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Interna medicine

Amado Jiménez-Ruiz, Omar Cárdenas-Sáenz, José Luis Ruiz-Sandoval
Introduction: Symmetric, bilateral basal ganglia calcification is rare finding that sometimes occurs asymptomatically. Its prevalence increases with age, and the most affected site is the globus pallidus. Report of cases: A series of seven cases with clinical and imaging diagnosis of basal ganglia calcification, recorded during the 2012 to 2016 period at the Department of Internal Medicine of the Hospital Civil de Guadalajara "Fray Antonio Alcalde, is presented...
2018: Gaceta Médica de México
J Ena, R Gómez-Huelgas, B C Gracia-Tello, P Vázquez-Rodríguez, J N Alcalá-Pedrajas, F J Carrasco-Sánchez, B Murcia-Casas, M Romero-Sánchez, J V Segura-Heras, J Carretero
OBJECTIVES: We developed a predictive model for the hospital readmission of patients with diabetes. The objective was to identify the frail population that requires additional strategies to prevent readmissions at 90 days. METHODS: Using data collected from 1977 patients in 3 studies on the national prevalence of diabetes (2015-2017), we developed and validated a predictive model of readmission at 90 days for patients with diabetes. RESULTS: A total of 704 (36%) readmissions were recorded...
May 4, 2018: Revista Clínica Española
R Monte-Secades, E Montero-Ruiz, J Feyjoo-Casero, M González-Anglada, M Freire-Romero, A Gil-Díaz, A Granados-Maturano, D Rubal-Bran, R Rabuñal-Rey, L Nevado Lopez-Alegria
OBJECTIVE: To analyse the activity of interconsultations conducted by internal medicine (IM) departments, their formal aspects and the profile of clinical care required and to quantify the workload they represent. MATERIAL AND METHOD: A multicentre, observational prospective study was conducted with consecutive hospitalised patients treated by IM departments using interconsultations between May 15 and June 15, 2016. We estimated the workload related to this activity (1time unit [TU]=10min)...
April 24, 2018: Revista Clínica Española
J Torres Macho, F J García Sánchez, P Garmilla Ezquerra, L Beltrán Romero, J Canora Lebrato, J M Casas Rojo, P Arribas Arribas, S López Palmero, S Pintos Martínez, J M Cepeda Rodrigo, D Luordo, M Beltrán López, M Méndez Bailón, E Rodilla Sala, L Manzano Espinosa, A Zapatero Gaviria, G García de Casasola
This positioning document describes the most important aspects of clinical ultrasonography in the internal medicine setting, from its fundamental indications to the recommended training period. There is no question as to the considerable usefulness of this tool in the standard clinical practice of internists in numerous clinical scenarios and settings (emergencies, hospital ward, general and specific consultations and home care). Ultrasonography has a relevant impact on the practitioner's ability to resolve issues, increasing diagnostic reliability and safety and providing important information on the prognosis and progression...
May 2018: Revista Clínica Española
C Franchi, I Ardoino, A Nobili, L Pasina, P M Mannucci, A Marengoni, F Perticone
PURPOSE: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. METHODS: People aged 65 years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy)...
December 2017: Pharmacoepidemiology and Drug Safety
Nedra Badri, Maroua Mhamdi, Ridha Ben Ali, Horea Matei, Walid-Habib Tekaya, Adrian Florea, Samira Maghraoui, Leila Tekaya
Gold, a heavy yellow-colored metal, is usually found in nature as a metallic element or as salts. This noble metal historically had a reputation as an anti-inflammatory medicine for rheumatoid arthritis, a nervine, and a remedy for nervous disorders, as well as a potential anticancer agent. It has also been used as component in dental restorations and in implant materials. The present study was undertaken to point out histological and ultrastructural effects of gold, administered by intraperitoneal route, in pregnant female reproductive organs (ovary and uterus), in order to clarify its side effects on the reproductive function...
June 2018: Biological Trace Element Research
E Casariego-Vales, A Zapatero-Gaviria, F J Elola-Somoza
The Spanish Society of Internal Medicine has developed a consensus document on the standards and recommendations that they consider essential to the organisation of internal medicine units for conducting their activities efficiently and with high quality. We defined 3 groups of key processes: the care of acutely ill adult patients, the comprehensive care of complex chronic patients and the examination of a patient with a difficult diagnosis and no organ-specific disease. As support processes, we identified the structure and operation of the Internal Medicine units...
December 2017: Revista Clínica Española
R Monte-Secades, M Blanco-Soto, J A Díaz-Peromingo, A Sanvisens-Bergé, M C Martín-González, A Barbosa, B Rosón-Hernández, M A Tejero-Delgado, R Puerta-Louro, R Rabuñal-Rey
OBJECTIVES: To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). MATERIAL AND METHODS: A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens...
October 2017: Revista Clínica Española
Jesús Díez-Manglano, Jesús Recio Iglesias, José Manuel Varela Aguilar, Pere Almagro Mena, Gabriel Zubillaga Garmendia
BACKGROUND AND OBJECTIVE: To determine the effectiveness of a simple educational intervention to improve the management of cardiovascular comorbidities in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: Multicenter study participated in by 26 hospital centers. A panel of experts elaborated a set of recommendations about diagnostic and therapeutic management of acute exacerbation of COPD and cardiovascular comorbidities (coronary artery disease, atrial fibrillation, heart failure and diabetes)...
September 20, 2017: Medicina Clínica
Marco Bertolotti, Carlotta Franchi, Marco B L Rocchi, Andrea Miceli, M Vittoria Libbra, Alessandro Nobili, Giulia Lancellotti, Lucia Carulli, Chiara Mussi
BACKGROUND: Older patients are prone to multimorbidity and polypharmacy, with an inherent risk of adverse events and drug interactions. To the best of our knowledge, available information on the appropriateness of lipid-lowering treatment is extremely limited. AIM: The aim of the present study was to quantify and characterize lipid-lowering drug use in a population of complex in-hospital older patients. METHODS: We analyzed data from 87 units of internal medicine or geriatric medicine in the REPOSI (Registro Politerapie della Società Italiana di Medicina Interna) study, with reference to the 2010 and 2012 patient cohorts...
April 2017: Drugs & Aging
Jordi Pérez-López, Leticia Ceberio-Hualde, José Salvador García Morillo, Josep M Grau-Junyent, Álvaro Hermida Ameijeiras, Mónica López-Rodríguez, Montserrat Morales-Conejo, Juan José Nava Mateos, Luis José Aldámiz Echevarri Azuara, Jaume Campistol, M Luz Couce, María Teresa García-Silva, Luis González Gutiérrez-Solana, Mireia Del Toro
BACKGROUND AND OBJECTIVE: The transition process from paediatric to adult care is a subject of great interest in recent years, especially in chronic diseases with childhood onset, such as inborn errors of metabolism (IEM). Advances in diagnosis and treatment of these diseases have improved their prognosis, with a high number of patients with IEM who currently reach adult age and need to be attended to by non-paediatric professionals. The objective of this work is to establish action guidelines so that the specialists involved can guarantee a successful transition of these patients' healthcare...
December 2, 2016: Medicina Clínica
J Ena, R Gómez-Huelgas, A Zapatero-Gaviria, P Vázquez-Rodriguez, C González-Becerra, M Romero-Sánchez, M J Igúzquiza-Pellejero, A Artero-Mora, J M Varela-Aguilar
OBJECTIVES: We evaluated the effect of an intervention on certain quality indicators employed for improving the treatment of hospital hyperglycemia. MATERIAL AND METHODS: A multicenter cross-sectional study was conducted on patients with hyperglycemia hospitalized in the internal medicine departments of 44 hospitals evaluated in 2 time periods: 2014 (baseline period) and 2015 (postintervention period). The intervention consisted of the dissemination of the indicators obtained in 2014 and the objectives for improvement...
October 2016: Revista Clínica Española
P Mazón, E Galve, J Gómez, M Gorostidi, J L Górriz, J D Mediavilla
INTRODUCTION: The opinion of experts (different specialties) on the triple fixed-dose antihypertensive therapy in clinical practice may differ. MATERIALS AND METHODS: Online questionnaire with controversial aspects of the triple therapy answered by panel of experts in hypertension (HT) using two-round modified Delphi method. RESULTS: The questionnaire was completed by 158 experts: Internal Medicine (49), Nephrology (26), Cardiology (83). Consensus was reached (agreement) on 27/45 items (60%); 7 items showed differences statistically significant...
October 2016: Hipertensión y Riesgo Vascular
R Monte-Secades, E Montero-Ruiz, A Gil-Díaz, J Castiella-Herrero
Medical interconsultation for hospitalised patients is a regular activity among internal medicine specialists. However, despite its growing impact and importance, a model that defines its characteristics, objectives and information has not been established. This study, conducted by the Shared Care and Interconsultations Group of the Spanish Society of Internal Medicine, proposes a number of general recommendations concerning the method for requesting and responding to hospital medical interconsultations, as well as a format for these interconsultations...
January 2016: Revista Clínica Española
E Montero Ruiz
Surgical departments have increasing difficulties in caring for their hospitalised patients due to the patients' advanced age and comorbidity, the growing specialisation in medical training and the strong political-healthcare pressure that a healthcare organisation places on them, where surgical acts take precedence over other activities. The pressure exerted by these departments on the medical area and the deficient response by the interconsultation system have led to the development of a different healthcare organisation model: Shared care, which includes perioperative medicine...
January 2016: Revista Clínica Española
Mónica P González-Ramírez, Karla Miravete-Lagunes, Andrés Gómez-de-León, Sergio Ponce-de-León, Andrea P Tenorio-Rojo, Nora A Martagón-Herrera, Jesús A Hernández-Reyes, Arturo García-Villasenor, Esteban Burguette, María Fernanda Vallejo-Villalobos, Guillermo J Ruiz-Delgado, David Gómez-Almaguer, Guillermo J Ruiz-Argüelles
BACKGROUND: Quality of life (QOL) is an important consideration in the counseling, implementation, and post-treatment management of arduous treatments for life-threatening conditions such as allogeneic hematopoietic cell transplantation (allo-HCT). OBJECTIVE: To analyze the QOL of leukemia patients allografted with the Mexican reduced-intensity conditioning regimen in two Mexican academic medical centers. MATERIAL AND METHODS: By means of the quality metric short form 36 version 2 to measure generic health concepts, relevant QOL was analyzed in leukemia patients who underwent allo-HCT using reduced-intensity conditioning on an outpatient basis at either the Centro de Hematología y Medicina Interna de Puebla of the Clínica Ruiz or the Hematology Service of the Internal Medicine Department of the Hospital "Dr...
March 2015: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
E Montero Ruiz, R Monte Secades
The inpatient profile is changing towards patients with multiple diseases, the elderly and those with high comorbidity. The growing complexity of their care, the progressive medical superspecialization and the organizational problems that often hinder daily patient follow-up by the same physician have contributed to a progressive increase in the participation of medical departments, especially Internal Medicine, in the care of patients hospitalized in other medical and surgical specialties. The hospital activities that the departments of internal medicine perform outside of their own department do not have well-established definitions and criteria at the organizational level; their assessment and accountability are different in each hospital...
April 2015: Revista Clínica Española
Laura De La Higuera, Emma Riva, Codjo Djignefa Djade, Sara Mandelli, Carlotta Franchi, Alessandra Marengoni, Francesco Salerno, Salvatore Corrao, Luca Pasina, Mauro Tettamanti, Maura Marcucci, Pier Mannuccio Mannucci, Alessandro Nobili
A multicenter observational study, REPOSI (REgistro POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital re-admission and death within 3 months, in a sample of elderly patients (n = 1,363) admitted to 66 internal medicine and geriatric wards. Based on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hospital admission were classified into three groups: group 1 with normal eGFR (≥60 ml/min/1...
October 2014: Internal and Emergency Medicine
Joan Carles Trullàs, José Luís Morales-Rull, Francesc Formiga
Many of the primary clinical manifestations of heart failure (HF) are due to fluid retention, and treatments targeting congestion play a central role in HF management. Diuretic therapy remains the cornerstone of congestion treatment, and diuretics are prescribed to the majority of HF patients. Despite this ubiquitous use, there is limited evidence from prospective randomized studies to guide the use of diuretics. With the chronic use of diuretic and usually in advanced stages of HF, diuretics may fail to control salt and water retention...
February 20, 2014: Medicina Clínica
J Casademont, J M Porcel, J A Vargas Núñez, J González Macías
BACKGROUND AND OBJECTIVES: One of the core subjects in university training of the physicians has been General Pathology. Responsibility for this has historically fallen on Internal Medicine specialists. However, we are unaware if this situation is currently maintained. METHODS: A questionnaire was sent to the coordinators of the subject of the 39 Spanish medical schools to know, among other things, the current denomination of the subjects (traditionally known as «General Pathology»), number of credits, teaching activities included in the subject and number and specialty of the professors responsible for it...
December 2013: Revista Clínica Espanõla
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