Revista clínica española
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Revista clínica española · Aug 2020
ReviewPCSK9 inhibitors: Ratification of the role of LDL cholesterol in cardiovascular prevention. Towards a convergence of European and North American prevention guidelines?
The epidemiological association of cholesterol associated with low density lipoproteins (LDL-c) levels and the development of atherosclerotic vascular disease has been ratified by mendelian randomization studies. Paradoxically, the success of statins led to the underestimation of other lipid-lowering therapies and even the measurement of LDL-c. ⋯ However, the high cost and limited experience with PCSK-9 inhibitors advised a prudent use of them. An appropriate selection of patients most likely to benefit from treatment with PCSK9 inhibitors emerges as the basis for a consensus of international guidelines: the combination of a high absolute vascular risk and a greater expected benefit by the starting LDL-c levels.
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Revista clínica española · Aug 2020
Management of patients with heart failure treated in cardiology consultations: IC-BERG Study.
To determine the perception and management of heart failure with reduced ejection fraction (HFrEF) by clinical cardiologists and to establish a consensus with recommendations. ⋯ Our current understanding of «stable» HF is insufficient, and the treatment needs to be optimised, even for apparently stable patients, to decrease the risk of disease progression.
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This article brings together the views of a working group to deliberate on Burnout among Physicians in Spain. The document is the result of the answers that different members of the group have prepared to different questions on the subject with conclusions derived from the discussion among all the participants. Burnout is an entity with a high incidence in physicians, with serious work, personal and economic repercussions, whose recognition as a disease is changing in recent years. ⋯ The common factor being an increased qualitative or quantitative demand on the professional. Although it may have a substratum of personal characteristics, it is more commonly associated with extrinsic factors specific to the organisation of work and the management of occupational risks. It involves serious indirect costs for the health system including absenteeism, high financial costs and leads to loss of health and well-being in people who suffer it.