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101.
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George Kosmadakis Enrique Da Costa Correia Odette Carceles Frederic Somda Didier Aguilera 《Renal failure》2014,36(4):638-650
Despite the significant technical evolution of the blood purification methods, cardiovascular morbidity and mortality in dialysis patients is still several times higher than that observed in the general population. Vitamins are playing a crucial role in multiple key metabolic pathways. Due to multiple factors, dialysis patients present very often hypo- or hypervitaminosis for a broad range of vitamins. Dialysis in the context of renal replacement therapy is associated with a non-physiological potassium-sparing dietetic regime. Additionally, there is a non-selective intradialytic loss of micro- and macronutrients, deranged intracellular kinetics and gastrointestinal malabsorption due to uratemia. Frequent treatment with antibiotics due to infections associated with the acquired uremia-related immunosuppression may derange the vitamin-producing intestinal microflora. Certain agents prescribed in the context of renal failure or other conditions may reduce the absorption of vitamins from the gastrointestinal tract. These factors may deplete a dialysis patient from vitamins, especially the ones with antioxidant activity that may be associated with cardioprotective properties. In other cases, vitamins metabolized and excreted by the kidneys may be accumulated and exert toxic effects. The scope of this paper is to describe the main issues on vitamin therapy in dialysis patients in view of the ever contradictory opinions and practices. 相似文献
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Gonzalo Jr Recondo Enrique Dìaz Canton Màximo de la Vega Martin Greco Gonzalo Sr Recondo Matias E Valsecchi 《World journal of clinical oncology》2014,5(3):440-454
During the last 15 years we have witnessed an unprecedented expansion in the drugs developed to target human epidermal growth factor receptor-2 (HER-2) positive breast cancer. Trastuzumab, pertuzumab, ado-trastuzumab emtansine and lapatinib are currently food and drug administration (FDA)-approved for the treatment of breast cancer patients with HER-2 over-expressed. However, given the amount of information gathered from years of uninterrupted clinical research, it is essential to have periodic updates that succinctly recapitulate what we have learnt over these last years and help us to apply that information in our daily practice. This review will pursue that objective. We will summarize the most relevant and updated information related to the state of the art management of HER-2 positive breast cancer in all the clinical scenarios including the adjuvant, neoadjuvant and metastatic settings. But we will also critically appraise that literature in order to highlight some key clinical concepts that should not be overlooked. Lastly, this review will also point out some of the most promising strategies that are currently being tested and may soon become available. 相似文献
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Escarlata Angullo-Martínez Enrique Carretero-Anibarro Ignacio Manuel Snchez Barrancos Xavier Cos Claramunt Domingo Orozco Beltrn Jos Luis Torres Baile Patxi Ezkurra Loiola en representacin del Grupo de Trabajo de Diabetes de la SemFyC en representacin del Grupo de Trabajo de Diabetes de la SemFyC 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2021,53(4)
Las circunstancias actuales provocadas por la COVID-19 nos obligan a los profesionales de atención primaria a idear nuevas formas de garantizar la atención sanitaria de nuestros pacientes con diabetes tipo 2 (DM2). Existen evidencias que respaldan la eficacia de la telemedicina en el control glucémico de los pacientes con DM2. Ante la rápida adaptación de la práctica clínica al uso de la telemedicina, el Grupo de Trabajo de Diabetes de la Sociedad Española de Medicina Familiar y Comunitaria (SemFyC) optó por elaborar un documento de consenso plasmado en un algoritmo de actuación/seguimiento telemático en la atención de los pacientes con DM2.Palabras clave: Telemedicina, Diabetes mellitus tipo 2, COVID-19 相似文献
108.
Larissa Rodrigues Fabris úrsulla Vilella Andrade Aline Ferreira Dos Santos Ana Paula da Costa Marques Sandra Maria do Valle Leone de Oliveira Rinaldo P?ncio Mendes Anamaria Mello Miranda Paniago 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(2):121-125
With the objective to evaluate the behavior of paracoccidioidomycosis
in the last three decades, clinical and epidemiological data of 595 patients
admitted to clinical services of the Federal University of Mato Grosso do Sul
from 1980 to 2009 were investigated. Gender, age distribution, clinical form,
comorbidity with tuberculosis or AIDS, and mortality were compared by decades of
clinical admission. It was shown that during the three decades there was a
decrease in women percentage, and the same manner occurred a reduction in
participants in the age group of 20 to 39 years. Moreover, the acute/subacute
forms have been diminished in the period. These fluctuations are closely related
and can be simultaneously analyzed. Increased AIDS co-infection prevalence from
the first to the second decade was also revealed, coinciding with the appearance
of the retroviral epidemic and stabilizing during the third decade. No change in
the tuberculosis co-infection rate was observed (overall = 6.9%). It
reinforces the importance of this co-morbidity. The overall mortality rate
remained steady at 6.7%, not varying significantly from one decade to another.
The persistent mortality rate calls attention to the importance of this
neglected disease. 相似文献
109.
Cristian Candela-Juan Alegría Montoro Enrique Ruiz-Martínez Juan Ignacio Villaescusa Luis Martí-Bonmatí 《European radiology》2014,24(3):649-656
Risks associated to ionising radiation from medical imaging techniques have focused the attention of the medical society and general population. This risk is aimed to determine the probability that a tumour is induced as a result of a computed tomography (CT) examination since it makes nowadays the biggest contribution to the collective dose. Several models of cancer induction have been reported in the literature, with diametrically different implications. This article reviews those models, focusing on the ones used by the scientific community to estimate CT detriments. Current estimates of the probability that a CT examination induces cancer are reported, highlighting its low magnitude (near the background level) and large sources of uncertainty. From this objective review, it is concluded that epidemiological data with more accurate dosimetric estimates are needed. Prediction of the number of tumours that will be induced in population exposed to ionising radiation should be avoided or, if given, it should be accompanied by a realistic evaluation of its uncertainty and of the advantages of CTs. Otherwise they may have a negative impact in both the medical community and the patients. Reducing doses even more is not justified if that compromises clinical image quality in a necessary investigation. Key Points ? Predictions of radiation-induced cancer should be discussed alongside benefits of imaging. ? Estimates of induced cancers have noticeable uncertainties that should always be highlighted. ? There is controversy about the acceptance of the linear no-threshold model. ? Estimated extra risks of cancer are close to the background level. ? Patients should not be alarmed by potential cancer induction by CT examinations. 相似文献
110.