Revista clínica española
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Revista clínica española · Jul 2009
Comparative Study[Effectiveness of PRECEDE model for health education in metabolic control and reduction of cardiovascular risk factors in patients with diabetes type 2].
To evaluate the effectiveness of PRECEDE model for health education, in the metabolic control and the reduction of cardiovascular risk factors, in type 2 diabetic patients followed for over two years in primary health care services. ⋯ PRECEDE model for health education is a useful method in the management of type 2 diabetes, that reduce the levels of blood pressure both systolic and diastolic, decrease the lipid levels, and improve the level of therapeutic adherence in type 2 diabetic patients, followed for two years.
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Revista clínica española · Jul 2009
Comparative Study[Hereditary and acquired angioedema: clinical characteristics in 8 patients and review of the literature].
C1 inhibitor disorders are a group of rare conditions in which the C1 inhibitor is deficient or defective. We present the clinical characteristics of 8 patients and a review of the literature. These are characterized by recurrent episodes of angioedema, which most often affect the skin or mucosal tissues of the upper respiratory and gastrointestinal tract. ⋯ Acquired C1 inhibitor disorders are similar, but lack a family background. Treatment is divided into short and long-term prophylaxis with androgens, antifibrinolytics and C1 inhibitor replacement. First line therapy of acute attacks is C1 inhibitor.
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Revista clínica española · Jul 2009
Comparative Study[Diagnostic approach to cancer of unknown primary site].
Cancer of unknown primary site (CUPS) is a heterogeneous entity defined by the presence of a histologically-proven metastatic neoplasm, in which the original tumor cannot be identified after a targeted study. The current guidelines for CUPS focus is not based on the search for the primary neoplasm but rather on the identification of patients who may benefit from a treatment that will prolong their survival, based on the clinical and histological characteristics of each case. By improving the diagnostic study, we avoid using fruitless tests in patients with limited therapeutic possibilities and poor short-term prognosis.
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Revista clínica española · Jun 2009
[Differential factors of tumor etiology for iron deficiency anemia of probable gastrointestinal origin].
Diagnosis of iron deficiency anemia (IDA) of probably gastrointestinal (GI) tract origin is a difficult task for the clinician. ⋯ In IDA, colonoscopy (or contrast barium enema in certain circumstances) is the most important exploration to rule out malignancy. Only NSAID use is useful to exclude cancer. Patients without identifiable lesions have a favorable prognosis. A moderate frequency of synchronous lesions was found. We recommend a complete conventional GI endoscopic study if no evident bleeding lesion is found during the initial endoscopic procedure. Capsule endoscopy and celiac disease serology are useful in obscure gastrointestinal bleeding.