Pub Date : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102639
I. Bretón , E. González Arnáiz , A. Zugasti Murillo
Obesity is a chronic disease that requires appropriate management and treatment. Given its high prevalence and clinical consequences, it is essential to coordinate clinical care and make appropriate use of healthcare resources. This review includes 100 evidence-based recommendations to avoid inappropriate practices for the management of obesity in clinical practice, based on the guidelines of leading scientific societies.
{"title":"Propuesta de 100 recomendaciones de «no hacer» en la atención clínica de las personas con obesidad","authors":"I. Bretón , E. González Arnáiz , A. Zugasti Murillo","doi":"10.1016/j.semerg.2025.102639","DOIUrl":"10.1016/j.semerg.2025.102639","url":null,"abstract":"<div><div>Obesity is a chronic disease that requires appropriate management and treatment. Given its high prevalence and clinical consequences, it is essential to coordinate clinical care and make appropriate use of healthcare resources. This review includes 100 evidence-based recommendations to avoid inappropriate practices for the management of obesity in clinical practice, based on the guidelines of leading scientific societies.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102639"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927261","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102669
I.M. Paúles-Cuesta , A. Gomis-Merenciano , B. Serrat-Segurana , L. Ferrer-Aguiló , E. Fuentes-Gonzalvo , M.N. Güerre-Oto , E. Gascón-Puyo , M. Aguilar-Julián
Objective
To evaluate the impact of a smoking screening and intervention program in a rural population aged 14 years and older, treated at the Caspe Health Center (Aragón, Spain).
Materials and methods
A quasi-experimental, prospective and observational study was conducted between June 2023 and December 2024 in a rural primary health care area (n = 11,680 inhabitants). Patients aged 15 years and older, seen in routine and continuing care consultations, were included. Patients were systematically questioned about tobacco use, and if they responded positively, appropriate intervention was provided. This intervention was tailored to patient motivation (Richmond test) and dependence level (Fagerström test), including brief counseling or intensive intervention with possible pharmacological treatment.
Results
A total of 1,159 patients (59.96% men) were evaluated. Tobacco use registration coverage was 59.5% in 2023 and 60.2% in 2024, far exceeding established standards. Recorded smoking prevalence increased from 18.12% to 41.63% between the two periods. Sixty-seven percent of registered smokers had some type of intervention recorded at least one year prior to the evaluation period, meeting quality standards for all indicators.
Conclusions
Brief and intensive interventions systematically applied in rural Primary Care are effective for the detection and treatment of tobacco use. Compliance with standards and the results obtained support the feasibility of replicating this strategy in other rural areas, contributing to the reduction of tobacco use and its consequences on public health.
{"title":"Efectividad de un programa de identificación e intervención planificada sobre el hábito de fumar en centros de salud rurales: estudio de tipo cuasi-experimental en Aragón, España (2023-2024)","authors":"I.M. Paúles-Cuesta , A. Gomis-Merenciano , B. Serrat-Segurana , L. Ferrer-Aguiló , E. Fuentes-Gonzalvo , M.N. Güerre-Oto , E. Gascón-Puyo , M. Aguilar-Julián","doi":"10.1016/j.semerg.2025.102669","DOIUrl":"10.1016/j.semerg.2025.102669","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of a smoking screening and intervention program in a rural population aged 14 years and older, treated at the Caspe Health Center (Aragón, Spain).</div></div><div><h3>Materials and methods</h3><div>A quasi-experimental, prospective and observational study was conducted between June 2023 and December 2024 in a rural primary health care area (n<!--> <!-->=<!--> <!-->11,680 inhabitants). Patients aged 15 years and older, seen in routine and continuing care consultations, were included. Patients were systematically questioned about tobacco use, and if they responded positively, appropriate intervention was provided. This intervention was tailored to patient motivation (Richmond test) and dependence level (Fagerström test), including brief counseling or intensive intervention with possible pharmacological treatment.</div></div><div><h3>Results</h3><div>A total of 1,159 patients (59.96% men) were evaluated. Tobacco use registration coverage was 59.5% in 2023 and 60.2% in 2024, far exceeding established standards. Recorded smoking prevalence increased from 18.12% to 41.63% between the two periods. Sixty-seven percent of registered smokers had some type of intervention recorded at least one year prior to the evaluation period, meeting quality standards for all indicators.</div></div><div><h3>Conclusions</h3><div>Brief and intensive interventions systematically applied in rural Primary Care are effective for the detection and treatment of tobacco use. Compliance with standards and the results obtained support the feasibility of replicating this strategy in other rural areas, contributing to the reduction of tobacco use and its consequences on public health.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102669"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927281","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102663
M.B. Roldán Rodríguez , R. Pérez Tanoira , M. Pérez Butragueño , A. Ortigado Matamala
Chagas disease (CD), endemic in 21 Latin American countries, affects 6–7 million people worldwide, causes approximately 12,000 deaths annually, and leads to 9,000 newborns being infected through vertical transmission. Spain is the European country with the highest number of cases, with vertical transmission being the main route of infection in our setting. Although most infected individuals are asymptomatic, around 30% will develop Chagas cardiomyopathy over time, which carries an annual mortality rate of approximately 4%. The effectiveness of treatment decreases as the duration of infection and the patient's age increase. Once cardiac involvement is established, treatment neither reverses the damage nor halts disease progression. Therefore, screening programs are of vital importance. In 2024, the Spanish Ministry of Health published a national consensus document on prenatal screening for Chagas disease, applicable across the entire national territory.
{"title":"La enfermedad de Chagas en España: actualización, recomendaciones y protocolos de cribado para su control en todo el territorio nacional","authors":"M.B. Roldán Rodríguez , R. Pérez Tanoira , M. Pérez Butragueño , A. Ortigado Matamala","doi":"10.1016/j.semerg.2025.102663","DOIUrl":"10.1016/j.semerg.2025.102663","url":null,"abstract":"<div><div>Chagas disease (CD), endemic in 21 Latin American countries, affects 6–7 million people worldwide, causes approximately 12,000 deaths annually, and leads to 9,000 newborns being infected through vertical transmission. Spain is the European country with the highest number of cases, with vertical transmission being the main route of infection in our setting. Although most infected individuals are asymptomatic, around 30% will develop Chagas cardiomyopathy over time, which carries an annual mortality rate of approximately 4%. The effectiveness of treatment decreases as the duration of infection and the patient's age increase. Once cardiac involvement is established, treatment neither reverses the damage nor halts disease progression. Therefore, screening programs are of vital importance. In 2024, the Spanish Ministry of Health published a national consensus document on prenatal screening for Chagas disease, applicable across the entire national territory.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102663"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927262","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102666
S. Sánchez Hernández , D. Martos Medina , J. Moral Malagón
Foot pathologies are a frequent reason for consultation in primary care, particularly among patients with diabetes, chronic conditions, biomechanical alterations, and vulnerable populations. However, the integration of podiatrists into primary care teams remains limited, hindering early detection and appropriate management of these conditions. This article reviews the available evidence and proposes practical criteria for effective referral to podiatrists, aiming to improve care coordination and optimize healthcare resources. Six main categories of foot pathologies eligible for referral are identified, organized by priority levels (urgent, preferential, and scheduled), and a decision-making algorithm applicable in family medicine practice is presented. The implementation of clinical pathways and standardized protocols can reduce severe complications such as ulcerations and amputations, contributing to safer, more efficient, and patient-centered care.
{"title":"El papel del podólogo en atención primaria: criterios de derivación eficaz","authors":"S. Sánchez Hernández , D. Martos Medina , J. Moral Malagón","doi":"10.1016/j.semerg.2025.102666","DOIUrl":"10.1016/j.semerg.2025.102666","url":null,"abstract":"<div><div>Foot pathologies are a frequent reason for consultation in primary care, particularly among patients with diabetes, chronic conditions, biomechanical alterations, and vulnerable populations. However, the integration of podiatrists into primary care teams remains limited, hindering early detection and appropriate management of these conditions. This article reviews the available evidence and proposes practical criteria for effective referral to podiatrists, aiming to improve care coordination and optimize healthcare resources. Six main categories of foot pathologies eligible for referral are identified, organized by priority levels (urgent, preferential, and scheduled), and a decision-making algorithm applicable in family medicine practice is presented. The implementation of clinical pathways and standardized protocols can reduce severe complications such as ulcerations and amputations, contributing to safer, more efficient, and patient-centered care.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102666"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927263","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102652
B. Sánchez Galindo , N.A. Ruiz Cambra
{"title":"Síndrome de Hamman en adolescente. A propósito de un caso","authors":"B. Sánchez Galindo , N.A. Ruiz Cambra","doi":"10.1016/j.semerg.2025.102652","DOIUrl":"10.1016/j.semerg.2025.102652","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102652"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927258","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102654
M. Yanes-Rodríguez
{"title":"Síndrome de Klippel-Feil en Atención Primaria: una aproximación clínica y genética","authors":"M. Yanes-Rodríguez","doi":"10.1016/j.semerg.2025.102654","DOIUrl":"10.1016/j.semerg.2025.102654","url":null,"abstract":"","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102654"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927260","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102643
M.D. Ballesteros Pomar, E. González Arnáiz
Introduction
Sarcopenic obesity (SO) is characterized by the coexistence of excess body fat and reduced muscle mass and strength. It is associated with increased cardiovascular and metabolic risk and entails greater disability, limiting patients’ quality of life and increasing the risk of mortality.
Objective
To assess whether the diagnosis of SO adds an extra clinical impact in patients with severe obesity who are candidates for bariatric surgery.
Material and methods
Prospective observational study in 124 patients with severe obesity (BMI > 40 Kg/m2 or BMI 35-40 Kg/m2 with comorbidities) aged 18 to 60 years. Collection of sociodemographic, clinical, anthropometric, quality of life (EuroQol-5D), analytical variables and use of health resources. Evaluation of body composition by DXA (fat mass and appendicular lean mass [MMA]), muscle strength (hand grip dynamometry) and physical performance (Timed-up-and-Go). Diagnosis of SO according to ESPEN/EASO criteria.
Results
28 patients (22.6%) had SO. Patients with SO had higher weight, BMI, waist circumference and calf (P < .05). Higher prevalence of arterial hypertension (AHT), type 2 diabetes mellitus (DM2), hypertriglyceridemia (P < .05), and tendency to more complications (OSA, cholelithiasis, etc.). There were no significant differences in quality of life, drug consumption or health resources. Patients with SO showed worse physical performance (slower TUG; P < .05) and higher risk of falls (P < .05).
Conclusions
SO is frequent in candidates for bariatric surgery and is associated with worse cardiometabolic and functional profile, suggesting a higher clinical risk in these patients.
{"title":"El diagnóstico de obesidad sarcopénica podría añadir un plus de repercusiones clínicas a la obesidad grave","authors":"M.D. Ballesteros Pomar, E. González Arnáiz","doi":"10.1016/j.semerg.2025.102643","DOIUrl":"10.1016/j.semerg.2025.102643","url":null,"abstract":"<div><h3>Introduction</h3><div>Sarcopenic obesity (SO) is characterized by the coexistence of excess body fat and reduced muscle mass and strength. It is associated with increased cardiovascular and metabolic risk and entails greater disability, limiting patients’ quality of life and increasing the risk of mortality.</div></div><div><h3>Objective</h3><div>To assess whether the diagnosis of SO adds an extra clinical impact in patients with severe obesity who are candidates for bariatric surgery.</div></div><div><h3>Material and methods</h3><div>Prospective observational study in 124 patients with severe obesity (BMI ><!--> <!-->40<!--> <!-->Kg/m<sup>2</sup> or BMI 35-40<!--> <!-->Kg/m<sup>2</sup> with comorbidities) aged 18 to 60<!--> <!-->years. Collection of sociodemographic, clinical, anthropometric, quality of life (EuroQol-5D), analytical variables and use of health resources. Evaluation of body composition by DXA (fat mass and appendicular lean mass [MMA]), muscle strength (hand grip dynamometry) and physical performance (Timed-up-and-Go). Diagnosis of SO according to ESPEN/EASO criteria.</div></div><div><h3>Results</h3><div>28 patients (22.6%) had SO. Patients with SO had higher weight, BMI, waist circumference and calf (<em>P</em> <!--><<!--> <!-->.05). Higher prevalence of arterial hypertension (AHT), type<!--> <!-->2 diabetes mellitus (DM2), hypertriglyceridemia (<em>P</em> <!--><<!--> <!-->.05), and tendency to more complications (OSA, cholelithiasis, etc.). There were no significant differences in quality of life, drug consumption or health resources. Patients with SO showed worse physical performance (slower TUG; <em>P</em> <!--><<!--> <!-->.05) and higher risk of falls (<em>P</em> <!--><<!--> <!-->.05).</div></div><div><h3>Conclusions</h3><div>SO is frequent in candidates for bariatric surgery and is associated with worse cardiometabolic and functional profile, suggesting a higher clinical risk in these patients.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102643"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927265","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 : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.semerg.2025.102674
J. Sathya, S. Ramkumar
Thyroid diseases are increasingly prevalent and have a major influence on endocrine and metabolic functions. Ultrasound imaging is popular for early diagnosis and categorizing thyroid abnormalities because it is non-invasive, inexpensive, and real-time. From this paper, we planned to study the recent developments in computer-aided diagnosis (CAD) systems in detecting and classifying thyroid diseases based on ultrasound images. Researchers are focused on traditional image processing algorithms, machine learning techniques, and deep learning techniques to improve accuracy. Modern classifiers like convolutional neural networks (CNNs) have garnered much attention in nodule segmentation, benign/malignant classification, and feature extraction. Our study encompasses major methodologies, datasets, performance measures, and challenges. Our investigation seeks to integrate a comprehensive view of existing studies in this area, point out existing gaps, and make recommendations on future research in thyroid ultrasound image analysis. From our survey, we concluded that the Deep learning models have shown superior performance relative to traditional techniques in several benchmark studies with very good accuracy, sensitivity, and specificity.
{"title":"A study on ultrasound imaging for thyroid detection and classification using machine learning and deep learning techniques","authors":"J. Sathya, S. Ramkumar","doi":"10.1016/j.semerg.2025.102674","DOIUrl":"10.1016/j.semerg.2025.102674","url":null,"abstract":"<div><div>Thyroid diseases are increasingly prevalent and have a major influence on endocrine and metabolic functions. Ultrasound imaging is popular for early diagnosis and categorizing thyroid abnormalities because it is non-invasive, inexpensive, and real-time. From this paper, we planned to study the recent developments in computer-aided diagnosis (CAD) systems in detecting and classifying thyroid diseases based on ultrasound images. Researchers are focused on traditional image processing algorithms, machine learning techniques, and deep learning techniques to improve accuracy. Modern classifiers like convolutional neural networks (CNNs) have garnered much attention in nodule segmentation, benign/malignant classification, and feature extraction. Our study encompasses major methodologies, datasets, performance measures, and challenges. Our investigation seeks to integrate a comprehensive view of existing studies in this area, point out existing gaps, and make recommendations on future research in thyroid ultrasound image analysis. From our survey, we concluded that the Deep learning models have shown superior performance relative to traditional techniques in several benchmark studies with very good accuracy, sensitivity, and specificity.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"52 1","pages":"Article 102674"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927278","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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