Medicina de Familia-SEMERGEN最新文献

英文中文

Carga de la enfermedad por VIH/sida en los departamentos de Colombia, 2018-2022 [2018-2022年哥伦比亚各省艾滋病毒/艾滋病造成的疾病负担]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102335

O.A. Gutierrez-Lesmes , J. Martínez-Torres , L.I. Plata Casas

Introduction

HIV/AIDS is a disease that continues to be a threat to public health.

Objective

Estimate the burden of disease generated by HIV/AIDS in the departments of Colombia, 2018 - 2022.

Methodology

Disease burden study, based on the metrics of global health estimates from the World Health Organization. State morbidity and mortality databases were used.

Results

The departments of Colombia lost 1051,599 (II 95% 849,217.41-1,253,980) DALYs due to HIV/AIDS. When classifying the departments by DALYs rates per 100,000 inhabitants, the differences in the burden in the departments become visible, departments, with rates in the study period, ranging from 4029.8 (3274.4-4785.2) DALYs, in the case of the department of Quindío and 297.2 (103.9-490.5) DALYs in the department of Vichada, men lost on average 23,833.48 (II 95% 13813-35809), while women lost 8,033 (II95% 5214-11177), 75% of DALYs in men occur between 20 and 49 years, in women 71.4% in the same age group.

Conclusions

There are differences in the loss of years of healthy life between the departments of Colombia, and annual variations in each department.

引言艾滋病毒/艾滋病是一种持续威胁公众健康的疾病：艾滋病毒/艾滋病是一种持续威胁公众健康的疾病：估算2018-2022年哥伦比亚各省艾滋病毒/艾滋病造成的疾病负担：疾病负担研究以世界卫生组织的全球健康估算指标为基础。研究使用了各州的发病率和死亡率数据库：哥伦比亚各省因艾滋病毒/艾滋病造成的残疾调整寿命年损失为 1051,599 (II 95% 849,217.41-1,253,980) 年。如果按照每 10 万居民的残疾调整寿命年数对各省进行分类，各省的负担差异就会显现出来，在研究期间，金迪奥省的残疾调整寿命年数为 4029.8 (3274.4-4785.2) 年，金迪奥省为 297.2 (103.9-490.2) 年。男性平均损失 23833.48 年（II 95% 13813-35809），女性损失 8033 年（II95% 5214-11177），男性 75% 的残疾调整寿命年数发生在 20 至 49 岁之间，女性 71.4% 发生在同一年龄段：结论：哥伦比亚各省之间的健康寿命损失年数存在差异，各省每年的情况也不尽相同。

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引用次数: 0

Estrategia de detección precoz de hepatitis víricas en pacientes con solicitud de perfil bioquímico hepático e hipertransaminasemia [对要求进行肝脏生化检查和高转氨酶血症患者进行病毒性肝炎早期检测的策略]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102339

P. Tajada Alegre , V. Villalta Robles , L. Gómez-Chacón Galán , D. Monge Monge , M. Álvarez González , B. Heredia Gálvez , M. Calvo Sánchez , L. Herrera García , M.R. Caro Narros , L. Salinas-Ortega , A. Casado Gómez , M.A. Casado

Objective

Undiagnosed viral hepatitis is an impediment to the elimination of viral hepatitis. Clinical Practice Guidelines (CPG) recommend screening in patients with hypertransaminasemia. The aim of the study was to evaluate the early detection of viral hepatitis B and C established in our health area in this population group.

Methods

Prospective observational study over a period of 28 months (February 2021-May 2023) of all patients with a request for a liver biochemical profile in whom hypertransaminasemia was detected and who met the inclusion criteria for early detection of viral hepatitis. In these patients, a one-step comprehensive diagnosis of viral hepatitis was performed. A preferential care circuit was established for the selected patients with active infection with a specialist in hepatology for linkage, evaluation and prescription, if appropriate, of antiviral treatment.

Results

Of the 2,058 patients selected, 148 patients (7.2%) tested positive for previously undiagnosed viral infection: 121 for hepatitis B virus (HBV) and 27 for hepatitis C virus (HCV). Of the 11 patients with chronic HBV infection, 10 had active HBV infection, of whom 3 had treatment indications. Of the patients with positive HCV serology, 77.8% were viremic and all were treated with sustained viral response (SVR).

Conclusions

Implementation of this strategy has identified and treated an appreciable number of undiagnosed HBV and HCV infections with impact at the individual and community level.

目的：未确诊的病毒性肝炎是消除病毒性肝炎的障碍。临床实践指南（CPG）建议对高转氨酶血症患者进行筛查。本研究的目的是评估在我们的卫生保健区对这一人群进行乙型和丙型病毒性肝炎早期检测的情况：为期 28 个月（2021 年 2 月至 2023 年 5 月）的前瞻性观察研究，研究对象为所有要求进行肝脏生化检查的患者，这些患者均检测出高转氨酶血症，并符合病毒性肝炎早期检测的纳入标准。对这些患者进行病毒性肝炎的一步综合诊断。为被选中的活动性感染患者建立了优先护理回路，由肝病学专家进行联系、评估并酌情开具抗病毒治疗处方：在被选中的 2 058 名患者中，有 148 名患者（7.2%）检测出先前未确诊的病毒感染呈阳性：其中 121 人感染乙型肝炎病毒（HBV），27 人感染丙型肝炎病毒（HCV）。在 11 例慢性 HBV 感染患者中，10 例为活动性 HBV 感染，其中 3 例有治疗指征。在HCV血清学呈阳性的患者中，77.8%为病毒携带者，所有患者均接受了持续病毒应答（SVR）治疗：结论：这一策略的实施发现并治疗了大量未确诊的 HBV 和 HCV 感染，对个人和社区都产生了影响。

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引用次数: 0

Alteraciones en la ecogenicidad testicular asociadas al síndrome de hipogonadismo de inicio tardío del varón [与睾丸回声改变有关的晚发性性腺功能减退综合征]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102338

J. Monllor Méndez , J. Carballido Rodríguez , J. González-Spinola San Gil , A. Monllor Méndez

Objective

This study aims to investigate the relationship between the presence of late-onset hypogonadism (LOH) syndrome in men and alterations in testicular echogenicity in a rural population sample.

Materials and methods

Prospective observational cohort study in which men between 45 and 75 years old from Villarta de San Juan area (Ciudad Real) were included. In order to determine the incidence of HIT, each patient was administered the AMSS test, a blood test to determine the concentration of testosterone, and a bilateral testicular ultrasound was performed.

Results

287 patients were included in the study. The diagnosis of LOH syndrome was established in 9.76% of them. 154 bilateral testicular ultrasounds were performed in which their testicular echogenicity patterns were evaluated. In 72.7% of the cases, alterations could be described in accordance with the standards proposed by the European Academy of Andrology of the year 2022. Testicular echogenicity evaluated by ultrasound demonstrated a sensitivity of 72.7%, a specificity of 78.8%, a negative predictive value of 94.5% and a positive predictive value of 36.4%, for the diagnosis of LOH.

Conclusions

The determination of testicular echogenicity in patients with suspected LOH syndrome showed much greater specificity than the AMSS test and a similar negative predictive value. Based on its innocuousness and the fact that it is a relatively simple examination from a technical point of view, it could be postulated as a diagnostic tool to be taken into account in the identification of this syndrome.

研究目的本研究旨在调查农村人口样本中男性晚发型性腺功能减退症（LOH）与睾丸回声改变之间的关系：前瞻性观察性队列研究：研究对象包括雷阿尔城 Villarta de San Juan 地区 45 至 75 岁的男性。为了确定 HIT 的发病率，每位患者都接受了 AMSS 测试、血液测试以确定睾酮浓度，并进行了双侧睾丸超声波检查。结果：研究共纳入 287 名患者，其中 9.76% 确诊为 LOH 综合征。共进行了 154 次双侧睾丸超声波检查，对睾丸回声模式进行了评估。72.7%的病例可根据欧洲 Andrology 学会提出的 2022 年标准描述其变化。通过超声评估睾丸回声，诊断 LOH 的灵敏度为 72.7%，特异度为 78.8%，阴性预测值为 94.5%，阳性预测值为 36.4%：结论：对疑似 LOH 综合征患者进行睾丸回声测定，其特异性远高于 AMSS 检测，阴性预测值与 AMSS 检测相似。从技术角度看，这项检查是一项相对简单的检查，因此可以将其作为一种诊断工具，在确定该综合征时加以考虑。

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引用次数: 0

Necrosis aséptica de hombros y caderas simulando una polimialgia reumática [模拟多发性风湿性关节炎的肩部和髋部无菌性坏死]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102313

E. Cañadillas Sánchez, E.M. Oliver García, C.A. Peralta Ginés, M.C. Osorio Sanjuan, P. del Río Martínez

引用次数: 0

Diagnóstico de la hipertensión durante el embarazo y preeclampsia, los límites del control y tratamiento [妊娠期高血压和子痫前期的诊断、控制和治疗的限度]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102330

M.A. María-Tablado

引用次数: 0

Nuevas competencias emergentes para el médico de familia [家庭医生的新能力]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102329

M. Algaba Montes , A.Á. Oviedo García , C. Montero Peña

引用次数: 0

Sintomatología esofágica como síntoma guía de tuberculosis ganglionar [食道症状是淋巴结结核的主要症状]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102314

P. Pérez Solís, B.N. Brizzi

引用次数: 0

Revisión del ejercicio físico como tratamiento de la lumbalgia en la mujer embarazada [回顾体育锻炼对孕妇腰背痛的治疗]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102340

L.M. Gallo-Galán , J.L. Gallo-Vallejo , J. Mozas-Moreno

Low back pain (LBP) in pregnant women can have a negative impact on daily activities, reduce quality of life and increase absenteeism from work. Despite its high prevalence, ranging from 13.2 to 80%, it is estimated that more than 50% of pregnant women receive little or no intervention from healthcare professionals, and it is often mistakenly considered as a normal phenomenon.

Given the side effects of pharmacological treatment of LBP in pregnant women, and the fact that physical exercise during pregnancy has been shown to be effective in reducing the intensity of LBP, the aim of this article is to raise awareness among primary care physicians so that they prescribe physical exercise to pregnant women with LBP and avoid physical inactivity as a consequence of LBP, as this can lead to a higher incidence of obstetric complications and caesarean section.

孕妇腰背痛（LBP）会对日常活动产生负面影响，降低生活质量，增加缺勤率。尽管腰背痛的发病率很高，从 13.2%到 80%不等，但据估计，50% 以上的孕妇很少或根本没有得到医护人员的干预，而且腰背痛常常被误认为是一种正常现象。考虑到药物治疗对孕妇枸杞痛的副作用，以及孕期体育锻炼可有效降低枸杞痛的强度这一事实，本文旨在提高初级保健医生的认识，以便他们为患有枸杞痛的孕妇开具体育锻炼处方，避免因枸杞痛而导致缺乏运动，因为这会导致产科并发症和剖腹产的发生率升高。

引用次数: 0

Equidad y reticencia vacunal: más ética, por favor [公平与疫苗犹豫不决：请提供更多伦理信息]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102344

M. Cruz-Piqueras , J. Hortal-Carmona

引用次数: 0

Optimization of adherence to fixed-dose combination therapy in the treatment of cardiovascular risk factors in primary care 在初级保健中优化固定剂量联合疗法在心血管风险因素治疗中的依从性。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2025-01-01 DOI: 10.1016/j.semerg.2024.102337

F.J. Alonso Moreno , J. Espinosa García , F. López Simarro , L. Aliaga Gutiérrez , C. Montero Peña , A. Manzano Vilches , M. Ricote Belinchón , P. Panero Hidalgo , C. Escobar Cervantes

Objective

Provide consensus recommendations for the optimal management of fixed-dose combination therapies (FCT) in patients with cardiovascular risk factors (CVRF) in primary care (PC).

Material and methods

A modified Delphi technique was used. A scientific committee wrote 80 statements addressing controversial issues regarding adherence and the use of FCT in patients with CVRF. A panel of 52 PC specialists, experts in CVRF management and adherence evaluated the questionnaire in two rounds. The work was promoted by the Network of Experts in Adherence in Primary Care (REAAP).

Results

Agreement was reached on 66 of the 80 issues (82.5%). The panellists considered that the adherence of patients with CVRF treated in PC was inadequate, which could have clinical implications. The use of FCT might increase adherence compared to separate treatments. FCT usage promotion in PC was considered necessary, especially in polymedicated patients. Measures such as establishing specific protocols or improving the training of professionals in the FTC use are necessary. The FTC use was recommended as a reduction in long-term cardiovascular events in hypertension was observed, together with changes of the concept of high-intensity statins to high-intensity lipid-lowering therapy in dyslipidemia, or considering the use of FCT if the option was available in type 2 diabetes mellitus.

Conclusions

The expert consensus recommendations from this work may facilitate the use of FCT in patients with CVRF in PC.

摘要为基层医疗机构（PC）对具有心血管风险因素（CVRF）的患者进行固定剂量联合疗法（FCT）的最佳管理提供共识建议：材料与方法：采用改良德尔菲技术。一个科学委员会针对心血管风险因素患者在坚持治疗和使用 FCT 方面的争议问题撰写了 80 份声明。由 52 名 PC 专家、CVRF 管理专家和依从性专家组成的小组对问卷进行了两轮评估。这项工作由初级保健依从性专家网络（REAAP）推动：结果：在 80 个问题中，有 66 个（82.5%）达成了一致意见。小组成员认为，在 PC 中接受治疗的 CVRF 患者的依从性不足，这可能会对临床产生影响。与单独治疗相比，使用 FCT 可提高依从性。他们认为有必要在 PC 中推广 FCT 的使用，尤其是在使用多种药物的患者中。有必要采取措施，如制定具体方案或加强对专业人员使用 FTC 的培训。由于观察到高血压患者的长期心血管事件有所减少，因此建议使用 FTC，同时改变高强度他汀类药物的概念，对血脂异常患者进行高强度降脂治疗，或考虑在 2 型糖尿病患者可以选择的情况下使用 FCT：本研究提出的专家共识建议有助于在 PC 中的 CVRF 患者中使用 FCT。

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