Medicina de Familia-SEMERGEN最新文献

英文中文

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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引用次数: 0

Inteligencia artificial para el abordaje integral de las enfermedades huérfanas/raras: revisión sistemática exploratoria [人工智能用于孤儿/罕见病的综合方法：范围审查]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-28 DOI: 10.1016/j.semerg.2024.102434

L.M. Acero Ruge , D.A. Vásquez Lesmes , E.H. Hernández Rincón , L.P. Avella Pérez

Introduction

Orphan diseases (OD) are rare but collectively common, presenting challenges such as late diagnoses, disease progression, and limited therapeutic options. Recently, artificial intelligence (AI) has gained interest in the research of these diseases.

Objective

To synthesize the available evidence on the use of AI in the comprehensive approach to orphan diseases.

Methods

An exploratory systematic review of the Scoping Review type was conducted in PubMed, Bireme, and Scopus from 2019 to 2024.

Results

fifty-six articles were identified, with 21.4% being experimental studies; 28 documents did not specify an OD, 8 documents focused primarily on genetic diseases; 53.57% focused on diagnosis, and 36 different algorithms were identified.

Conclusions

The information found shows the development of AI algorithms in different clinical settings, confirming the potential benefits in diagnosis times, therapeutic options, and greater awareness among health professionals.

孤儿病（Orphan disease， OD）是一种罕见但普遍的疾病，存在诊断晚、疾病进展和治疗选择有限等挑战。近年来，人工智能（AI）对这些疾病的研究产生了兴趣。目的：综合人工智能在孤儿病综合治疗中的应用。方法：对2019 - 2024年PubMed、Bireme和Scopus进行Scoping review类型的探索性系统评价。结果：共纳入56篇文献，其中实验研究占21.4%；28份文件没有指定OD， 8份文件主要侧重于遗传病；53.57%的人关注于诊断，共有36种不同的算法。结论：发现的信息显示了人工智能算法在不同临床环境中的发展，证实了在诊断时间、治疗选择和卫生专业人员意识提高方面的潜在益处。

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引用次数: 0

El monstruo viene a verme [怪物来了]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-27 DOI: 10.1016/j.semerg.2024.102414

L. Fernández Segura

引用次数: 0

Mobile application development to improve the active search for functional impairment and persistent symptoms in individuals post-COVID-19 移动应用程序开发，以改善对covid -19后个体功能障碍和持续症状的主动搜索。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-27 DOI: 10.1016/j.semerg.2024.102430

L.M. Serafim , R.F. Guimarães , L.V. Martins , G.K.F. Freitas , F.M.G. Liberato , G.P. de Morais Giglio , P.H.B. Rizzi , H.C. Moreira , L.A. Martins , S.C. de Souza Cruz , V.A. da Silva , F.M. Paro

Objectives

This study aimed to develop a mobile application (App) to be used by primary care teams in the active search for functional impairment, long-term symptoms, and disabilities in individuals who have recovered from COVID-19, contributing to early treatment and referrals for multidisciplinary care and rehabilitation. This experimental study used the minimum viable product (MVP) methodology to develop an App named ReabilitaCOVID.

Methods

This methodology involves ideation, content creation, prototype creation, usability tests, and adjustments based on feedback. The study was conducted in Brazil, and the population of the study included community health workers, who were the App's target users, and individuals from the community who had previously had COVID-19 and were at risk of developing PCS.

Results

The App included a sociodemographic questionnaire, a clinical questionnaire, the post-COVID-19 Functional Status Scale (PCFS), the Modified Medical Research Council (MRC) Dyspnea Scale, and a flowchart. Usability tests were conducted, with feedback collected and adjustments made for improvements. Barriers to community health workers’ use of the application were identified.

Conclusion

A tailored app was developed for primary care teams to use in the active search for PCS. Functional and usability tests were performed in simulated and real environments. The App has the potential to facilitate referrals for multidisciplinary care and rehabilitation efficiently, and it will be available freely to public health care services. MVP is a suitable approach for developing a tailored App for healthcare teams.

目的：本研究旨在开发一款移动应用程序（App），供初级保健团队用于主动搜索COVID-19康复个体的功能障碍、长期症状和残疾，有助于早期治疗和多学科护理和康复的转诊。本实验研究采用最小可行产品（MVP）方法开发了ReabilitaCOVID应用程序。方法：此方法包括构思、内容创建、原型创建、可用性测试和基于反馈的调整。这项研究是在巴西进行的，研究对象包括社区卫生工作者，他们是该应用程序的目标用户，以及以前感染过COVID-19并有患PCS风险的社区个人。结果：该应用程序包括社会人口调查问卷、临床调查问卷、covid -19后功能状态量表（PCFS）、改良医学研究委员会（MRC）呼吸困难量表和流程图。进行了可用性测试，收集了反馈并进行了调整以进行改进。确定了社区卫生工作者使用该应用程序的障碍。结论：为初级保健团队开发了一款定制应用程序，用于主动搜索PCS。在模拟和真实环境中进行了功能和可用性测试。该应用程序有可能有效地促进多学科护理和康复的转诊，并将免费提供给公共卫生保健服务。MVP是为医疗团队开发量身定制的应用程序的合适方法。

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引用次数: 0

El tiempo es oro [时间的价值]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-27 DOI: 10.1016/j.semerg.2024.102412

L. Fernández Segura

引用次数: 0

«Dolor mixto»: conceptualización actual y aproximación para Atención Primaria [“混合性疼痛”：当前初级保健的概念和方法]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-27 DOI: 10.1016/j.semerg.2024.102447

A. Alcántara Montero

Despite being referenced in the literature for over a decade, the term “mixed pain” has hardly been formally defined. The strict binary classification of pain as purely neuropathic or nociceptive left a good proportion of patients unclassified; even the introduction of the term “nociplastic pain” in the International Association for the Study of Pain terminology leaves out patients who clinically present with a substantial overlap of nociceptive, neuropathic, and nociplastic symptoms. For these patients the term “mixed pain” is becoming increasingly recognized and accepted by the scientific community. This narrative review summarizes the highlights of mixed pain and emphasizes the importance of recognizing this type of pain in clinical practice.

尽管在文献中被引用了十多年，但“混合性疼痛”一词几乎没有正式定义。将疼痛严格分为纯粹神经性疼痛和伤害性疼痛，使得很大一部分患者无法分类；甚至在国际疼痛研究协会术语中引入“伤害性疼痛”一词时，也忽略了临床表现为伤害性、神经性和伤害性症状大量重叠的患者。对于这些病人来说，“混合性疼痛”一词正逐渐被科学界所认可和接受。本文总结了混合性疼痛的特点，并强调了在临床实践中认识到这种类型疼痛的重要性。

引用次数: 0

Ureterocele: hallazgo ecográfico poco común 输尿管囊肿：超声异常表现。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-24 DOI: 10.1016/j.semerg.2024.102436

I. Martín de la Sierra-Ruiz de Pascual , M. Sánchez-García , A.M. Gómez-Martín , M. Paños-Martínez , M.M. Alcázar-Martínez

引用次数: 0

Hidratación y aguas minerales naturales: una revisión sobre la importancia para la salud del aporte de agua y los minerales [水合作用和天然矿泉水：水和矿物质摄入对健康的重要性综述]。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-20 DOI: 10.1016/j.semerg.2024.102441

J.M. Fernández-García , O. García-Vallejo , A.M. López-Sobaler , C. Martín-Salinas , M. González-Gross , R. Urrialde

The aim of this review is to highlight the properties of water and the need for adequate hydration for the proper functioning of the body. Spanish and European legislation on natural mineral waters has been reviewed, as well as the consensus documents of national and international congresses on hydration. In addition, relevant articles and, in particular, reviews on hydration and health, as well as other adapted terms of interest for each of the sections of this manuscript have been included. The total daily adequate amount of water recommended by EFSA for adults is between 2.0-2.5 liters, depending on gender and it should be adapted to each person's physiological situation and individual state of health. Water is an essential nutrient that helps maintaining normal physical and cognitive functions of the body. The mineralogical composition of natural mineral waters is important and can have health benefits depending on the needs of each individual.

这篇综述的目的是强调水的特性和身体正常运作需要足够的水合作用。已经审查了西班牙和欧洲关于天然矿泉水的立法，以及关于水合作用的国家和国际大会的协商一致文件。此外，还包括了相关文章，特别是关于水合作用和健康的评论，以及本手稿每个部分的其他改编术语。欧洲食品安全局建议的成人每日充足饮水总量在2.0-2.5升之间，这取决于性别，并应适应每个人的生理状况和个人健康状况。水是一种必需的营养物质，有助于维持身体正常的生理和认知功能。天然矿泉水的矿物成分很重要，可以根据每个人的需要对健康有益。

引用次数: 0

Head and neck cancer: An opportunity to review primary preventive care 头颈癌：回顾初级预防保健的机会。

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN

Pub Date : 2024-12-20 DOI: 10.1016/j.semerg.2024.102429

P. García-Regueras, R. Aispuru-Lanche

引用次数: 0

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