Síndrome febril en el paciente de edad avanzada. Estrategias diagnósticas / Febrile syndrome in an elderley patient

El síndrome febril en la persona de edad avanzadarespecto al adulto joven tiene una expresión clinica,una prevalencia de causas específicas y un abordajediagnóstico, que requieren una evaluacióndiferencial. La importancia de este síndrome seincrementa, además, con el aumento de la edad denuestra población, y debe ser considerada en estospacientes siempre como un síntoma de alarma. Encuanto a la etiologia, la arteritis de células giganteses la causa más frecuente de fiebre prolongada sinfoco evidente, seguida –según ambienteepidemiológico– de la tuberculosis y de lasneoplasias hematológicas. No hay consenso sobre elabordaje diagnóstico, pero es imprescindibleconsiderar el principio de no maleficiencia, debido almayor riesgo de complicaciones asociadas a laspruebas invasivas y a la menor tolerancia a éstas

Fever in the elderly as compared with young adultshas a clinical expression, prevalence, and diagnosisthat require a specific type of evaluation. Thesignificance of fever in the elderly gains importancewith the increase of the population’s age and it mustbe considered an alarm signal in these patients.Etiologically, the primary cause of prolonged feverwith unspecific origin in this population, is arteritisof giant cells, followed by (according toepidemiological environment) tuberculosis andhematological neoplasias. There is no consensus ondiagnostic approaches, but it is essential to takegreat care in the process due to risk associated withinvasive tests and low tolerance to them

[Febrile syndrome in an elderly patient]. / Síndrome febril en el paciente de edad avanzada. Estrategias diagnósticas.

Fever in the elderly as compared with young adults has a clinical expression, prevalence, and diagnosis that require a specific type of evaluation. The significance of fever in the elderly gains importance with the increase of the population's age and it must be considered an alarm signal in these patients. Etiologically, the primary cause of prolonged fever with unspecific origin in this population, is arteritis of giant cells, followed by (according to epidemiological environment) tuberculosis and hematological neoplasias. There is no consensus on diagnostic approaches, but it is essential to take great care in the process due to risk associated with invasive tests and low tolerance to them.

[Continuity of medical care. Evaluation of a collaborative program between hospital and Primary Care]. / Continuidad asistencial. Evaluación de un programa de colaboración entre Atención Hospitalaria y Atención Primaria.

The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike.

Bloqueo auriculoventricular completo secundario a toxicidad cardíaca por cloroquina / Complete auriculoventricular block secondary to cardiac toxicity due to chloroquine

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Fiebre de origen desconocido como presentación de arteritis de Takayasu de inicio tardío / Fever of unknown origin as presentation of Takayasu late onset arteritis

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