitions of hypertension has led to identification and drug treatment of larger populations of patients despite lack of evidence that drugs reduce morbidity or mortality
Summary points
Vitamin B12 deficiency is a common but serious condition
Clinical presentation may not be obvious thus leading to complex issues around diagnosis and treatment
There is no ideal test to define deficiency and therefore the clinical condition of patients is of the utmost importance
There is evidence that new techniques such as the measurement of holotranscobalamin and methylmalonic acid levels seem useful in more accurately defining deficiency
If the clinical features suggest deficiency then it is important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features
 
BRITISH JOURNAL OF PSYCHIATRY
 
There have been a large number of studies in recent years reporting on the reproductive safety of antidepressant medication. Some studies, but not all, have reported an association of antidepressant exposure in pregnancy and the subsequent development of autism spectrum disorders. It remains difficult to know whether the modest increase in risk is due to the medication, to the mood disorder itself, or to other confounding factors. For any individual woman the decision to commence or continue antidepressant medication in pregnancy must be made after a full consideration of the potential risks and benefits of all options, including non-pharmacological treatments. In making these difficult decisions it is important to recognise that episodes of severe psychiatric illness may have very serious negative consequences for the woman, her baby and her family, and these must be weighed against what is known about the risks of taking medication.
In this issue, El Marroun et al suggest an association between prenatal selective serotonin reuptake inhibitor (SSRI) exposure and autistic traits in children, as well as an association with prenatal depressive symptoms. However, SSRIs may be mere markers of severity of underlying illnesses and it may be premature to reach such conclusions about effects of treatment. Studies like this raise concerns as this may fuel further anxiety and guilt among women who are faced with depression in pregnancy and possibly leave some women without treatment.            
Our results suggest an association between prenatal SSRI exposure and autistic traits in children. Prenatal depressive symptoms without SSRI use were also associated with autistic traits, albeit this was weaker and less specific. Long-term drug safety trials are needed before evidence-based recommendations are possible.
Electronic monitoring has been used in criminal justice and some health settings for three decades. Technological interventions are becoming more common in psychiatry, but may be a cause for ethical concerns and controversy. We discuss electronic monitoring as an aid to security and public safety in a forensic setting.
Psychosocial adversity between 10 and 20 years of age may warrant key periods of intervention.
 
CIRCULATION
 
Aspirin after anticoagulant treatment reduces the overall risk of recurrence by more than a third in a broad cross-section of patients with a first unprovoked VTE, without significantly increasing the risk of bleeding.
 
DIABETES CARE
 
The trend toward personalized management of diabetes has focused attention on the differences among available pharmacological agents in terms of mechanisms of action, efficacy, and, most important, safety. Clinicians must select from these features to develop individualized therapy regimens. In June 2013, a nine-member Diabetes Care Editors' Expert Forum convened to review safety evidence for six major diabetes drug classes: insulin, sulfonylureas (SUs), thiazolidinediones (TZDs), glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium glucose cotransporter 2 inhibitors. This article, an outgrowth of the forum, summarizes well-delineated and theoretical safety concerns related to these drug classes, as well as the panelists' opinions regarding their best use in patients with type 2 diabetes. All of the options appear to have reasonably wide safety margins when used appropriately. Those about which we know the most-metformin, SUs, insulin, and perhaps now also TZDs-are efficacious in most patients and can be placed into a basic initial algorithm. However, these agents leave some clinical needs unmet. Selecting next steps is a more formidable process involving newer agents that are understood less well and for which there are unresolved questions regarding risk versus benefit in certain populations. Choosing a specific agent is not as important as implementing some form of early intervention and advancing rapidly to some form of combination therapy as needed. When all options are relatively safe given the benefits they confer, therapeutic decision making must rely on a personalized approach, taking into account patients' clinical circumstances, phenotype, pathophysiological defects, preferences, abilities, and costs.
Early in the course of obesity, there is evidence of CAC independent of glycemia. The different biomarkers of subclinical atherosclerosis appear to be differentially modulated, adiposity being the major determinant of CAC, hyperglycemia, age, and race for IMT, and leptin and IS for arterial stiffness. These findings highlight the increased cardiovascular disease risk in obese youth and the need for early interventions to reverse obesity and atherosclerosis.
In the SAVOR-TIMI 53 trial, within 2.1 years of follow-up, risk for pancreatitis in type 2 diabetic patients treated with saxagliptin was low and apparently similar to placebo, with no sign of increased risk for pancreatic cancer. Further studies are needed to completely resolve the pancreatic safety issues with incretin-based therapy.
After 6 months of treatment, exenatide or sitagliptin had no significant effect on functional ß-cell mass as measured by ß-cell secretory capacity, whereas glimepiride appeared to enhance ß- and a-cell secretion.
Prediabetes represents a high-risk state for CVD. Restoration of NGR and/or medical treatment of CVD risk factors can significantly reduce the estimated CVD risk in people with prediabetes.
In this large study, individuals with diabetes who used metformin had a similar risk of developing cancer compared with those who used sulfonylureas.
Having diabetes is associated with substantially higher lifetime medical expenditures despite being associated with reduced life expectancy. If prevention costs can be kept sufficiently low, diabetes prevention may lead to a reduction in long-term medical costs.
 
DRUGS
 
Fluticasone furoate/vilanterol (Relvar(®), Breo(®), Revinty(®)) is a fixed combination of a corticosteroid and a long-acting ß2-adrenergic agonist (LABA) for once-daily use via a dry powder inhaler (Ellipta(®)). Fluticasone furoate/vilanterol 100/25 µg is approved for the treatment of chronic obstructive pulmonary disease (COPD) in several countries. This article reviews the clinical use of the combination in COPD and summarises pharmacological properties. Fluticasone furoate has enhanced affinity for the glucocorticoid receptor compared with other clinically used inhaled corticosteroids (ICS) and longer lung retention than fluticasone propionate. Vilanterol is highly selective for ß2-adrenoreceptors and provides a rapid and prolonged duration of action. In phase 3 trials in patients with moderate to very severe COPD, overall, once-daily fluticasone furoate/vilanterol 100/25 µg improved pulmonary function more than placebo and fluticasone furoate alone and improved exacerbation rates more than vilanterol alone. With regard to pulmonary function, once-daily fluticasone furoate/vilanterol 100/25 µg was more effective than twice-daily fluticasone propionate/salmeterol 250/50 µg and similarly effective as twice-daily fluticasone propionate/salmeterol 500/50 µg. In 12-month trials, fluticasone furoate/vilanterol was generally well tolerated, and in 12- and 24-week trials, the incidence of adverse events was similar overall to that associated with the individual components or fluticasone propionate/salmeterol. However, as with the long-term use of all ICS agents, 12-month data indicate an increase in the risk of pneumonia with fluticasone furoate/vilanterol. In conclusion, fluticasone furoate/vilanterol is an effective and generally well tolerated additional LABA/ICS agent for the treatment of COPD with the added convenience of once-daily administration, which may improve treatment adherence in some patients.
Rosacea is a chronic inflammatory skin condition that negatively impacts patients' quality of life. We sought to review important aspects of the pathogenesis of rosacea and the role of new treatment options in its management. New, emerging treatments show promise; however, quality randomized controlled trials for many of these drugs are lacking. Brimonidine tartrate is an effective newly approved treatment for erythematotelangiectatic rosacea. Topical oxymetazoline has potential for the treatment of erythematotelangiectatic rosacea, with efficacy described in case reports and randomized controlled trials currently underway. Both oral and topical ivermectin have been studied for the treatment of papulopustular rosacea, both showing benefit; however, only topical ivermectin 1 % cream has been studied in randomized controlled trials. As our understanding of the etiology of rosacea continues to evolve, so will our options for therapeutic interventions. Further studies need to be performed to assess the long-term safety and efficacy of these treatments.
The substantial economic impact of influenza on society results primarily from lost work time and reduced productivity of patients and caregivers and increased use of medical resources. Additionally, since the 1980s, aging of the US population has meant rising influenza-related morbidity and mortality. According to the most current published data on this topic, in 2003 the total economic burden of influenza epidemics in the USA across all age groups was US$87.1 billion. As of February 2013, overall vaccine effectiveness for the 2012/2013 season was estimated to be 56 %. The Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases has concluded that more effective vaccines and vaccination strategies are needed. Moderate efficacy of the influenza vaccine, continued questions regarding the value of treatment with antivirals, and a growing self-care movement have led to increased use of over-the-counter (OTC) medicines, which play a vital role in managing symptoms associated with mild to moderate influenza and provide an estimated US$102 billion in annual savings for the US healthcare system. A primary benefit to society of using OTC medicines to manage influenza is decreased use of the healthcare system, thereby mitigating the socioeconomic burden of influenza. Considering the stresses placed on the US healthcare system and the substantial productivity losses resulting from seasonal influenza as well as the growing self-care movement, OTC medicines will play an important role in the course of future influenza epidemics.
Indacaterol is the first once-daily, long-acting ß2-adrenergic agonist (LABA) approved for the treatment of chronic obstructive pulmonary disease (COPD). Indacaterol was developed using a combination of informed drug design and molecular chemistry to generate a ß2-adrenergic agonist with a fast onset and long duration of action, enabling once-daily dosing with an acceptable safety profile. Early preclinical studies with indacaterol demonstrated these characteristics, and this promising molecule was taken into clinical development, originally for asthma treatment. Subsequent safety concerns over LABA monotherapy in patients with asthma redirected indacaterol's development to centre on COPD, where a good evidence base and guideline recommendations for bronchodilator monotherapy existed. Clinical development was initially complicated by different inhaler devices and differing doses of indacaterol. Using a phase III innovative adaptive-design clinical trial (INHANCE), indacaterol 150 and 300 µg once-daily doses were selected to be taken forward into the phase III INERGIZE programme. This programme delivered placebo-controlled and active-comparator data, including comparisons with formoterol, tiotropium and salmeterol/fluticasone, as well as the use of indacaterol in combination with tiotropium. Together, these studies provided a comprehensive assessment of the benefit-risk profile of indacaterol, allowing for regulatory submission. Indacaterol was first approved at once-daily doses of 150 and 300 µg in the European Union in 2009, followed by 150 µg in Japan (2011) and China (2012), and 75 µg in the United States (2011). To date, indacaterol is approved and marketed in more than 100 countries worldwide for once-daily maintenance treatment of COPD.
 
FAMILY MEDICINE
 
Prior to the new requirements, residents who completed a SAM had higher board scores and exam passing rates. Likelihood of passing initial board certification may be improved by requiring resident participation in MC-FP.
The smartphone application was an effective tool for both increasing confidence in depression treatment and educating physicians. Future studies to evaluate the effectiveness and impact of smartphone applications on medical education and postgraduate training are warranted.
Unexplained medication discrepancies are common at the first ambulatory visit post-hospital discharge and underscore the need to maintain accurate medication lists across the continuum of care. Individual-level characteristics may potentially be used to identify patients who need special attention for their medication management.
Violence curricular content and number of hours has been constant in family medicine residencies over time. An increase in the reported use of active learning strategies was identified as a trend across surveys. Next steps for violence curricula involve assessment of residents' competency to identify and intervene in violence.
 
GACETA SANITARIA
 
La fortaleza de esta revisión es que se ha llevado a cabo de modo exhaustivo, y apunta a que intervenciones bien implementadas pueden promover la salud adolescente. Los hallazgos son consistentes con revisiones recientes, y sus implicaciones para la práctica, la salud pública, y la investigación han sido discutidos.
Se observa una alta prevalencia de consumo de hipnosedantes en mujeres y en mayores de 45 años. Sería necesario profundizar en el estudio de la relación entre el consumo de hipnosedantes y la salud de los trabajadores, y del papel de los factores de estrés laboral en esta relación.
El diagnóstico precoz de la enfermedad de Alzheimer presenta importantes problemas bioéticos. Entre la detección temprana de la enfermedad y la aparición de sus síntomas media un período de tiempo en el cual la autonomía, la intimidad y la dignidad de quien la sufre pueden verse lesionadas por las eventuales medidas de apoyo y atención sanitaria o familiar que se decida adoptar. Éstas pueden terminar por transformar al paciente en un objeto de cuidado, impidiéndole asumir la enfermedad, elaborar la identidad y reordenar el espacio vital. Debe procurarse entonces que el cuidar no se traduzca en un asedio compasivo y un efecto invasivo que lleve a la anulación del paciente con Alzheimer.
Se obtiene confirmación parcial de la estructura original del instrumento, lo cual se atribuye a las características de la muestra. Se constata la relevancia de la variabilidad en la evaluación familiar y de sus indicadores adecuados de fiabilidad. Se señala la potencialidad para la salud pública de los hallazgos para la identificación de contextos familiares de calidad deficiente y para la elaboración de criterios preventivos, centrados en el desarrollo de competencias parentales.
Diferencias significativas en posiciones médicas entre hombres y mujeres configuran el fenómeno conocido como “tuberías con fugas”’, que consiste en un número desproporcionado de mujeres que llegan a posiciones médicas principales. El potencial de la feminización médica no se alcanzará sin esfuerzos de mejora ambiental continua en la medicina hospitalaria.
La intervención mejoró la salud percibida y la salud mental de las personas participantes. Debería evitarse que estas personas residan en edificios con barreras arquitectónicas, y si no es posible, implementar programas similares a éste.
Despite the implementation of the new law, most of the burden of the disease is bourne by the family.
 
JAMA INTERNAL MEDICINE
 
Primary ADT is not associated with improved long-term overall or disease-specific survival for men with localized prostate cancer. Primary ADT should be used only to palliate symptoms of disease or prevent imminent symptoms associated with disease progression.
After announcement of the results of the ENHANCE trial, nearly 2% of all continuously enrolled adult beneficiaries within a large US pharmacy benefit manager used ezetimibe, although ezetimibe initiations declined and discontinuations increased.
 
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
 
Nearly 1 in 5 men in the United States reported lifetime IPV perpetration toward their current intimate partner. Physical symptoms from irritable bowel syndrome and insomnia, substance use disorders, and prior family violence are associated with IPV perpetration by men. Understanding these associations may aid primary care physicians in identifying male patients who perpetrate IPV.
The anger and stress coping skills program may increase the success of quitting smoking.
These exploratory findings suggest administration of brief depression symptom measures, particularly the PHQ-9, may be associated with depression diagnosis and antidepressant recommendation and prescription among patients unlikely to have major depression. If these findings are confirmed, researchers should investigate the balance of benefits and risks (eg, overdiagnosis of depression and overtreatment with antidepressants) associated with use of a brief symptom measure.
 
JOURNAL OF THE AMERICAN MEDICALASSOCIATION
 
Ideally, treatment of hypercholesterolemia for patients at risk of ASCVD should start before they turn 80 years old. No RCT evidence exists to guide statin initiation after age 80 years. Decisions to use statins in older individuals are made individually and are not supported by high-quality evidence.
Analyses of nationally representative data from 1980 to 2012 suggest a doubling of the incidence and prevalence of diabetes during 1990-2008, and a plateauing between 2008 and 2012. However, there appear to be continued increases in the prevalence or incidence of diabetes among subgroups, including non-Hispanic black and Hispanic subpopulations and those with a high school education or less.
Using meta-analytic pooling, there were no statistically significant differences for efficacy and safety associated with most treatment strategies used to treat acute venous thromboembolism compared with the LMWH-vitamin K antagonist combination. However, findings suggest that the UFH-vitamin K antagonist combination is associated with the least effective strategy and that rivaroxaban and apixaban may be associated with the lowest risk for bleeding.
Among older adults with COPD, particularly those with asthma and those not receiving a long-acting anticholinergic medication, newly prescribed LABA and inhaled corticosteroid combination therapy, compared with newly prescribed LABAs alone, was associated with a significantly lower risk of the composite outcome of death or COPD hospitalization.
 
MEDICINA CLINICA
 
The treatment response to Cognitive Behavioral Therapy, nutritional support and psychotropic drugs in the majority of patients was favorable and similar in most patients with different types of Eating Disorders. Furthermore, a young age and no use of psychotropic drugs predict a favorable outcome in patients with ED.
Los resultados presentados ponen de manifiesto la clara asociación entre el MNA y los criterios de Fried. También evidencian que la categoría del MNA «riesgo de desnutrición» es la que está más fuertemente asociada al índice de fragilidad.
La versión española de la MacCAT-T es fiable, factible y válida para la evaluación de la capacidad de los pacientes para consentir tratamiento.
 
MORBIDITY AND MORTALITY WEEKLY REPORT
 
This report summarizes the epidemiology of human papillomavirus (HPV) and associated diseases, describes the licensed HPV vaccines, provides updated data from clinical trials and postlicensure safety studies, and compiles recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of HPV vaccines. Persistent infection with oncogenic HPV types can cause cervical cancer in women as well as other anogenital and oropharyngeal cancers in women and men. HPV also causes genital warts. Two HPV vaccines are licensed in the United States. Both are composed of type-specific HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein using recombinant DNA technology produces noninfectious virus-like particles (VLPs). Quadrivalent HPV vaccine (HPV4) contains four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18. Bivalent HPV vaccine (HPV2) contains two HPV type-specific VLPs prepared from the L1 proteins of HPV 16 and 18. Both vaccines are administered in a 3-dose series. ACIP recommends routine vaccination with HPV4 or HPV2 for females aged 11 or 12 years and with HPV4 for males aged 11 or 12 years. Vaccination also is recommended for females aged 13 through 26 years and for males aged 13 through 21 years who were not vaccinated previously. Males aged 22 through 26 years may be vaccinated. ACIP recommends vaccination of men who have sex with men and immunocompromised persons (including those with HIV infection) through age 26 years if not previously vaccinated. As a compendium of all current recommendations for use of HPV vaccines, information in this report is intended for use by clinicians, vaccination providers, public health officials, and immunization program personnel as a resource. ACIP recommendations are reviewed periodically and are revised as indicated when new information and data become available.
 
REUMATOLOGIA CLINICA
 
El programa de prevención secundaria de fracturas coordinado por reumatología consigue que el número de pacientes que inicia bisfosfonato se multiplique por 4 en comparación con la visita basal.
 
REVISTA ESPAÑOLA DE CARDIOLOGIA
 
La monitorización de la presión arterial de 1 h es un método válido y fiable para diagnosticar la hipertensión arterial y clasificar subpoblaciones de hipertensos, especialmente en hipertensión de bata blanca e hipertensión refractaria, que permite un mayor rendimiento de los instrumentos de monitorización.
Las enfermedades cardiovasculares son la primera causa de muerte en el mundo, y afectan no solo a países industrializados, sino sobre todo a países de ingresos medios-bajos, donde han superado a las enfermedades infecciosas como primera causa de muerte y su impacto amenaza al desarrollo social y económico de estas regiones. El aumento en la prevalencia de las enfermedades cardiovasculares de los últimos años, junto con las proyecciones de mortalidad para las próximas décadas, supone un argumento irrefutable acerca del carácter urgente de implementar intervenciones bien planificadas para controlar la pandemia de enfermedades cardiovasculares, especialmente en los países económicamente más deprimidos. La combinación de factores de comportamiento, sociales, medioambientales, biológicos y relacionados con sistemas de salud que contribuyen al desarrollo de la enfermedades cardiovasculares requiere una estrategia multisectorial que promueva estilos de vida saludables, reduzca los factores de riesgo cardiovascular y disminuya la mortalidad y la morbilidad a través de servicios sanitarios de calidad. Dichas propuestas deben ser dirigidas por líderes de la comunidad científica, el gobierno, la sociedad civil, el sector privado y las comunidades locales.
S25172069
La enfermedad cardiovascular es la primera causa de muerte en el mundo, y su impacto está siendo especialmente devastador en países de rentas medias-bajas. La combinación de factores como la urbanización y sus efectos derivados, como la obesidad, el sedentarismo, los cambios en hábitos dietéticos y el tabaquismo, se han combinado para situar la enfermedad cardiovascular en esa posición. Dado el enorme alcance de este problema y la complejidad de sus causas, que incluyen factores culturales, sociales, políticos y sanitarios, la estrategia para combatir la enfermedad cardiovascular a escala global debe ser igualmente sofisticada e integral. Como la exposición a los factores de riesgo cardiovascular se da desde edades tempranas, se debe expandir y ajustar esta estrategia a lo largo de la vida del individuo. Por ello, es necesario centrar los esfuerzos no solo en el tratamiento de la enfermedad y la prevención cardiovascular, sino también en la promoción de la salud y la prevención primordial. En esta revisión se presentan diferentes estrategias que han proporcionado resultados esperanzadores a escala poblacional, desde la infancia hasta la vejez, para defenderse de los retos a los que la comunidad científica se enfrenta para luchar contra la enfermedad cardiovascular.
La práctica regular de ejercicio físico es una recomendación establecida para prevenir y tratar los principales factores de riesgo cardiovascular modificables, como la diabetes mellitus, la hipertensión y la dislipemia. Realizar actividad física de intensidad moderada durante un mínimo de 30 min 5 días por semana o de intensidad alta durante un mínimo de 20 min 3 días por semana mejora la capacidad funcional y se asocia a reducciones en la incidencia de enfermedad cardiovascular y mortalidad. El ejercicio físico induce adaptaciones fisiológicas cardiovasculares que mejoran el rendimiento físico, y solo en casos extremos pueden conducir a un riesgo aumentado de complicaciones asociadas al ejercicio físico. La incidencia de muerte súbita o complicaciones graves durante la práctica de ejercicio físico es muy baja, se concentra en las personas con cardiopatías o con adaptación cardiaca muy patológica al ejercicio y la mayoría de estos casos los pueden detectar unidades de cardiología o profesionales bien instruidos.
Se han publicado multitud de estudios sobre la relación entre el riesgo de enfermedad cardiovascular y diversos nutrientes, alimentos y patrones de alimentación. A pesar del concepto bien aceptado de que la dieta tiene una influencia significativa en el desarrollo y la prevención de la enfermedad cardiovascular, los alimentos considerados saludables o perjudiciales han variado con el paso de los años. Esta revisión tiene como objetivo resumir la evidencia científica existente sobre el efecto cardioprotector de los alimentos y nutrientes que se ha considerado saludables y el de aquellos a los que se ha atribuido un carácter no saludable en algún momento de la historia. Para este fin, se ha revisado la literatura científica más reciente empleando las palabras clave foods y nutrients (p. ej., carne, omega-3) y términos relacionados con la enfermedad cardiovascular (p. ej., enfermedades cardiovasculares, ictus). Se ha hecho especial énfasis en los metanálisis y las revisiones Cochrane. En general, son escasos los estudios de intervención con un nivel de evidencia alto que respaldan los efectos beneficiosos de los alimentos saludables (como frutas y verduras), mientras que la evidencia que respalda los argumentos en contra de los alimentos considerados menos saludables (como las grasas saturadas) parece haberse debilitado con la evidencia más reciente. En resumen, la mayor parte de la evidencia que respalda los efectos beneficiosos y nocivos de alimentos y nutrientes se basa en estudios epidemiológicos observacionales. Los resultados de los ensayos clínicos aleatorizados revelan un cuadro más confuso, en el que la mayoría de los estudios muestran unos efectos muy pequeños en uno u otro sentido; la evidencia más sólida es la que procede de los patrones de alimentación. El conocimiento actual de la relación entre dieta y riesgo de enfermedad cardiovascular requiere unas recomendaciones más individualizadas, basadas en técnicas de genómica.
 
THE LANCET
 
Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.
Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030.
Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.
We recommend these international fetal growth standards for the clinical interpretation of routinely taken ultrasound measurements and for comparisons across populations.
We have developed, for routine clinical practice, international anthropometric standards to assess newborn size that are intended to complement the WHO Child Growth Standards and allow comparisons across multiethnic populations.
Many factors affect child and adolescent mortality in high-income countries. These factors can be conceptualised within four domains-intrinsic (biological and psychological) factors, the physical environment, the social environment, and service delivery. The most prominent factors are socioeconomic gradients, although the mechanisms through which they exert their effects are complex, affect all four domains, and are often poorly understood. Although some contributing factors are relatively fixed--including a child's sex, age, ethnic origin, and genetics, some parental characteristics, and environmental conditions--others might be amenable to interventions that could lessen risks and help to prevent future child deaths. We give several examples of health service features that could affect child survival, along with interventions, such as changes to the physical or social environment, which could affect upstream (distal) factors.
In addition to relapse prevention and psychiatric symptom relief, the benefits of antipsychotics and mood stabilisers might also include reductions in the rates of violent crime. The potential effects of these drugs on violence and crime should be taken into account when treatment options for patients with psychiatric disorders are being considered.
 
THE NEW ENGLAND JOURNAL OF MEDICINE
 
Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year. (Funded by the Swedish Research Council and others; TASTE ClinicalTrials.gov number, NCT01093404.).
Initial ultrasonography was associated with lower cumulative radiation exposure than initial CT, without significant differences in high-risk diagnoses with complications, serious adverse events, pain scores, return emergency department visits, or hospitalizations. (Funded by the Agency for Healthcare Research and Quality.).
Prehospital administration of ticagrelor in patients with acute STEMI appeared to be safe but did not improve pre-PCI coronary reperfusion. (Funded by AstraZeneca; ATLANTIC ClinicalTrials.gov number, NCT01347580.).
Quality-of-life measures were generally similar among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam group than in the surgery group. All treatments had similar clinical efficacy, but complications were less frequent after laser treatment and ablation rates were lower after foam treatment. (Funded by the Health Technology Assessment Programme of the National Institute for Health Research; Current Controlled Trials number, ISRCTN51995477.).
 
THORAX
 
Our understanding of chronic obstructive pulmonary disease (COPD) has changed dramatically over the past two decades. We have moved from an airflow limitation-centric view to the realisation that COPD is a complex and heterogeneous disease, which leads inevitably to the need for personalising the assessment and treatment of patients with COPD. This review provides a brief perspective of the extraordinary transition that the COPD field has experienced in the last two decades, and speculates on how it should/can move forward in the near future in order to really achieve the goal of personalising COPD medicine in the clinic.
Pulmonary metastasectomy is a commonly performed operation and is tending to increase as part of a concept of personalised treatment for advanced cancer. There have been no randomised trials; belief in effectiveness of metastasectomy is based on registry data and surgical follow-up studies. These retrospective series are comprised predominately of solitary or few metastases with primary resection to metastasectomy intervals longer than 2-3 years. Five-year survival rates of 30-50% are recorded, but as case selection is based on favourable prognostic features, an apparent association between metastasectomy and survival cannot be interpreted as causation. Cancers for which lung metastasectomy is used are considered in four pathological groups. In non-seminomatous germ cell tumour, for which chemotherapy is highly effective, excision of residual pulmonary disease guides future treatment and in particular allows an informed decisions as to further chemotherapy. Sarcoma metastasises predominately to lung and pulmonary metastasectomy for both bone and soft tissues sarcoma is routinely considered as a treatment option but without randomised data. The commonest circumstance for lung and liver metastasectomy is colorectal cancer. Repeated resections and ablations are commonplace but without evidence of effectiveness for either. For melanoma, results are particularly poor, but lung metastases are resected when no other treatment options are available. In this review, the available evidence is considered and the conclusion reached is that in the absence of randomised trials there is uncertainty about effectiveness. A randomised controlled trial, Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC), is in progress and randomised trials in sarcoma seem warranted.
 
 
 
 

                      

XXVIII Congreso de Comunicación y Salud

 

 

semFYC - JRT 2017

 

Cáceres, 10 y 11 de Noviembre 2017


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