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TOPIC COLLECTION: ARTIFICIAL INTELLIGENCE AND OPHTHALMIC DIAGNOSIS

Miércoles, Agosto 5, 2020

Papilledema detection by nonophthalmologists can be challenging. Conversely, the classification of anomalous optic discs as papilledematous may subject patients to anxiety regarding the diagnosis and to expensive and invasive testing, such as MRI and lumbar puncture, that ultimately proves unnecessary. In the NEJM article “Artificial Intelligence to Detect Papilledema from Ocular Fundus Photographs,” Milea and colleagues report on a deep-learning system developed to distinguish papilledematous discs from normal optic discs or discs with other abnormalities.

 

 

 

NEJM Journal Watch

Aortic Stenosis and Dyslipidemia

Miércoles, Agosto 5, 2020

A study using a Mendelian randomization design finds causal associations between elevated total cholesterol and LDL levels and AS.

To date, aortic stenosis (AS) has no recommended prevention strategies, and statins have failed to slow disease progression in randomized trials. However, questions remain about whether dyslipidemia is associated with the condition.

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-UMC-CHL-0034

Thoracic Spine Fractures Are Rarely Identified by Chest Radiographs

Miércoles, Agosto 5, 2020

Most of these fractures can be treated conservatively and are not associated with neurologic sequelae.

To better understand the rate and sequelae of thoracic spine fractures identified in the modern era of liberal computed tomography (CT) scanning of trauma patients, researchers performed a secondary analysis of data from the NEXUS Chest CT study.

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-UMC-CHL-0033

MRI Scores for Cerebral Small Vessel Disease and Prediction of Dementia

Miércoles, Agosto 5, 2020

Using MRI to score cerebral small-vessel disease may help predict dementia.

Cerebrovascular disease increases the risk for dementia. To determine whether an MRI score for cerebral small vessel disease (SVD) can assist in the prediction of dementia, investigators examined MRI scans from participants in three longitudinal cohorts. Participants’ SVD ranged from mild and asymptomatic to severe and symptomatic.

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-UMC-CHL-0032

Listeriosis and other Food-borne infectious diseases

Lunes, Juinio 22, 2020

In recent years, two types of infection seem to be on the rise. Zoonosis is infection carried in animals and transferred to human by direct contact (e.g., rabies, perhaps COVID-19) or via an insect vector, such as mosquitoes (e.g., Zika virus, West Nile virus, Lyme disease).

 

NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-IMU-CHL-0001

Topic Collection: Transcatheter or surgical Aortic valve replacement

Viernes, Juinio 12, 2020

Letter from the Editor
In the past decade, there has been a powerful shift toward the use of transcatheter aortic valve replacement (TAVR) for patients with severe symptomatic aortic stenosis.

Cardiac Reserve Predicts Hepatorenal Syndrome in Patients with Cirrhosis

Viernes, Juinio 12, 2020

Cardiac testing could potentially identify at-risk patients who might benefit from early intervention.
Hepatorenal syndrome (HRS) is a serious complication of cirrhosis associated with high morbidity and mortality. Recent studies suggest that cardiac dysfunction may play a role in the pathogenesis of HRS.

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-UMC-CHL-0015

 

Impact of single-pill combination therapy on adherence, blood pressure control, and clinical outcomes- a rapid evidence assessment of recent literature

Martes, Mayo 26, 2020

The 2018 European Society of Cardiology/ European Society of Hypertension Guidelines for the management of arterial hypertension raised the need for evidence to support the use of single-pill combination (SPC) therapy in preference to free-dosed therapy for hypertension. This systematic rapid evidence assessment sought to determine if initiating SPC therapy improves adherence, blood pressure (BP) control and/or cardiovascular outcomes vs. initiation of free-dose combination therapy.

 

 

Código de aprobación: PP-UMC-CHL-0008

Understanding the Complexity of the Migraine Brain

Viernes, Mayo 22, 2020

Brain regions showing consistent alterations in migraineurs converge to a common brain network, which includes areas with a pivotal role in migraine pathophysiology.
Neuroimaging studies have shown functional and structural alterations of different brain areas in migraine patients, raising new questions. How do these regions interact with each other? Does a unique network enclose all these brain areas? Are these neuroimaging findings migraine specific?

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0198

How Unhealthy is Pollution with Fine Particle

Jueves, Mayo 7, 2020

Researchers in China find heightened short-term risks for cardiovascular hospitalizations.
Studies are accumulating about the relationship between air quality and cardiovascular risk. Because air quality in many areas of the world is deficient, we need to quantify the health effects at levels exceeding those that have been designated as safe, particularly with respect to short-term exposure.

Trends in Heart Failure Outcomes

Miércoles, Abril 29, 2020

Although overall mortality has changed little between 2002 and 2013, noncardiovascular mortality has increased, especially among the oldest old.
We have made substantial progress in improving outcomes for patients with ischemic heart disease, but what about for patients with heart failure? Investigators examined a clinical database of about 7% of the U.K. population to assess trends in 1-year mortality and hospital admissions among 86,833 patients with a diagnosis of incident heart failure from 2002 through 2013 (aged ≥80, 48%; ≥3 comorbidities, 79%; women, 49%).

 

 


NEJM Journal Watch

Does Physical Activity Affect Early Prodromal Parkinson Symptoms

Miércoles, Abril 29, 2020

A long-term study suggests so.
Researchers sought to uncover a potential relationship between physical activity and prodromal features of Parkinson disease (PD) — features that precede the clinical diagnosis — using the Nurses’ Health Study and the Health Professionals Follow-Up Study. Participants were followed from 1986 through 2012, with assessments at baseline and longitudinally at many consecutive 24-month periods thereafter.

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0190

A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke

Miércoles, Abril 29, 2020

The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied.

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-LIP-CHL-0013

Review of the Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia

Miércoles, Abril 29, 2020

In 2010, itwas estimated that more than 200million peopleworldwide were living with peripheral arterial disease. Chronic limbthreatening ischemia (CLTI) represents the end stage of peripheral arterial disease, which, left untreated, incurs a risk of major amputation, approaching 25%at 1 year.

 

 

© 2020 American Medical Association. All rights reserved. This journal and the individual contributions contained in it are protected under copyright by AMA, and the following terms and conditions apply to their use. JAMA® is a registered trademark of AMA, used under license.

Autism Spectrum Disorder and Comorbid Mood and Anxiety Disorders.

Martes, Abril 28, 2020

1+1=3: Autism significantly increases risks for both mood and anxiety disorders.
When Kanner described autistic disturbances of affective contact in 1943, he observed that one of the hallmark clinical features was an “anxiously obsessive desire for the maintenance of sameness.” Many studies since have documented the prevalence of co-occurring psychiatric disorders in patients with autism spectrum disorder (ASD).

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0188

Percutaneous Treatment of Tricuspid Regurgitation

Martes, Abril 28, 2020

Catheter-based edge-to-edge repair may provide benefit, according to results from a preliminary single-arm trial.
Tricuspid regurgitation (TR), a common form of valvular heart disease, frequently results from right ventricular dilatation and leaflet tethering, leading to malcoaptation of the leaflets. TR has been associated with poor long-term survival and with impaired response to correction of left-sided cardiac pathology.

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0187

Updated AAP Guidance on ASD Detection and Management. NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

Martes, Abril 28, 2020

Primary care clinicians are encouraged to refer early, partner with families to make treatment decisions, and know their community resources.
With the prevalence of autism spectrum disorder (ASD) now estimated at 1 in 59 U.S. children, the American Academy of Pediatrics (AAP) has updated its 2007 clinical report on ASD screening and management. Important points for clinicians include the following:

 

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0184

Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation

Viernes, Abril 3, 2020

Optical sensors on wearable devices can detect irregular pulses. The ability of a smartwatch application (app) to identify atrial fibrillation during typical use is unknown.
Participants without atrial fibrillation (as reported by the participants themselves) used a smartphone (Apple iPhone) app to consent to monitoring. If a smartwatchbased irregular pulse notification algorithm identified possible atrial fibrillation,

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-MCM-CHL-0181

An instrumental treatment for negative symptoms in schizophrenia

Viernes, Abril 3, 2020

Improvement with 1 week of treatment with transcranial direct current stimulation is sustained for 12 weeks.
Because negative symptoms of schizophrenia have been associated with low activity in the prefrontal cortex (PFC), researchers in a sham-controlled, Brazilian study examined the effects of transcranial direct current stimulation (tDCS) in 95 schizophrenia patients with prominent negative symptoms.

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-ZOL-CHL-0029

Connecting Stress Disorders with Life-Threatening Infections

Viernes, Abril 3, 2020

Multiple stress disorders, but most strongly post-traumatic stress disorder, increase the risk for serious infections.
The poor physical health of individuals with post-traumatic stress disorder (PTSD) is presumed to occur through the stress-related compromise of multiple physiological systems producing an excess of somatic complaints and bona fide medical illnesses.

 


NEJM Journal Watch summary, reutilizado con permiso del Grupo NEJM.

 

Código de aprobación: PP-ZOL-CHL-0030

Light, Dark, and Bipolar Disorder- Some Practical Guidance

Martes, Marzo 31, 2020

Interventions affecting circadian rhythm can be therapeutic, with some approaches more effective than others.
Chronotherapies, interventions that affect the circadian rhythm, have been studied in both the depressive and the manic stages of bipolar disorder through the years (e.g., NEJM JW Psychiatry Nov 2017 and Am J Psychiatry 2017; 175:131; NEJM JW Psychiatry Nov 2009 and Biol Psychiatry 2009; 66:298).

 

 

Código de aprobación: PP-MCM-CHL-0177

Health Connect

Martes, Septiembre 25, 2018

 

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Medic Latina

Lunes, Septiembre 9, 2019

MedicLatina es una colección única de revistas especializadas en la investigación médica, obra de reconocidas editoriales médicas Latinoamérica y España. Esta base de datos en español contiene texto completo de alrededor de 130 publicaciones especializadas en medicina arbitradas en español nativo.

 

Descargue artículo completo

 

Perspectivas futuras para el tratamiento de los trastornos de ansiedad

Martes, Agosto 29, 2017

 

Perspectivas futuras para el tratamiento de los trastornos de ansiedad

 

La ansiedad por el estado de salud o hipocondría, es una experiencia que surge cuando se cree que las sensaciones o los cambios corporales son indicativos de una enfermedad grave. Aunque la hipocondría se clasifica en el DSM - IV como un trastorno somatomorfo, se han sugerido varias alternativas para su clasificación. Estas incluyen, por ejemplo, la reclasificación como un trastorno de ansiedad, como parte de los trastornos del espectro obsesivo compulsivo, o como un nuevo trastorno somatomorfo complejo.

Visión general de DSM-5 y trastornos del estado de ánimo

Martes, Agosto 29, 2017

 

Visión general de DSM-5 y trastornos del estado de ánimo

 

En el DSM-5 se han propuesto diversos cambios para los trastornos del estado de ánimo, con especial enfoque en trastornos mixtos, trastorno bipolar y abordaje correcto del suicidio. Existen dos nuevos diagnósticos en adultos: trastorno mixto de ansiedad y depresión, y síndrome premenstrual disfórico.

El rol de la terapia cognitivo conductual en la depresión.

Martes, Agosto 29, 2017

 

El rol de la terapia cognitivo conductual en la depresión

 

Aunque se tiende a pensar en la depresión como un trastorno tratable, las tasas de remisión no son tan impresionantes. Se estima que sólo 1 de cada 3 pacientes remitirá después de un esquema breve de tratamiento, que dura varios meses; y sólo 2 de cada 3 remitirá después de un tratamiento prolongado, que dura hasta un año. Por lo que se han realizado múltiples estudios en los que se evidencia la importancia de la terapia cognitivo conductual (TCC) asociada a la terapia farmacológica en pacientes con depresión.

El rol de la epigenética en la eficacia de los fármacos antidepresivos

Martes, Agosto 29, 2017

El rol de la epigenética en la eficacia de los fármacos antidepresivos

 

El Instituto Nacional de Salud Mental de Estados Unidos, estima que casi 15 millones de estadounidenses padecen trastorno depresivo mayor, convirtiéndose en un problema de salud alarmante. En la búsqueda de nuevos objetivos terapéuticos para controlar la depresión recientemente, grupos de expertos se han enfocado en la epigenética, la cual parece tener respuestas potenciales.

Envejecer con orgullo

Viernes, Enero 6, 2017

Consejos para lograr Envejecer con Orgullo

 

En la actualidad no se han podido superar los comentarios discriminatorios para con los que han construido nuestra historia y forjado nuestras raíces, con gran sacrificio. Dichas aseveraciones olvidan que en aquellos tiempos nuestros abuelos, sin los avances tecnológicos actuales, afrontaron todos los desafíos con tesón, empuje y gran entrega. Así, se logró la construcción de nuestras naciones y con ello las expectativas y proyecciones hacia el siglo XXI.

El “Edadismo” y  llevándolo a un término más entendible para nosotros el “Viejismo”, ha