Pub Date : 2026-03-01Epub Date: 2026-02-10DOI: 10.1016/j.semerg.2026.102702
R. Solis-Camarena , Y. Soto-Agreda , K.V. Quiroz-Cornejo , M.P. Arellano-Salazar , T.J. Haider , B. Zutta , V.J. Samillan
Objectives
The accessibility of automated haematology analysers is frequently limited to clinical centres and thus not available for a significant number of patients, especially those living in remote areas (e.g. high-altitude regions), the objective of the present study was to compare a portable and easy to handle hemoglobinometer (HM) with an automated haematology analyser (HA) as a reference standard for their agreement in measuring the Hb concentration in high altitude resident patients.
Methods
We applied two different devices (HA: Sysmex XN-1000™ analyses, HM: Hemo Control hemoglobinometer, EKF Diagnostics) to determine the Hb concentration in 520 venous blood samples, which were obtained from patients, who were admitted to the Clinical Laboratory of Ramiro Priale-Essalud National Hospital (Huancayo, Peru, 3259 m.a.s.l.). The agreement between the two methods was evaluated by applying the Bland–Altman method and calculating the bias and the precision between the two devices.
Results
The Hb concentrations (mean ± SD g/dL) of measured blood samples were 14.6 ± 2.8 g/dL and 14.7 ± 2.8 g/dL for the HA and for HM respectively. The bias (mean difference ± SD g/dL, HA − HM) was −0.080 ± 0.5428 g/dL and the agreement limits were −1.091 to 0.930 g/dL.
Conclusions
The Hemo Control is a portable, easy to handle and a comparatively accurate device with sufficient agreement with the reference standard to determine Hb concentration in patients living in remote regions without access to automated haematology analysers.
{"title":"Comparison of haemoglobin assessments with Hemo Control and Sysmex XN-1000™ in high altitude resident patients (Huancayo – Peru)","authors":"R. Solis-Camarena , Y. Soto-Agreda , K.V. Quiroz-Cornejo , M.P. Arellano-Salazar , T.J. Haider , B. Zutta , V.J. Samillan","doi":"10.1016/j.semerg.2026.102702","DOIUrl":"10.1016/j.semerg.2026.102702","url":null,"abstract":"<div><h3>Objectives</h3><div>The accessibility of automated haematology analysers is frequently limited to clinical centres and thus not available for a significant number of patients, especially those living in remote areas (e.g. high-altitude regions), the objective of the present study was to compare a portable and easy to handle hemoglobinometer (HM) with an automated haematology analyser (HA) as a reference standard for their agreement in measuring the Hb concentration in high altitude resident patients.</div></div><div><h3>Methods</h3><div>We applied two different devices (HA: Sysmex XN-1000™ analyses, HM: Hemo Control hemoglobinometer, EKF Diagnostics) to determine the Hb concentration in 520 venous blood samples, which were obtained from patients, who were admitted to the Clinical Laboratory of Ramiro Priale-Essalud National Hospital (Huancayo, Peru, 3259 m.a.s.l.). The agreement between the two methods was evaluated by applying the Bland–Altman method and calculating the bias and the precision between the two devices.</div></div><div><h3>Results</h3><div>The Hb concentrations (mean<!--> <!-->±<!--> <!-->SD<!--> <!-->g/dL) of measured blood samples were 14.6<!--> <!-->±<!--> <!-->2.8<!--> <!-->g/dL and 14.7<!--> <!-->±<!--> <!-->2.8<!--> <!-->g/dL for the HA and for HM respectively. The bias (mean difference<!--> <!-->±<!--> <!-->SD g/dL, HA<!--> <!-->−<!--> <!-->HM) was −0.080<!--> <!-->±<!--> <!-->0.5428<!--> <!-->g/dL and the agreement limits were −1.091 to 0.930<!--> <!-->g/dL.</div></div><div><h3>Conclusions</h3><div>The Hemo Control is a portable, easy to handle and a comparatively accurate device with sufficient agreement with the reference standard to determine Hb concentration in patients living in remote regions without access to automated haematology analysers.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102702"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.semerg.2025.102653
D. Rey Aldana, D. Rial Villar, I. Barreiro Vázquez, L. Rarís Frois
{"title":"La utilidad de la ecografía a pie de cama en el diagnóstico diferencial del dolor en fosa renal: a propósito de un caso de absceso renal por Klebsiella pneumoniae","authors":"D. Rey Aldana, D. Rial Villar, I. Barreiro Vázquez, L. Rarís Frois","doi":"10.1016/j.semerg.2025.102653","DOIUrl":"10.1016/j.semerg.2025.102653","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102653"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145993607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-03DOI: 10.1016/j.semerg.2026.102684
R. Damián-García , S. Jiménez Jiménez , E. Ramos Lledó
Genital ulcers are a frequent reason for consultation in Primary Care, primarily due to new in sexual practices in recent years. They are caused by different reasons; its origin is usually infectious and they are transmitted through sexual contact. Its etiology can be non-infectious too. This review, focused on Primary Care, aims to provide an updated overview of the clinical characteristics, diagnosis, and management of genital ulcers, both of infectious origin (genital herpes, syphilis, lymphogranuloma venereum, chancroid, and donovanosis) and non-infectious origin (acute Lipschütz vulvar).
{"title":"Úlceras genitales. Artículo de revisión","authors":"R. Damián-García , S. Jiménez Jiménez , E. Ramos Lledó","doi":"10.1016/j.semerg.2026.102684","DOIUrl":"10.1016/j.semerg.2026.102684","url":null,"abstract":"<div><div>Genital ulcers are a frequent reason for consultation in Primary Care, primarily due to new in sexual practices in recent years. They are caused by different reasons; its origin is usually infectious and they are transmitted through sexual contact. Its etiology can be non-infectious too. This review, focused on Primary Care, aims to provide an updated overview of the clinical characteristics, diagnosis, and management of genital ulcers, both of infectious origin (genital herpes, syphilis, lymphogranuloma venereum, chancroid, and donovanosis) and non-infectious origin (acute Lipschütz vulvar).</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102684"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.semerg.2025.102679
A. Pía-Morandeira, E. Carracedo-Martínez, en nombre del grupo de estudio UFACOA
Objective
To assess the effectiveness of the electronic interconsultation between primary care pharmacists and physicians (PC-PC e-consultation) in resolving drug-related problems (DRPs) and potentially inappropriate prescriptions (PIPs).
Methods
A quasi-experimental pre-post study was conducted in a healthcare area located in northwestern Spain, serving approximately 450,000 inhabitants. DRPs and PIPs were predefined as duplications and inappropriate treatment regimens within two therapeutic subgroups: inhaled drugs used in asthma/COPD, and the antidiabetic agents DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors. The presence of DRPs and PIPs was identified using a computerized tool for analyzing prescription billing data (SIAC-PF), and interventions were carried out through e-consultations between primary care professionals. All patients identified at the time of data extraction were included in the study. The mean age was 71.1 ± 13.3 years, and 56.8% were male. The resolution of the identified problems was assessed after one or two interventions.
Results
The SIAC-PF system identified 242 patients with at least one predefined DRP or PIP, of whom 227 were included in the study. The presence of DRPs/PIPs was confirmed in 171 of the 227 patients (75.33%). The PC-PC e-consultation resolved DRPs/PIPs in 136 of the 162 patients in whom this tool was applied (83.95%). Following the e-consultation, a statistically significant reduction was observed in the proportion of patients with DRPs/PIPs among the total study population (n = 227) compared with the pre-e-consultation period (P<0.01, McNemar test).
Conclusions
The PC-PC e-consultation appears to be an effective tool for resolving DRPs and PIPs. The SIAC-PF system provides valid detection, although subsequent clinical review is required.
{"title":"Evaluación de la herramienta de e-consulta entre farmacéutico de atención primaria y médico especialista en medicina familiar y comunitaria en la resolución de prescripciones potencialmente inapropiadas y problemas relacionados con los medicamentos","authors":"A. Pía-Morandeira, E. Carracedo-Martínez, en nombre del grupo de estudio UFACOA","doi":"10.1016/j.semerg.2025.102679","DOIUrl":"10.1016/j.semerg.2025.102679","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effectiveness of the electronic interconsultation between primary care pharmacists and physicians (PC-PC e-consultation) in resolving drug-related problems (DRPs) and potentially inappropriate prescriptions (PIPs).</div></div><div><h3>Methods</h3><div>A quasi-experimental pre-post study was conducted in a healthcare area located in northwestern Spain, serving approximately 450,000 inhabitants. DRPs and PIPs were predefined as duplications and inappropriate treatment regimens within two therapeutic subgroups: inhaled drugs used in asthma/COPD, and the antidiabetic agents DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors. The presence of DRPs and PIPs was identified using a computerized tool for analyzing prescription billing data (SIAC-PF), and interventions were carried out through e-consultations between primary care professionals. All patients identified at the time of data extraction were included in the study. The mean age was 71.1<!--> <!-->±<!--> <!-->13.3 years, and 56.8% were male. The resolution of the identified problems was assessed after one or two interventions.</div></div><div><h3>Results</h3><div>The SIAC-PF system identified 242 patients with at least one predefined DRP or PIP, of whom 227 were included in the study. The presence of DRPs/PIPs was confirmed in 171 of the 227 patients (75.33%). The PC-PC e-consultation resolved DRPs/PIPs in 136 of the 162 patients in whom this tool was applied (83.95%). Following the e-consultation, a statistically significant reduction was observed in the proportion of patients with DRPs/PIPs among the total study population (n<!--> <!-->=<!--> <!-->227) compared with the pre-e-consultation period (P<0.01, McNemar test).</div></div><div><h3>Conclusions</h3><div>The PC-PC e-consultation appears to be an effective tool for resolving DRPs and PIPs. The SIAC-PF system provides valid detection, although subsequent clinical review is required.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102679"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-10DOI: 10.1016/j.semerg.2026.102692
J. Polo-García , R.M. Micó-Pérez , E. García-Gabriel , J.C. Romero-Vigara , L. García-Matarín , A. Segura-Fragoso , A. García-Lerín , B. Sánchez-Sánchez , C. Santos-Altozano , on behalf of the RACOVIR Study Researchers and SEMERGEN Foundation
Introduction
Anticoagulant treatment is key to reducing the risk of developing thromboembolic complications in patients with atrial fibrillation (AF).
Methods
The RACOVIR study is a descriptive and observational study, whose main objective is to know the clinical profile and management of patients with AF on oral anticoagulant treatment in the clinical practice of Primary Care setting in Spain. Furthermore, the degree of anticoagulation control of patients taking vitamin K antagonists (VKAs), the reasons for not changing to direct-acting oral anticoagulants (DOACs) when indicated, the frequency of cardiovascular events, as well as the degree of satisfaction with oral anticoagulant treatment will be assessed. In this article, the design and baseline sociodemographic and physical examination data are presented.
Results
In total, 1901 patients have been enrolled, 428 (22.5%) taking VKAs and 1473 (77.5%) DOACs. Overall, 45.4% of patients were >80 years old, 52.0% were men, 66.3% lived in an urban habitat and 78.9% were retired. At baseline, compared to DOACs, patients taking VKA were older (>80 years: 52.6% vs 43.4%; P = 0.003), lived less in an urban habitat (60.5% vs 68.0%; P < 0.001), and were more frequently retired (84.5% vs 77.3%; P = 0.004). Regarding physical examination parameters, patients taking VKA (vs taking DOACs) were more obese (body mass index 29.33 ± 5.72 vs 28.75 ± 5.03 kg/m2; P = 0.042) and had a lower diastolic blood pressure (73.89 ± 10.41 vs 75.43 ± 10.76 mmHg; P = 0.009).
Conclusions
The RACOVIR study will offer an updated and very relevant information about patients with AF taking anticoagulant treatment treated in Primary Care in Spain.
前言：抗凝治疗是降低心房颤动（AF）患者血栓栓塞并发症风险的关键。方法：RACOVIR研究是一项描述性和观察性研究，其主要目的是了解西班牙初级保健机构临床实践中AF患者口服抗凝治疗的临床概况和管理。此外，还将评估服用维生素K拮抗剂（VKAs）患者的抗凝控制程度、在指征时不改用直接作用口服抗凝剂（DOACs）的原因、心血管事件的发生频率以及口服抗凝治疗的满意度。在本文中，设计和基线的社会人口和体格检查数据提出。结果：共纳入1901例患者，其中428例（22.5%）采用vka， 1473例（77.5%）采用doac。总体而言，45.4%的患者年龄在80岁至80岁之间，52.0%为男性，66.3%居住在城市，78.9%为退休人员。基线时，与DOACs相比，服用VKA的患者年龄更大（80岁：52.6% vs 43.4%； P=0.003），在城市居住时间更短（60.5% vs 68.0%; P2； P=0.042），舒张压更低（73.89±10.41 vs 75.43±10.76mmHg； P=0.009）。结论：RACOVIR研究将为西班牙初级保健中接受抗凝治疗的房颤患者提供最新且非常相关的信息。
{"title":"Oral anticoagulation in patients with atrial fibrillation in Primary Care in Spain. Rationale, design and baseline data of the RACOVIR study","authors":"J. Polo-García , R.M. Micó-Pérez , E. García-Gabriel , J.C. Romero-Vigara , L. García-Matarín , A. Segura-Fragoso , A. García-Lerín , B. Sánchez-Sánchez , C. Santos-Altozano , on behalf of the RACOVIR Study Researchers and SEMERGEN Foundation","doi":"10.1016/j.semerg.2026.102692","DOIUrl":"10.1016/j.semerg.2026.102692","url":null,"abstract":"<div><h3>Introduction</h3><div>Anticoagulant treatment is key to reducing the risk of developing thromboembolic complications in patients with atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>The RACOVIR study is a descriptive and observational study, whose main objective is to know the clinical profile and management of patients with AF on oral anticoagulant treatment in the clinical practice of Primary Care setting in Spain. Furthermore, the degree of anticoagulation control of patients taking vitamin K antagonists (VKAs), the reasons for not changing to direct-acting oral anticoagulants (DOACs) when indicated, the frequency of cardiovascular events, as well as the degree of satisfaction with oral anticoagulant treatment will be assessed. In this article, the design and baseline sociodemographic and physical examination data are presented.</div></div><div><h3>Results</h3><div>In total, 1901 patients have been enrolled, 428 (22.5%) taking VKAs and 1473 (77.5%) DOACs. Overall, 45.4% of patients were >80 years old, 52.0% were men, 66.3% lived in an urban habitat and 78.9% were retired. At baseline, compared to DOACs, patients taking VKA were older (>80 years: 52.6% vs 43.4%; <em>P</em> <!-->=<!--> <!-->0.003), lived less in an urban habitat (60.5% vs 68.0%; <em>P</em> <!--><<!--> <!-->0.001), and were more frequently retired (84.5% vs 77.3%; <em>P</em> <!-->=<!--> <!-->0.004). Regarding physical examination parameters, patients taking VKA (vs taking DOACs) were more obese (body mass index 29.33<!--> <!-->±<!--> <!-->5.72 vs 28.75<!--> <!-->±<!--> <!-->5.03<!--> <!-->kg/m<sup>2</sup>; <em>P</em> <!-->=<!--> <!-->0.042) and had a lower diastolic blood pressure (73.89<!--> <!-->±<!--> <!-->10.41 vs 75.43<!--> <!-->±<!--> <!-->10.76<!--> <!-->mmHg; <em>P</em> <!-->=<!--> <!-->0.009).</div></div><div><h3>Conclusions</h3><div>The RACOVIR study will offer an updated and very relevant information about patients with AF taking anticoagulant treatment treated in Primary Care in Spain.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102692"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.semerg.2025.102683
E. Trillo-Calvo
{"title":"Burnout: del dato a la acción en la atención primaria española","authors":"E. Trillo-Calvo","doi":"10.1016/j.semerg.2025.102683","DOIUrl":"10.1016/j.semerg.2025.102683","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102683"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.semerg.2025.102678
R. de Simón Gutiérrez , B. Alcázar Navarrete , M.B. Alonso Ortiz , J.F. Delgado Jiménez , J.J. Gómez Doblas , R. Hurtado García , J.C. López Caro , M. Méndez Bailón , J. Núñez Villota , P. Piñera Salmerón , E. Pulido Herrero , D. Rey Aldana , J.J. Soler-Cataluña , J.A. Trigueros Carrero , M.J. Zamorano Serrano , J. de Miguel-Díez
Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist, each increasing the prevalence of the other and worsening their clinical manifestations and prognosis. The common pathophysiological mechanisms, as well as the overlap of certain symptoms and findings in complementary tests, make diagnosis and follow-up of these patients difficult. Therefore, a comprehensive approach to cardiopulmonary risk requires a multidisciplinary approach that prioritises prevention and coordinated care between the different clinical specialties involved. This document, jointly developed by several specialists in pulmonology, cardiology, internal medicine, emergency medicine, and Primary Care belonging to seven medical societies in Spain, with extensive clinical experience in the management of COPD and CVD, proposes practical recommendations and shared care pathways based on an analysis of the available scientific evidence and the clinical experience of the authors, aimed at facilitating decision-making and optimising the management of these patients.
{"title":"Integrated care for COPD and cardiovascular comorbidities: A multidisciplinary approach for the cardiopulmonary patient","authors":"R. de Simón Gutiérrez , B. Alcázar Navarrete , M.B. Alonso Ortiz , J.F. Delgado Jiménez , J.J. Gómez Doblas , R. Hurtado García , J.C. López Caro , M. Méndez Bailón , J. Núñez Villota , P. Piñera Salmerón , E. Pulido Herrero , D. Rey Aldana , J.J. Soler-Cataluña , J.A. Trigueros Carrero , M.J. Zamorano Serrano , J. de Miguel-Díez","doi":"10.1016/j.semerg.2025.102678","DOIUrl":"10.1016/j.semerg.2025.102678","url":null,"abstract":"<div><div>Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist, each increasing the prevalence of the other and worsening their clinical manifestations and prognosis. The common pathophysiological mechanisms, as well as the overlap of certain symptoms and findings in complementary tests, make diagnosis and follow-up of these patients difficult. Therefore, a comprehensive approach to cardiopulmonary risk requires a multidisciplinary approach that prioritises prevention and coordinated care between the different clinical specialties involved. This document, jointly developed by several specialists in pulmonology, cardiology, internal medicine, emergency medicine, and Primary Care belonging to seven medical societies in Spain, with extensive clinical experience in the management of COPD and CVD, proposes practical recommendations and shared care pathways based on an analysis of the available scientific evidence and the clinical experience of the authors, aimed at facilitating decision-making and optimising the management of these patients.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102678"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.semerg.2025.102680
A. Rodríguez-Armesto , K.S. Khan , S. Cinza-Sanjurjo
Background and objective
Cardiovascular polypills, that combine aspirin, antihypertensive and statin, are controversial with respect to cardiovascular risk factors (CVRFs) and cardiovascular events (CVE). We conducted a meta-analysis to examine their effects.
Methodology
A systematic review was conducted, searching clinical studies, both randomised and observational, that compared polypills versus administering the individual drugs separately. Four bibliographic databases (PubMed, Cochrane Library, Science Direct, and Google Scholar) were searched till December 2024. Risk of bias was assessed using the Newcastle-Ottawa Scale, the Cochrane bias risk assessment tool and the Egger's test. We developed separate analyses for the CNIC-polypill (ramipril, aspirin and atorvastatin), which is recommended by the WHO, and other polypills with different compositions. Outcomes CVRF (systolic and diastolic blood pressure or SBP and DBP, and LDL cholesterol), CVE, and adherence were meta-analysed, estimating mean differences (MD) and relative risks (RR) with 95% confidence intervals (CIs).
Results
There were 15 studies (n = 24,364) included. Randomised trials (n = 13) and observational studies (n = 2) both showed low risk of bias. The CNIC-polypill decreased SBP (MD = −1.43 mmHg [95% CI: −2.86; −0.00], p = 0.05), DBP (MD = −2.62 mmHg [95% CI: −5.41; 0.18], p = 0.07), LDL cholesterol (MD = −5.52 mg/dL [95% CI: −8.66; −2.38], p = 0.0006), and CVE (RR = 0.82 [95% CI: 0.73–0.92], p = 0.0007), in clinical trials and observational studies combined. The other polypills also decreases SBP (MD = −2.93 mmHg [95% CI: −3.96; −1.91], p < 0.000001), DBP (MD = −1.52 mmHg [95% CI: −2.00; −1.05], p < 0.00001), LDL (MD = −10.48 mg/dL [95% CI: −16.89; −4.07], p = 0.001), and CVE (RR = 0.77 [95% CI: 0.68–0.87], p < 0.0001). There was higher therapeutic adherence both with the CNIC-polypill (RR = 1.16 [95% CI: 1.12–1.21], p < 0.00001) as well as with other polypills (RR = 1.26 [95% CI: 1.04–1.52], p = 0.02).
Conclusions
Polypills were effective in reducing CVRF and CVE, and improved adherence compared to taking the constituent individual drugs separately.
{"title":"Effects of polypills on cardiovascular outcomes: Meta-analysis of clinical trials and observational studies","authors":"A. Rodríguez-Armesto , K.S. Khan , S. Cinza-Sanjurjo","doi":"10.1016/j.semerg.2025.102680","DOIUrl":"10.1016/j.semerg.2025.102680","url":null,"abstract":"<div><h3>Background and objective</h3><div>Cardiovascular polypills, that combine aspirin, antihypertensive and statin, are controversial with respect to cardiovascular risk factors (CVRFs) and cardiovascular events (CVE). We conducted a meta-analysis to examine their effects.</div></div><div><h3>Methodology</h3><div>A systematic review was conducted, searching clinical studies, both randomised and observational, that compared polypills <em>versus</em> administering the individual drugs separately. Four bibliographic databases (PubMed, Cochrane Library, Science Direct, and Google Scholar) were searched till December 2024. Risk of bias was assessed using the Newcastle-Ottawa Scale, the Cochrane bias risk assessment tool and the Egger's test. We developed separate analyses for the CNIC-polypill (ramipril, aspirin and atorvastatin), which is recommended by the WHO, and other polypills with different compositions. Outcomes CVRF (systolic and diastolic blood pressure or SBP and DBP, and LDL cholesterol), CVE, and adherence were meta-analysed, estimating mean differences (MD) and relative risks (RR) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>There were 15 studies (<em>n</em> <!-->=<!--> <!-->24,364) included. Randomised trials (<em>n</em> <!-->=<!--> <!-->13) and observational studies (<em>n</em> <!-->=<!--> <!-->2) both showed low risk of bias. The CNIC-polypill decreased SBP (MD<!--> <!-->=<!--> <!-->−1.43<!--> <!-->mmHg [95% CI: −2.86; −0.00], <em>p</em> <!-->=<!--> <!-->0.05), DBP (MD<!--> <!-->=<!--> <!-->−2.62<!--> <!-->mmHg [95% CI: −5.41; 0.18], <em>p</em> <!-->=<!--> <!-->0.07), LDL cholesterol (MD<!--> <!-->=<!--> <!-->−5.52<!--> <!-->mg/dL [95% CI: −8.66; −2.38], <em>p</em> <!-->=<!--> <!-->0.0006), and CVE (RR<!--> <!-->=<!--> <!-->0.82 [95% CI: 0.73–0.92], <em>p</em> <!-->=<!--> <!-->0.0007), in clinical trials and observational studies combined. The other polypills also decreases SBP (MD<!--> <!-->=<!--> <!-->−2.93<!--> <!-->mmHg [95% CI: −3.96; −1.91], <em>p</em> <!--><<!--> <!-->0.000001), DBP (MD<!--> <!-->=<!--> <!-->−1.52<!--> <!-->mmHg [95% CI: −2.00; −1.05], <em>p</em> <!--><<!--> <!-->0.00001), LDL (MD<!--> <!-->=<!--> <!-->−10.48<!--> <!-->mg/dL [95% CI: −16.89; −4.07], <em>p</em> <!-->=<!--> <!-->0.001), and CVE (RR<!--> <!-->=<!--> <!-->0.77 [95% CI: 0.68–0.87], <em>p</em> <!--><<!--> <!-->0.0001). There was higher therapeutic adherence both with the CNIC-polypill (RR<!--> <!-->=<!--> <!-->1.16 [95% CI: 1.12–1.21], <em>p</em> <!--><<!--> <!-->0.00001) as well as with other polypills (RR<!--> <!-->=<!--> <!-->1.26 [95% CI: 1.04–1.52], <em>p</em> <!-->=<!--> <!-->0.02).</div></div><div><h3>Conclusions</h3><div>Polypills were effective in reducing CVRF and CVE, and improved adherence compared to taking the constituent individual drugs separately.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102680"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.semerg.2025.102656
M.E. Montes Belloso , C.M. Mengual González , M. Ciprián Tejero
{"title":"Lesiones eritemato-edematosas crónicas en espalda de larga evolución: diagnóstico final de infiltración linfocitaria de Jessner-Kanof","authors":"M.E. Montes Belloso , C.M. Mengual González , M. Ciprián Tejero","doi":"10.1016/j.semerg.2025.102656","DOIUrl":"10.1016/j.semerg.2025.102656","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 2","pages":"Article 102656"},"PeriodicalIF":0.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145993590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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