Revista clínica española
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Revista clínica española · May 2020
Completion of the medical certificate of cause of death in Madrid: A descriptive cross-sectional study.
The medical certificate of cause of death is a dual-purpose document: an official registration of an individual's death and a statistical analysis of the populational causes of death. However, the completion of this document in clinical practice creates significant conflicts. ⋯ We propose possible improvements to the official document so that it meets the legal requirements, facilitates its completion and fulfils its function. We also offer recommendations for hospitals that have their own document and suggestions for improving its completion.
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For patients to be able to make decisions autonomously (and to grant informed consent), they must have information, understanding, freedom and willingness, with competence a prerequisite for autonomy. Clinicians are often faced with patients lacking competence to make decisions but detect less than half of such cases and often inadequately assess the patients' competence. This article offers guidelines for assessing the competence of patients for whom there are doubts about their ability to make decisions concerning their health. The procedure is based on 5 steps: 1) recognising the conditions that require a competence assessment; 2) fully evaluating the competence; 3) correlating the degree of competence with the complexity of the decision; 4) improving the patient's competence when possible; and 5) establishing who will make the decision.
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Revista clínica española · May 2020
An exaggerated increase in blood pressure with exercise does not predict mortality or severe cardiovascular events in women referred for exercise echocardiography for clinical reasons.
The association between an exaggerated systolic blood pressure increase with exercise (EBPIE) and the probability of cardiovascular events is controversial and poorly studied in the female population. Our aim was to determine the possible association between EBPIE on one hand and mortality and cardiovascular events on the other in women referred for exercise echocardiography due to known or suspected coronary artery disease. ⋯ EBPIE is not associated with mortality or severe cardiovascular events in women with known or suspected coronary artery disease.