Medicina clinica
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One of the main sources of energy in Spain is still coal combustion. It releases multiple pollutants into the atmosphere, such as PM2.5, that has been linked to an increase in cardiovascular morbidity and mortality. The objectives of this paper are: 1) to determine the national distribution of these particles and their proximity to coal plants, 2) to estimate the cardiovascular impact of PM2.5 particles in Spain in 2014. ⋯ This study describes an increase in cardiovascular mortality and morbidity in Spain, due to coal combustion pollutants. It finds a greater impact in the provinces of Asturias and Castilla León, where a higher presence of coal power plants can be found. This reflects that the people that live in those areas have a greater risk of cardiovascular death due to PM2.5 pollutant exposure from coal.
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Multicenter Study Clinical Trial
A multidisciplinary approach for patients with multiple chronic conditions: IMPACTO study.
The objective of the study was to evaluate the effects of a multidisciplinary intervention on the outcomes of polypathological patients (PP). ⋯ This multidisciplinary intervention reduced the risk of PP hospital admission and days of hospitalization. Educational workshop programs for PP and their caregivers and structured IM medical visits were associated with improvements of survival.
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Bronchogenic carcinoma is the leading cause of death due to cancer worldwide. Nearly 75% of patients have a disseminated carcinoma at diagnosis. ⋯ Nevertheless, the current scientific evidence has demonstrated that when the metastatic disease is limited, particularly in specific locations such as the brain and the adrenal glands, a multidisciplinary approach with radical intent could achieve a longer survival. This review analyses the clinical evidence available in the literature that supports the treatment of both the primary and the metastatic disease, as well as the preoperative study and the most widely accepted indications.
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Patients with rheumatoid arthritis (RA) consider pain to be their main problem. The goal of this study was to evaluate validity and sensitivity to change to measure pain intensity using the MOS scale in RA patients. ⋯ MOS scale is a useful instrument to measure pain intensity as well as pain relief.