Salud, dinero y atención primaria: ¿Unidades de insuficiencia cardíaca? No, gracias.

Salud, dinero y atención primaria: ¿Unidades de insuficiencia cardíaca? No, gracias.: ¿Unidades de insuficiencia cardíaca? No, gracias. Pero hay que mejorar la atención a los pacientes con esta enfermedad. Juan Gérvas, mé...

GUIA INSUFICIENCIA CARDIACA 2016 SOCIEDAD EUROPEA CARDIOLOGIA.

http://www.revespcardiol.org/contenidos/pdf-avances/69-12-1167.e1-e85.pdf

Taller «Cuídate para cuidar» de apoyo a cuidadores informales (AMF 2016) Experiencias para compartir

http://amf-semfyc.com/web/article_ver.php?id=1521


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Limitación de actuaciones al final de la vida. Entre el criterio profesional y la autonomía del paciente (AMF 2016) El conflicto ético

http://amf-semfyc.com/web/article_ver.php?id=1925


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Gestión privada: ¿más eficiente? (AMF 2013) No todo es clínica

Aunque antiguo articulo sigue teniendo vigencia.
http://amf-semfyc.com/web/article_ver.php?id=1098


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manuel sanchez molla compartió un enlace: Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing

Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing del Tweet de 

manuel sanchez molla compartió un enlace: Evolocumab and Coronary Disease Progression in Statin-Treated Patients | Cardiology | JAMA | The JAMA Network

Evolocumab and Coronary Disease Progression in Statin-Treated Patients | Cardiology | JAMA | The JAMA Network del Tweet de https://twitter.com/jama_current/status/798589866049032192?refsrc=email&s=11

Descarga la aplicación de Twitter

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CAMBIOS CRIBADO CANCER CERVIX

http://appswl.elsevier.es/publicaciones/item/pdf/watermark?idApp=UINPBA00004N&piiItem=S021265671630419X&origen=zonadelectura&web=zonadelectura&urlApp=http://www.elsevier.es&estadoItem=S300&idiomaItem=es&textMensaje=Documento%20descargado%20de%20http://www.elsevier.es%20el%2015-11-2016

Tolerating Uncertainty — The Next Medical Revolution? — NEJM

http://www.nejm.org/doi/full/10.1056/NEJMp1606402

Carga de hospitalizaciones recurrentes tras una hospitalización por insuficiencia cardiaca aguda: insuficiencia cardiaca con función sistólica conservada frente a reducida | Revista Española de Cardiología

http://www.revespcardiol.org/es/carga-hospitalizaciones-recurrentes-tras-unahospitalizacion/avance-resumen/S0300893216305000/


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Algoritmos diagnósticos I.cardíaca ancianos.

http://linkis.com/bmjopen.bmj.com/cont/EnrYB

analisis de las GUIAS OSTEOPOROSIS

Al parecer las guias se centran mas en variables subrogadas como densitometria que en riesgo de fractura que parece lo razonable.

Management recommendations for osteoporosis in clinical guidelines

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• First published: 11 February 2016Full publication history
• DOI: 10.1111/cen.13000View/save citation
• Cited by: 2 articles
• Funding Information

Summary

Objective

Numerous guidelines advise about management of osteoporosis, but little research has been conducted on their recommendations. We analysed recommendations on management of bone health in clinical guidelines.

Design

We surveyed recommendations on assessment, treatment and monitoring of bone health in 78 clinical guidelines (22 primary focus osteoporosis, 56 primary focus not osteoporosis) lodged at the Agency for Health Research and Quality National Guidelines Clearinghouse between 1/1/2009 and 12/31/2014.

Measurements

Governance of guidelines; discussion of fracture risk in the target population; recommendations for assessment, treatment and monitoring of bone health.

Results

Only 14% of guidelines discussed fracture risk in the target population. When guidelines discussed assessment, 98% recommended bone mineral density (BMD) measurement but only 27% recommended estimation of fracture risk. When guidelines discussed treatment, 63–71% recommended calcium and/or vitamin D, while <12% recommended avoiding low body weight or smoking cessation. When guidelines discussed intervention, 53% did so on the basis of BMD measurement, and only 27% on the basis of estimated fracture risk. When guidelines discussed monitoring, >90% recommended BMD measurements, and only 3% recommended estimation of fracture risk. About 65% of guidelines that suggested a BMD monitoring interval recommended one of ≤3 years. Compared to guidelines with a primary focus on osteoporosis, guidelines whose primary focus was not osteoporosis were less likely to discuss fracture risk in the target population (2% vs 45%), recommend estimation of fracture risk (11% vs 55%) and recommend intervention on the basis of estimated fracture risk (10% vs 67%) (all P < 0·005).

Conclusions

Our findings highlight a strong focus in clinical guidelines on BMD, a surrogate measure, rather than fracture risk, the clinically important outcome, particularly when bone health is not the primary focus. Addressing this issue might facilitate more rational use of resources and improve patient care.