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1.
Semergen ; 49(7): 102030, 2023 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-37487423

RESUMO

Venous thromboembolic disease (VTE) is a frequent complication in patients diagnosed with cancer and a cause of morbidity and mortality. Approximately 20% of thromboembolic episodes develop in association with active cancer. On the other hand, it is estimated that about 2-12% of cases, the thromboembolic episode is the first manifestation of an occult cancer, diagnosed at that time or subsequently, which offers an opportunity for early diagnosis and treatment. There are multiple factors that contribute to increase the risk of VTE in oncological patients in relation to specific characteristics of the patient, the tumor and the treatments. Knowledge of these risk factors will contribute to early diagnosis when signs of VTE appear, as well as the assessment of thromboprophylaxis if indicated. The diagnosis of VTE in patients with cancer does not differ of those who do not suffer from it. Regarding the treatment of VTE in these patients, low molecular weight heparin (LMWH), direct acting anticoagulants (DACs) and antivitamin K (VKA) are the most commonly used, although the dosing regimen and length are not clear yet. The management of these patients should be interdisciplinary and early, so the primary care physician plays a key role in this process as he/she is liaise with his/her patients. It is also necessary to update knowledge in order to improve the care of these patients. For these reasons, this document has been prepared by the Working Group on Vasculopathies of the Spanish Society of Primary Care Physicians (SEMERGEN) whose objective is to present the available information regarding the management of VTE that may appear in oncological patients, as well as the assessment of thromboprophylaxis and treatment, if appropriate, from an approach focused on a primary care field.


Assuntos
Neoplasias , Tromboembolia Venosa , Humanos , Feminino , Masculino , Anticoagulantes/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Atenção Primária à Saúde
2.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 48(5): 344-355, Jul. - Ago. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-205251

RESUMO

La enfermedad venosa crónica (EVC) es la enfermedad vascular más frecuente en el ser humano y sigue siendo infradiagnosticada e infratratada en todos los niveles asistenciales. Los nuevos tiempos que vivimos suponen un aumento de la incertidumbre entre los pacientes crónicos sobre su diagnóstico, tratamiento y seguimiento por parte de los médicos de familia y especialmente en la EVC. Con el fin de abordar estos nuevos tiempos, el Grupo de Vasculopatías de Semergen ha diseñado el cuestionario Venocheck, que valora aspectos etiológicos, clínicos (clasificación CEAP), de severidad y calidad de vida, terapéuticos, presencia de complicaciones y criterios de derivación (AU)


Chronic venous disease (CVD) is the most common vascular disease in humans and continues to be underdiagnosed and undertreated at all levels of care. The new times we live in have led to an increase in uncertainty among chronic patients about their diagnosis, treatment and follow-up by family doctors and especially in CVD. In order to analyze these new times, the Semergen Vasculopathies Group has created the Venocheck questionnaire, which assesses aetiological, clinical (CEAP classification), severity and quality of life, therapeutic aspects, presence of complications and referral criteria (AU)


Assuntos
Humanos , Doenças Vasculares/diagnóstico , Doenças Vasculares/terapia , Insuficiência Venosa/diagnóstico , Insuficiência Venosa/terapia , Inquéritos e Questionários , Doença Crônica , Fatores de Risco , Qualidade de Vida
3.
Semergen ; 48(5): 344-355, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35618620

RESUMO

Chronic venous disease (CVD) is the most common vascular disease in humans and continues to be underdiagnosed and undertreated at all levels of care. The new times we live in have led to an increase in uncertainty among chronic patients about their diagnosis, treatment and follow-up by family doctors and especially in CVD. In order to analyze these new times, the Semergen Vasculopathies Group has created the Venocheck questionnaire, which assesses aetiological, clinical (CEAP classification), severity and quality of life, therapeutic aspects, presence of complications and referral criteria.


Assuntos
Doenças Vasculares , Insuficiência Venosa , Doença Crônica , Humanos , Qualidade de Vida , Doenças Vasculares/diagnóstico , Doenças Vasculares/epidemiologia , Doenças Vasculares/etiologia , Veias , Insuficiência Venosa/diagnóstico , Insuficiência Venosa/epidemiologia , Insuficiência Venosa/terapia
4.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 48(4): 235-244, mayo - jun. 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-205235

RESUMO

Introducción: La prevalencia de la enfermedad renal crónica (ERC) ha aumentado a nivel global (8-16%), debido principalmente a la incidencia de diabetes mellitus tipo 2 (DM2) y de hipertensión arterial (HTA). La educación o formación de los pacientes con enfermedades crónicas se considera una herramienta fundamental para prevenir el empeoramiento de estas. Objetivos: 1) Determinar si la asistencia a la formación de pacientes con hipertensión y/o diabetes, influye en la progresión o el desarrollo del deterioro de la función renal. 2) Valorar la asociación de la función renal con HTA, DM2 y la aparición de eventos cardiovasculares, analizando la influencia del grado de control de la presión arterial (PA) y la hemoglobina glicada (HbA1c). 3) Estudiar la aparición de eventos cardiovasculares. Material y métodos: Estudio observacional analítico de cohortes retrospectivo llevado a cabo en un Centro de Salud de Leganés, Madrid, utilizando bases de datos de pacientes con hipertensión, diabetes y ambas patologías a la vez (n = 200), asistentes o no a la formación del equipo médico durante los años 2017 a 2019. Resultados: Recibieron formación 120 de 200 pacientes (67,5% mujeres). Sólo en estos se observó una mejoría de la función renal acompañada de una reducción de las cifras de presión arterial (PA) y HbA1c, donde se apreció un mejor control y seguimiento de la enfermedad, siendo más destacada en pacientes con una sola patología, especialmente aquellos con hipertensión. Conclusiones: La formación de los pacientes resultó beneficiosa para prevenir el deterioro de la función renal, mediante la reducción de las cifras de PA y HbA1c, y fue más evidente en aquellos que partieron de un peor control de ambas. Se demostró la asociación de la evolución de la función renal con HTA y DM2 (AU)


Introduction: The prevalence of chronic kidney disease has increased globally (8–16%), mainly due to the incidence of type 2 diabetes mellitus (DM2) and hypertension (HT). Education or training programs for patients with chronic diseases is considered a fundamental tool to prevent their worsening. Objectives: (1) To determine whether attendance at training for patients with HT and/or diabetes affects the progression of the deterioration of renal function. (2) To assess the association of renal function with HT, DM2 and the occurrence of cardiovascular events, analyzing the influence of the control degree of blood pressure (BP) and glycated hemoglobin (HbA1c). (3) To study the occurrence of cardiovascular events. Material and methods: Retrospective analytical observational cohort study carried out in a Primary Care Center in Leganés, Madrid, using databases of patients with HT, diabetes and both pathologies simultaneously (n = 200), attending or not to the training of the medical team during the years 2017–2019. Results: 120 of 200 patients received training (60% women). Only in these patients, an improvement of renal function was observed. This was accompanied by a reduction in BP and HbA1c levels, being more prominent in patients with a single pathology, especially hypertensive patients. Conclusions: Training of patients was beneficial to prevent the deterioration of renal function, by means of the reduction of the BP and HbA1c. It was more evident in those who started from a worse control of both parameters. Association of renal function evolution with HT and DM2 was demonstrated (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Atenção Primária à Saúde , Estudos Retrospectivos , Estudos de Coortes , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/prevenção & controle , Hemoglobinas Glicadas/uso terapêutico , Hipertensão/complicações , Hipertensão/epidemiologia
5.
Semergen ; 48(4): 235-244, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35151555

RESUMO

INTRODUCTION: The prevalence of chronic kidney disease has increased globally (8-16%), mainly due to the incidence of type 2 diabetes mellitus (DM2) and hypertension (HT). Education or training programs for patients with chronic diseases is considered a fundamental tool to prevent their worsening. OBJECTIVES: (1) To determine whether attendance at training for patients with HT and/or diabetes affects the progression of the deterioration of renal function. (2) To assess the association of renal function with HT, DM2 and the occurrence of cardiovascular events, analyzing the influence of the control degree of blood pressure (BP) and glycated hemoglobin (HbA1c). (3) To study the occurrence of cardiovascular events. MATERIAL AND METHODS: Retrospective analytical observational cohort study carried out in a Primary Care Center in Leganés, Madrid, using databases of patients with HT, diabetes and both pathologies simultaneously (n = 200), attending or not to the training of the medical team during the years 2017-2019. RESULTS: 120 of 200 patients received training (60% women). Only in these patients, an improvement of renal function was observed. This was accompanied by a reduction in BP and HbA1c levels, being more prominent in patients with a single pathology, especially hypertensive patients. CONCLUSIONS: Training of patients was beneficial to prevent the deterioration of renal function, by means of the reduction of the BP and HbA1c. It was more evident in those who started from a worse control of both parameters. Association of renal function evolution with HT and DM2 was demonstrated.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipertensão , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobinas Glicadas , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/terapia , Rim/fisiologia , Masculino , Atenção Primária à Saúde , Estudos Retrospectivos
6.
Semergen ; 47(4): 256-266, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34112594

RESUMO

Giant cell arteritis is a systemic vasculitis with significant intra and extracranial involvement that, with early diagnosis and treatment in primary care, can improve its prognosis as it is a medical emergency. Our working group on vascular diseases of the Spanish Society of Primary Care Physicians (SEMERGEN) proposes a series of recommendations based on current scientific evidence for a multidisciplinary approach and follow-up in primary care.


Assuntos
Arterite de Células Gigantes , Médicos de Atenção Primária , Humanos , Atenção Primária à Saúde , Prognóstico
7.
Semergen ; 47(6): 361-368, 2021 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-33810943

RESUMO

INTRODUCTION: Patients suffering from coronavirus infection have an increased risk of venous thromboembolic disease (VTE) associated with COVID-19, which confers a higher risk of mortality. For this reason, it is necessary to analyze the knowledge and the different actions in the management of thromboprophylaxis in work environments. MATERIAL AND METHODS: Observational, descriptive and cross-sectional study with data collection through a Google® form with 19 questions for professionals involved in the care of COVID-19. 414 surveys were received. The quantitative variables were represented with means and standard deviation and the qualitative variables with percentages and confidence intervals. RESULTS: 414 surveys analyzed. 58.2% were women. The most participatory age group was 56-65 years. 95.2% stated that COVID-19 patients had a higher risk of VTE and peripheral arterial microthrombosis. 93.6% considered that outpatient COVID-19 patients should receive thromboprophylaxis. 60.5% of the physicians did not know any protocol for the evaluation of thrombotic risk in these patients. Low molecular weight heparin was considered the main treatment for thromboprophylaxis. CONCLUSIONS: The majority of doctors consider that COVID-19 patients have a higher risk of suffering VTE and peripheral arterial microthrombosis than the general population, however more than a third do not assess the thrombotic risk and a significant percentage claim not to know protocols to evaluate said risk. The survey highlights the training needs of our professionals in thromboprophylaxis so that our patients receive healthcare with the highest possible quality.


Assuntos
COVID-19 , Tromboembolia Venosa , Idoso , Anticoagulantes , Estudos Transversais , Atenção à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Espanha , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/prevenção & controle
10.
Semergen ; 46(7): 479-486, 2020 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-33046353

RESUMO

The new coronavirus (SARS-CoV-2) is responsible for a severe acute respiratory syndrome. Among its manifestations, it can develop a thrombotic disease, both venous and arterial, due to excessive inflammation that affects the vascular system, with platelet activation and endothelial dysfunction, among other mechanisms. Thrombosis is associated with SARS-CoV-2 infection, increasing its severity and conferring a worse prognosis. Our performance as Family Physicians can contribute important actions in the management and control of this severe complication. Considering that many of our patients already receive antithrombotic or anticoagulant therapy, the fact that they may develop a COVID-19 infection will have implications for the choice, dosage and control of their treatment. In this document we review, with the information currently available, the relationship between disease caused by SARS-CoV-2 and thrombosis, as well as its management with a focus on Primary Care.


Assuntos
Anticoagulantes/administração & dosagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Medicina de Família e Comunidade/métodos , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Atenção Primária à Saúde/métodos , Trombose/prevenção & controle , Tromboembolia Venosa/prevenção & controle , Anticoagulantes/uso terapêutico , Betacoronavirus , COVID-19 , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Medição de Risco , SARS-CoV-2 , Trombose/virologia , Tromboembolia Venosa/virologia
11.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(7): 479-486, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194386

RESUMO

El nuevo coronavirus (SARS-CoV-2) es el responsable de un síndrome respiratorio agudo severo (SARS). Entre sus manifestaciones puede desarrollar una enfermedad trombótica, tanto venosa como arterial, debido a la inflamación excesiva que afecta al sistema vascular, con activación plaquetaria y disfunción endotelial, entre otros mecanismos. La trombosis se asocia a la infección producida por el SARS- CoV-2, aumentando su gravedad y confiriendo un peor pronóstico. Nuestra actuación como Médicos de Familia puede aportar acciones importantes en el manejo y control de esta severa complicación. Teniendo en cuenta que muchos de nuestros pacientes ya reciben terapia antitrombótica o anticoagulante, el hecho de que puedan desarrollar una infección por COVID-19 tendrá implicaciones para la elección, la dosificación y el control en su tratamiento. En este documento, revisamos, con la información actualmente disponible, la relación entre enfermedad producida por el SARS-CoV-2 y trombosis, así como su manejo con un enfoque centrado en Atención Primaria


The new coronavirus (SARS-CoV-2) is responsible for a severe acute respiratory syndrome. Among its manifestations, it can develop a thrombotic disease, both venous and arterial, due to excessive inflammation that affects the vascular system, with platelet activation and endothelial dysfunction, among other mechanisms. Thrombosis is associated with SARS-CoV-2 infection, increasing its severity and conferring a worse prognosis. Our performance as Family Physicians can contribute important actions in the management and control of this severe complication. Considering that many of our patients already receive antithrombotic or anticoagulant therapy, the fact that they may develop a COVID-19 infection will have implications for the choice, dosage and control of their treatment. In this document we review, with the information currently available, the relationship between disease caused by SARS-CoV-2 and thrombosis, as well as its management with a focus on Primary Care


Assuntos
Humanos , Infecções por Coronavirus/complicações , Tromboembolia/prevenção & controle , Síndrome Respiratória Aguda Grave/complicações , Fibrinolíticos/administração & dosagem , Anticoagulantes/administração & dosagem , Inibidores da Agregação Plaquetária/administração & dosagem , Consenso , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave/patogenicidade , Pandemias/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco
13.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 45(3): 187-196, abr. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192742

RESUMO

La trombosis venosa superficial de miembros inferiores se venía considerando como una patología de naturaleza benigna con un curso clínico autolimitado, actualmente se conoce que sus potenciales complicaciones pueden ser graves o incluso mortales como pueden ser la trombosis venosa profunda o el tromboembolismo pulmonar. Existen diferentes formas de presentación clínica, factores de riesgo y diferentes tratamientos para su abordaje principalmente en Atención Primaria. Nuestro grupo de trabajo de vasculopatías de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) ha elaborado esta actualización con la evidencia científica actual de forma conjunta con el Capítulo Español de Flebología y Linfología de la Sociedad Española de Angiología y Cirugía Vascular


Superficial vein thrombosis of the lower limbs used to be considered a benign condition with a self-limiting clinical course. It is now known that its potential complications can be serious or even fatal, such as deep vein thrombosis or pulmonary thromboembolism. There are different forms of clinical presentation, risk factors and different treatments for its approach, mainly in Primary Care. The Vascular Diseases Working Group of the Spanish Society of Primary Care Physicians (SEMERGEN) has developed this update using current scientific evidence and jointly with the Spanish Chapter of Phlebology and Lymphology of the Spanish Society of Angiology and Vascular Surgery


Assuntos
Humanos , Atenção Primária à Saúde/métodos , Trombose Venosa/diagnóstico , Trombose Venosa/terapia , Terapia Combinada , Extremidade Inferior , Fatores de Risco , Sociedades Médicas , Espanha/epidemiologia , Trombose Venosa/complicações , Trombose Venosa/epidemiologia
14.
Semergen ; 45(3): 187-196, 2019 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-30522812

RESUMO

Superficial vein thrombosis of the lower limbs used to be considered a benign condition with a self-limiting clinical course. It is now known that its potential complications can be serious or even fatal, such as deep vein thrombosis or pulmonary thromboembolism. There are different forms of clinical presentation, risk factors and different treatments for its approach, mainly in Primary Care. The Vascular Diseases Working Group of the Spanish Society of Primary Care Physicians (SEMERGEN) has developed this update using current scientific evidence and jointly with the Spanish Chapter of Phlebology and Lymphology of the Spanish Society of Angiology and Vascular Surgery.


Assuntos
Atenção Primária à Saúde/métodos , Trombose Venosa/diagnóstico , Trombose Venosa/terapia , Terapia Combinada , Humanos , Extremidade Inferior , Fatores de Risco , Sociedades Médicas , Espanha/epidemiologia , Trombose Venosa/complicações , Trombose Venosa/epidemiologia
19.
Aten Primaria ; 36(5): 248-53, 2005 Sep 30.
Artigo em Espanhol | MEDLINE | ID: mdl-16194492

RESUMO

OBJECTIVE: To know different blood pressure (BP) measurement devices used in primary care (PC). DESIGN: Cross-sectional study, multilocated, with a non probabilistic sample of consecutive cases selection, all over the country. SETTING: Primary care practices from all the country. PARTICIPANTS: PC patients treated and they all were of age. METHODS: Two consecutive BP measures were made and measurement devices used in this process by physicians were booked. RESULTS: In this study participated 3592 PC physicians, BP were measured to 14,137 subjects. To a 69.8% of subjects BP were measured with a mercury sphygmomanometer; 16.5% with an electronic device; 11.8% with an aneroid manometer; and a 1.9% were measured with more than one measurement method. In rural environmental, electronic devices and aneroid manometer were used more, and some differences were noted in the different self ruled community in our country. There were differences in BP values in order to measurement methods, a third measurement was made often by physicians who managed electronic devices, and utilization of digits 0 and 5 was higher when measurement method was not an electronic device. CONCLUSIONS: In PC office, mercury sphygmomanometer is being used preferably and that aneroid manometers are still in use. Their utilization involves important bias in measurement process, so that electronic devices should be promoted.


Assuntos
Determinação da Pressão Arterial/instrumentação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , População Rural , Estudos de Amostragem , Espanha
20.
Aten. prim. (Barc., Ed. impr.) ; 36(5): 248-253, sept. 2005. tab
Artigo em Es | IBECS | ID: ibc-042001

RESUMO

Objetivo. Conocer diferentes aparatos de medida de la presión arterial (PA) utilizados en atención primaria (AP). Diseño. Estudio transversal, multicéntrico, con muestreo no probabilístico de selección de casos consecutivos. Emplazamiento. Consultas de atención primaria de todo el Estado. Participantes. Pacientes hipertensos tratados > 18 años de edad. Métodos. Se hicieron 2 medidas consecutivas de PA y se anotaron los aparatos de medida utilizados. Resultados. Participaron en el estudio 3.592 médicos de AP que midieron la PA en 14.137 pacientes. En un 69,8% de los pacientes, la PA se midió con un esfigmomanómetro de mercurio, en un 16,5% con un aparato electrónico, en un 11,8% con un manómetro aneroide y en un 1,9% con más de un método de medida. En el medio rural se utilizaron más los aparatos electrónicos y los manómetros aneroides, observándose diferencias en las distintas comunidades autónomas de nuestro país. Había diferencias en los valores de PA según el método de medida; la tercera medida la realizaron con más frecuencia los médicos que empleaban aparatos electrónicos y la utilización de los dígitos 0 y 5 fue mayor cuando el método de medida no era un aparato electrónico. Conclusiones. En las consultas de AP se siguen utilizando preferentemente los esfigmomanómetros de mercurio y también los aparatos aneroides. Su utilización implica sesgos importantes en el proceso de medición: por ello, se debería fomentar el uso de los aparatos electrónicos para medir la PA


Objective. To know different blood pressure (BP) measurement devices used in primary care (PC). Design. Cross-sectional study, multilocated, with a non probabilistic sample of consecutive cases selection, all over the country. Setting. Primary care practics from all the country. Participants. PC patients treated and they all were of age. Methods. Two consecutive BP measures were made and measurement devices used in this process by physicians were booked. Results. In this study participated 3592 PC physicians, BP were measured to 14 137 subjects. To a 69.8% of subjects BP were measured with a mercury sphygmomanometer; 16.5% with an electronic device; 11.8% with an aneroid manometer; and a 1.9% were measured with more than one measurement method. In rural environmental, electronic devices and aneroid manometer were used more, and some differences were noted in the different self ruled community in our country. There were differences in BP values in order to measurement methods, a third measurement was made often by physicians who managed electronic devices, and utilization of digits 0 and 5 was higher when measurement method was not an electronic device. Conclusions. In PC office, mercury sphygmomanometer is being used preferably and that aneroid manometers are still in use. Their utilization involves important bias in measurement process, so that electronic devices should be promoted


Assuntos
Pessoa de Meia-Idade , Humanos , Determinação da Pressão Arterial/instrumentação , Estudos Transversais , Atenção Primária à Saúde , População Rural , Estudos de Amostragem , Espanha
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