martes, 30 de junio de 2015

Prevalencia de la retinopatía diabetica en el primer nivel asistencial de Cataluña.mateo segui desde medfam

Ahora que estamos con la retinografia diabética


Prevalencia de la retinopatía diabetica en el primer nivel asistencial de Cataluña.


Según esto, la prevalencia de RD en los 108 723 pacientes (33% de la población) cribados fue del 12,3% (IC 95% 12,1-12,5%), un % bajo si comparamos con otras fuentes. En comparación con los pacientes con DM2 sin RD, aquellos con RD eran más mayores, utilizaban más insulina, eran  más hipertensos (sobre todo con hipertensión arterial sistólica), niveles de HbA1c más elevados, y su filtrado glomerular inferior a  60 ml/min/1,73 m2. La RD se incrementó con la duración de la DM2, un 6,9% en menores de 5 años llegando al 23.7% en los mayores de 15 años.




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¡Por fin entiendo los números de la evidencia! (AMF 2015) No todo es clínica

http://amf-semfyc.com/web/article_ver.php?id=1440

jueves, 25 de junio de 2015

Sesion Inhibidores tirosinquinasa y riesgo cardiovascular

Hoy hemos tenido una sesión sobre tratamiento de la LMC con inhibidores
 tirosinquinasa y riesgo cardiovascular aporto este estudio.

1. Ann Hematol. 2015 Mar;94(3):393-7. doi: 10.1007/s00277-014-2231-9. Epub 2014 Oct 12. Application of systematic coronary risk evaluation chart to identify chronic myeloid leukemia patients at risk of cardiovascular diseases during nilotinib treatment. Breccia M(1), Molica M, Zacheo I, Serrao A, Alimena G. Author information: (1)Department of Cellular Biotechnologies and Hematology, Sapienza University, Via Benevento 6, 00161, Rome, Italy, breccia@bce.uniroma1.it. Nilotinib is currently approved for the treatment of chronic myeloid leukemia (CML) in chronic (CP) and accelerated phase (AP) after failure of imatinib and in newly diagnosed patients. Atherosclerotic events were retrospectively reported in patients with baseline cardiovascular risk factors during nilotinib treatment. We estimated the risk of developing atherosclerotic events in patients treated with second or first-line nilotinib, with a median follow-up of 48 months, by retrospectively applying the SCORE chart proposed by the European Society of Cardiology (ESC) and evaluating risk factors at baseline (diabetes, obesity, smoking, and hypertension). Overall, we enrolled in the study 82 CP patients treated frontline (42 CP patients at the dose of 600 mg BID) or after failure of other tyrosine kinase inhibitors (40 CP patients treated with 400 mg BID). The SCORE chart is based on the stratification of sex (male vs female), age (from 40 to 65 years), smoker vs non-smoker, systolic pressure (from 120 to 180 mm Hg), and cholesterol (measured in mmol/l, from 150 to 300 mg/dl). For statistical purposes, we considered patients subdivided in low, moderate, high (with a score >5), and very high risk. There were 48 males and 34 females, median age 51 years (range 22-84). According to WHO classification, 42 patients were classified as normal weight (BMI <25), 26 patients were overweight (BMI 26 ≤ 30), and 14 were obese (BMI >30). Retrospective classification according to the SCORE chart revealed that 27 patients (33 %) were in the low-risk category, 30 patients (36 %) in the moderate risk category, and 24 patients (29 %) in the high risk. As regards risk factors, we revealed that 17 patients (20.7 %) had a concomitant type II controlled diabetes (without organ damage), 23 patients (28 %) were smokers, 29 patients (35 %) were receiving concomitant drugs for hypertension, and 15 patients (18 %) had concomitant dyslipidemia. Overall, the cumulative incidence of atherosclerotic events at 48 months was 8.5 % (95 % CI, 4.55-14.07): None of the low-risk patients according to the SCORE chart experienced atherosclerotic events compared to 10 % in the moderate risk category and 29 % in the high risk (p = 0.002). Atherosclerotic-free survival was 100, 89, and 69 % in the low, moderate, and high-risk population, respectively (p = 0.001). SCORE chart evaluation at disease baseline could be a valid tool to identify patients at high risk of atherosclerotic events during nilotinib treatment. PMID: 25304102 [PubMed - indexed for MEDLINE]

El Desembarco de La Flota: Manejo del Riesgo Cardiovascular en una consulta de Atención Primaria

http://eldesembarcodelaflota.blogspot.com.es/2015/06/manejo-del-riesgo-cardiovascular-en-una.html?utm_content=buffer73dfe&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer&m=1