ABSTRACT
Introducción Las personas con diabetes mellitus tipo 2 (DM2) tienen una prevalencia de fragilidad que se estima entre 3 y 5 veces mayor que aquellos que no la padecen, sin embargo, no existe un consenso claro sobre el diagnóstico y manejo clínico durante el itinerario de la persona frágil con DM2. Objetivos El objetivo principal de este estudio es identificar las limitaciones y necesidades actuales en el uso del concepto de fragilidad en personas con DM2 (PCDM2), así como definir y evaluar, según su importancia y novedad, las dimensiones que podrían incluirse en su valoración clínica de rutina. Métodos Se llevó a cabo un proceso basado en la técnica de grupo nominal con la participación de un equipo multidisciplinario de 8 profesionales de la salud que trabajan en diferentes hospitales de España. Resultados Se identificaron y clasificaron según su importancia un total de 8 limitaciones en la evaluación de la fragilidad en PCDM2, así como 10 necesidades no satisfechas relacionadas con el diagnóstico y seguimiento de la enfermedad. Además, se identificaron 7 dimensiones que consideramos que deben incluirse en la definición de la persona frágil con DM2, ordenadas por importancia y novedad. Conclusiones El presente artículo podría lograr aumentar el conocimiento y uso en la comunidad médica del concepto de fragilidad en la persona con DM2 y desembocar en un futuro proyecto que logre realizar, de manera consensuada, una definición de fragilidad adaptada a este colectivo (AU)
Introduction People with type 2 diabetes mellitus (DM2) have a higher prevalence of frailty compared to those without DM2. However, there is a lack of consensus on the diagnosis and clinical management of frail individuals with DM2. Objectives This study aims to identify limitations and current needs in the use of the frailty concept in PCDM2 (people with DM2), as well as define and evaluate the dimensions that should be included in its routine clinical assessment. Methods A multidisciplinary team of eight health professionals from different hospitals in Spain participated in a process based on the nominal group technique. Results The study identified eight limitations in the assessment of frailty in PCDM2, categorized by importance, and 10 unmet needs related to the diagnosis and follow-up of the disease. Additionally, seven dimensions were identified that should be included in the definition of frail individuals with DM2, prioritized by importance and novelty. Conclusions This article aims to increase knowledge and usage of the frailty concept in individuals with DM2 within the medical community. It also suggests the potential for future projects to develop a consensus definition of frailty tailored to this specific group (AU)
Subject(s)
Humans , Diabetes Mellitus, Type 2/complications , Frailty/diagnosis , Frailty/etiology , Surveys and QuestionnairesABSTRACT
INTRODUCTION: People with type 2 diabetes mellitus (DM2) have a higher prevalence of frailty compared to those without DM2. However, there is a lack of consensus on the diagnosis and clinical management of frail individuals with DM2. OBJECTIVES: This study aims to identify limitations and current needs in the use of the frailty concept in PCDM2 (people with DM2), as well as define and evaluate the dimensions that should be included in its routine clinical assessment. METHODS: A multidisciplinary team of eight health professionals from different hospitals in Spain participated in a process based on the nominal group technique. RESULTS: The study identified eight limitations in the assessment of frailty in PCDM2, categorized by importance, and 10 unmet needs related to the diagnosis and follow-up of the disease. Additionally, seven dimensions were identified that should be included in the definition of frail individuals with DM2, prioritized by importance and novelty. CONCLUSIONS: This article aims to increase knowledge and usage of the frailty concept in individuals with DM2 within the medical community. It also suggests the potential for future projects to develop a consensus definition of frailty tailored to this specific group.
Subject(s)
Diabetes Mellitus, Type 2 , Frailty , Humans , Aged , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Frailty/diagnosis , Frailty/epidemiology , Frail Elderly , Prevalence , ConsensusABSTRACT
Este documento de posicionamiento describe los aspectos más relevantes e imprescindibles sobre la valoración integral y multidimensional del anciano hospitalizado. El cambio del patrón demográfico y del perfil epidemiológico de las enfermedades requiere una adaptación de los Servicios de Medicina Interna, que tengan en cuenta las vulnerabilidades de las personas ancianas en este contexto. Una valoración integral y multidimensional y la elaboración multidisciplinar de un plan de atención durante el ingreso pueden tener un impacto para evitar mortalidad, discapacidad e institucionalización al alta. Es necesario que todos los internistas adquiramos competencias para mejorar la experiencia de la hospitalización en la persona mayor y obtengamos mejores resultados en salud en nuestros pacientes. Este documento lo ha desarrollado el Grupo Focal de Envejecimiento y el Grupo de Trabajo de Pluripatología y Edad Avanzada, y está avalado por la Sociedad Española de Medicina Interna (AU)
This position paper describes the most relevant and essential aspects of a comprehensive, multidimensional assessment of hospitalized elderly people. The change in demographic patterns and the epidemiological profiles of diseases makes it necessary for internal medicine departments to adapt in order to take into account the vulnerabilities of the elderly in this context. A comprehensive, multidimensional assessment and the multidisciplinary development of a care plan during hospitalization can have an impact in terms of preventing mortality, disability, and institutionalization at discharge. It is necessary for all internists to acquire skills to improve the hospitalization experience in the elderly and obtain better health outcomes in our patients. This document has been developed by the Focus Group on Aging and the Polypathological and Advanced Age Working Group and endorsed by the Spanish Society of Internal Medicine (AU)
Subject(s)
Humans , Aged , Health Services for the Aged , Integral Healthcare Practice , Hospitalization , Societies, Medical , SpainABSTRACT
This position paper describes the most relevant and essential aspects of a comprehensive, multidimensional assessment of hospitalized elderly people. The change in demographic patterns and the epidemiological profiles of diseases makes it necessary for internal medicine departments to adapt in order to take into account the vulnerabilities of the elderly in this context. A comprehensive, multidimensional assessment and the multidisciplinary development of a care plan during hospitalization can have an impact in terms of preventing mortality, disability, and institutionalization at discharge. It is necessary for all internists to acquire skills to improve the hospitalization experience in the elderly and obtain better health outcomes in our patients. This document has been developed by the Focus Group on Aging and the Polypathological and Advanced Age Working Group and endorsed by the Spanish Society of Internal Medicine.
Subject(s)
Hospitalization , Internal Medicine , Aged , Humans , Aging , SpainABSTRACT
This position paper describes the most relevant and essential aspects of a comprehensive, multidimensional assessment of hospitalized elderly people. The change in demographic patterns and the epidemiological profiles of diseases makes it necessary for internal medicine departments to adapt in order to take into account the vulnerabilities of the elderly in this context. A comprehensive, multidimensional assessment and the multidisciplinary development of a care plan during hospitalization can have an impact in terms of preventing mortality, disability, and institutionalization at discharge. It is necessary for all internists to acquire skills to improve the hospitalization experience in the elderly and obtain better health outcomes in our patients. This document has been developed by the Focus Group on Aging and the Polypathological and Advanced Age Working Group and endorsed by the Spanish Society of Internal Medicine.
ABSTRACT
Introducción. La ecografía es una técnica muy versátil, que permite en tiempo real visualizar múltiples órganos internos y es de inestimable ayuda para la exploración física de los pacientes. Objetivo. Evaluar si la ecografía puede incorporarse en la enseñanza de la medicina y si los alumnos pueden realizar una exploración ecográfica abdominal básica sin un largo periodo de formación. Metodología. Doce estudiantes de medicina recibieron formación en ecografía abdominal básica durante un programa formativo de 15h de duración, que incluía un curso teórico-práctico de 5h y prácticas supervisadas en 20 pacientes seleccionados. Posteriormente realizamos una prueba de evaluación objetiva en la que valoramos la capacidad de los alumnos para obtener los planos ecográficos y detectar diversas enfermedades en 5 pacientes distintos. Resultados. Los estudiantes fueron capaces de identificar correctamente los planos abdominales en más del 90% de las ocasiones. Solo en el corte subcostal derecho para localizar la vesícula este porcentaje fue inferior (80%). La precisión o eficiencia global de la ecografía para el diagnóstico de los hallazgos patológicos relevantes de los enfermos fue superior al 90% (colelitiasis 91,1%; aneurisma de aorta abdominal 100%; esplenomegalia 98,3%; ascitis 100%; vena cava inferior dilatada 100%, y retención aguda de orina 100%). Conclusión. La ecografía puede ser una herramienta formativa en la enseñanza de la medicina y puede ayudar a los alumnos a mejorar la exploración física (AU)
Introduction. Ultrasound is a very versatile diagnostic modality that permits real-time visualization of multiple internal organs. It is of invaluable help for the physical examination of the patients. Aim. To assess if ultrasound can be incorporated into medical education and if the students can perform a basic abdominal ultrasound examination without the necessity of a long period of training. Methodology. Twelve medical students were trained in basic abdominal ultrasound during a 15-hour training program including a 5-hour theoretical and practical course and supervised practice in 20 selected patients. Subsequently, we conducted an evaluation test that assessed the ability of students to obtain the ultrasound views and to detect various pathologies in five different patients. Results. The students were able to correctly identify the abdominal views more than 90% of the times. This percentage was only lower (80%) in the right subcostal view to locate the gallbladder. The accuracy or global efficiency of the ultrasound for the diagnosis of relevant pathological findings of the patients was greater than 90% (91.1% gallstones, abdominal aortic aneurysm 100%; splenomegaly 98.3%, ascites 100%; dilated inferior vena cava 100%; acute urinary retention 100%). Conclusion. The ultrasound may be a feasible learning tool in medical education. Ultrasound can help students to the improve the physical examination (AU)
Subject(s)
Humans , Male , Female , Adult , Ultrasonography/methods , Education/methods , Education/trends , Training Support/organization & administration , Training Support/standards , Education, Medical, Continuing/methods , Education, Medical, Continuing/trends , Cholelithiasis , Aneurysm , Aortic Aneurysm , Splenomegaly , Ascites , Vena Cava, Inferior , Urinary RetentionABSTRACT
INTRODUCTION: Ultrasound is a very versatile diagnostic modality that permits real-time visualization of multiple internal organs. It is of invaluable help for the physical examination of the patients. AIM: To assess if ultrasound can be incorporated into medical education and if the students can perform a basic abdominal ultrasound examination without the necessity of a long period of training. METHODOLOGY: Twelve medical students were trained in basic abdominal ultrasound during a 15-h training program including a 5-h theoretical and practical course and supervised practice in 20 selected patients. Subsequently, we conducted an evaluation test that assessed the ability of students to obtain the ultrasound views and to detect various pathologies in five different patients. RESULTS: The students were able to correctly identify the abdominal views more than 90% of the times. This percentage was only lower (80%) in the right subcostal view to locate the gallbladder. The accuracy or global efficiency of the ultrasound for the diagnosis of relevant pathological findings of the patients was greater than 90% (91.1% gallstones, abdominal aortic aneurysm 100%; splenomegaly 98.3%, ascites 100%; dilated inferior vena cava 100%; acute urinary retention 100%). CONCLUSION: The ultrasound may be a feasible learning tool in medical education. Ultrasound can help students to improve the physical examination.
Subject(s)
Abdomen/diagnostic imaging , Education, Medical, Undergraduate/methods , Students, Medical , Ultrasonography/methods , Clinical Competence , Educational Measurement , Feasibility Studies , Humans , Physical Examination/methods , Pilot ProjectsABSTRACT
No disponible
Subject(s)
Female , Aged, 80 and over , Humans , Brain Neoplasms/diagnosis , Neoplasms, Neuroepithelial/diagnosis , Fatal Outcome , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Paresis/etiology , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Scleroderma, Systemic/diagnosis , Scleroderma, Systemic/drug therapy , RNA Polymerase I , Leukocytosis/diagnosis , Respiratory Insufficiency/complications , Respiratory Insufficiency/diagnosis , Ofloxacin/therapeutic use , Tomography, Emission-Computed/methods , Cyclophosphamide/therapeutic use , Lung Diseases, Interstitial/diagnosis , Thorax/pathology , Scleroderma, Systemic/complications , Thorax , Thoracoscopy , Lung Diseases, Interstitial/drug therapySubject(s)
Brain Infarction/etiology , Factor V/analysis , Infarction/etiology , Kidney/blood supply , Adult , Female , HumansABSTRACT
No disponible
Subject(s)
Female , Adult , Humans , Factor V/analysis , Infarction/etiology , Kidney/blood supply , Cerebral Infarction/etiologySubject(s)
Multiple Myeloma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Plasmacytoma/diagnosis , Ribs , Thoracic Neoplasms/diagnosis , Aged , Chest Pain/etiology , Humans , Male , Multiple Myeloma/complications , Neoplasms, Multiple Primary/complications , Plasmacytoma/complications , Thoracic Neoplasms/complicationsABSTRACT
No disponible
