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  1. Article ; Online: Recomendaciones sobre enfermedad tromboembólica venosa en procesos oncológicos. Una visión desde la medicina de familia.

    García Vallejo, O / Aicart Bort, M D / Babiano Fernández, M Á / Caballer Rodilla, J / Cabrera Ferriols, M Á / Carrasco Carrasco, E / Gil Gil, I / Lahera García, A M / Martos Cárdenas, T / Piera Carbonell, A

    Semergen

    2023  Volume 49, Issue 7, Page(s) 102030

    Abstract: Venous thromboembolic disease (VTE) is a frequent complication in patients diagnosed with cancer and a cause of morbidity and mortality. Approximately 20% of thromboembolic episodes develop in association with active cancer. On the other hand, it is ... ...

    Title translation Recommendations for thromboembolic disease in oncological processes. A view from primary care.
    Abstract Venous thromboembolic disease (VTE) is a frequent complication in patients diagnosed with cancer and a cause of morbidity and mortality. Approximately 20% of thromboembolic episodes develop in association with active cancer. On the other hand, it is estimated that about 2-12% of cases, the thromboembolic episode is the first manifestation of an occult cancer, diagnosed at that time or subsequently, which offers an opportunity for early diagnosis and treatment. There are multiple factors that contribute to increase the risk of VTE in oncological patients in relation to specific characteristics of the patient, the tumor and the treatments. Knowledge of these risk factors will contribute to early diagnosis when signs of VTE appear, as well as the assessment of thromboprophylaxis if indicated. The diagnosis of VTE in patients with cancer does not differ of those who do not suffer from it. Regarding the treatment of VTE in these patients, low molecular weight heparin (LMWH), direct acting anticoagulants (DACs) and antivitamin K (VKA) are the most commonly used, although the dosing regimen and length are not clear yet. The management of these patients should be interdisciplinary and early, so the primary care physician plays a key role in this process as he/she is liaise with his/her patients. It is also necessary to update knowledge in order to improve the care of these patients. For these reasons, this document has been prepared by the Working Group on Vasculopathies of the Spanish Society of Primary Care Physicians (SEMERGEN) whose objective is to present the available information regarding the management of VTE that may appear in oncological patients, as well as the assessment of thromboprophylaxis and treatment, if appropriate, from an approach focused on a primary care field.
    MeSH term(s) Humans ; Female ; Male ; Anticoagulants/therapeutic use ; Heparin, Low-Molecular-Weight/therapeutic use ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Neoplasms/complications ; Neoplasms/drug therapy ; Primary Health Care
    Chemical Substances Anticoagulants ; Heparin, Low-Molecular-Weight
    Language Spanish
    Publishing date 2023-07-22
    Publishing country Spain
    Document type English Abstract ; Practice Guideline ; Journal Article
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2023.102030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Conocimiento de la tromboprofilaxis-COVID-19 en los profesionales sanitarios en España.

    García Vallejo, O / Frías Vargas, M / Gil Gil, I / Vázquez Gómez, N / Piera Carbonell, A / Peiró Morant, J

    Semergen

    2021  Volume 47, Issue 6, Page(s) 361–368

    Abstract: Introduction: Patients suffering from coronavirus infection have an increased risk of venous thromboembolic disease (VTE) associated with COVID-19, which confers a higher risk of mortality. For this reason, it is necessary to analyze the knowledge and ... ...

    Title translation Knowledge of thromboprophylaxis-COVID-19 in healthcare professionals in Spain.
    Abstract Introduction: Patients suffering from coronavirus infection have an increased risk of venous thromboembolic disease (VTE) associated with COVID-19, which confers a higher risk of mortality. For this reason, it is necessary to analyze the knowledge and the different actions in the management of thromboprophylaxis in work environments.
    Material and methods: Observational, descriptive and cross-sectional study with data collection through a Google® form with 19 questions for professionals involved in the care of COVID-19. 414 surveys were received. The quantitative variables were represented with means and standard deviation and the qualitative variables with percentages and confidence intervals.
    Results: 414 surveys analyzed. 58.2% were women. The most participatory age group was 56-65 years. 95.2% stated that COVID-19 patients had a higher risk of VTE and peripheral arterial microthrombosis. 93.6% considered that outpatient COVID-19 patients should receive thromboprophylaxis. 60.5% of the physicians did not know any protocol for the evaluation of thrombotic risk in these patients. Low molecular weight heparin was considered the main treatment for thromboprophylaxis.
    Conclusions: The majority of doctors consider that COVID-19 patients have a higher risk of suffering VTE and peripheral arterial microthrombosis than the general population, however more than a third do not assess the thrombotic risk and a significant percentage claim not to know protocols to evaluate said risk. The survey highlights the training needs of our professionals in thromboprophylaxis so that our patients receive healthcare with the highest possible quality.
    MeSH term(s) Aged ; Anticoagulants ; COVID-19 ; Cross-Sectional Studies ; Delivery of Health Care ; Female ; Humans ; Male ; Middle Aged ; SARS-CoV-2 ; Spain ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/prevention & control
    Chemical Substances Anticoagulants
    Language Spanish
    Publishing date 2021-03-08
    Publishing country Spain
    Document type Journal Article ; Observational Study
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2021.01.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Trombosis y COVID-19: Atención Primaria clave en el abordaje interdisciplinar.

    Piera Carbonell, A / García Lerín, A / García Vallejo, O / Frías Vargas, M / Cabrera Ferriols, M A

    Semergen

    2020  Volume 46 Suppl 1, Page(s) 93–94

    Title translation Thrombosis and COVID-19: Key primary care in the interdisciplinary approach.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Female ; Humans ; Interdisciplinary Communication ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Primary Health Care/methods ; SARS-CoV-2 ; Venous Thrombosis/diagnosis ; Venous Thrombosis/virology
    Keywords covid19
    Language Spanish
    Publishing date 2020-06-06
    Publishing country Spain
    Document type Case Reports ; Journal Article
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2020.06.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Disnea como síntoma de alarma. Importancia de la atención primaria en un nuevo modelo de atención a pacientes COVID-19.

    Peiró Morant, J F / Frías Vargas, M / Piera Carbonell, A / García Vallejo, O / Carrasco Carrasco, E

    Semergen

    2020  Volume 47, Issue 1, Page(s) 59–61

    Title translation Dyspnea as an alarm symptom. Importance of primary care in a new model of care for COVID-19 patients.
    MeSH term(s) COVID-19/complications ; COVID-19/diagnosis ; COVID-19/therapy ; COVID-19 Testing/methods ; Dyspnea/virology ; Humans ; Male ; Middle Aged ; Primary Health Care/methods ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/virology ; Tomography, X-Ray Computed
    Language Spanish
    Publishing date 2020-07-01
    Publishing country Spain
    Document type Case Reports ; Letter
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2020.06.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Manejo de la diabetes mellitus tipo 2 en adolescentes y adultos jóvenes en atención primaria.

    Miravet-Jiménez, S / Pérez-Unanua, M P / Alonso-Fernández, M / Escobar-Lavado, F J / González-Mohino Loro, B / Piera-Carbonell, A

    Semergen

    2020  Volume 46, Issue 6, Page(s) 415–424

    Abstract: The prevalence of type 2 diabetes (DM2) diagnosed in childhood and adolescence is currently increasing, and is characterised by a rapidly progressive decline in beta-cells and insulin resistance. Physical inactivity and obesity are the main risk factors ... ...

    Title translation Management of type 2 diabetes mellitus in adolescents and young adults in primary care.
    Abstract The prevalence of type 2 diabetes (DM2) diagnosed in childhood and adolescence is currently increasing, and is characterised by a rapidly progressive decline in beta-cells and insulin resistance. Physical inactivity and obesity are the main risk factors for its development. Diagnostic criteria are similar to those used in adults, although HbA1c as a diagnostic method is questioned. Diabetes-related complications are more aggressive than in adults. Diabetic nephropathy is the most frequent complication in the young population and macrovascular complications appear early, leading to high mortality rates. Healthy lifestyles are the basis of the treatment, and metformin, insulin and liraglutide (approved by FDA for its use in the United States) are the pharmacological options indicated in this population. It is important to establish models of health care transition from paediatric to adult care to ensure continuity of care and avoid patient disengagements.
    MeSH term(s) Adolescent ; Diabetes Mellitus, Type 2/therapy ; Humans ; Insulin ; Metformin ; Primary Health Care ; Transition to Adult Care ; United States ; Young Adult
    Chemical Substances Insulin ; Metformin (9100L32L2N)
    Language Spanish
    Publishing date 2020-02-21
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2019.11.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Home blood pressure self-measurement: "Current situation and new perspectives".

    Divisón-Garrote, J A / Velilla-Zancada, S / Artigao-Rodenas, L M / García-Lerín, A / Vicente-Molinero, A / Piera Carbonell, A M / Alonso-Moreno, F J / Crespo-Sabarís, R / Valls-Roca, F / Martín-Rioboó, E / Pallarés-Carratala, V

    Hipertension y riesgo vascular

    2022  Volume 40, Issue 2, Page(s) 85–97

    Abstract: The method typically used to diagnose and monitor hypertensive patients has been to measure blood pressure in the physician's surgery; however, it is a well-known fact that this approach poses certain drawbacks, such as observer bias, failure to detect ... ...

    Abstract The method typically used to diagnose and monitor hypertensive patients has been to measure blood pressure in the physician's surgery; however, it is a well-known fact that this approach poses certain drawbacks, such as observer bias, failure to detect an alert reaction in the clinic, etc., difficulties that affect its accuracy as a diagnostic method. In recent years, the varying international scientific societies have persistently recommended the use of blood pressure measurements outside the clinic (at home or in the outpatient setting), using validated automatic devices. Data from some studies suggest that if we rely solely on in-office measurements, approximately 15-20% of the time we may be wrong when making decisions, both in terms of diagnosis and patient follow-up. Home blood pressure measurements are a simple and very affordable method that has a similar reproducibility and prognostic value as ambulatory blood pressure monitoring, the availability of which is currently very limited. Moreover, ambulatory self-measurements have the significant benefit of being able to improve control of hypertensive individuals. Healthcare professionals and patients should be aware of the methodology of home blood pressure measurement, its usefulness and limitations.
    MeSH term(s) Humans ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory/methods ; Reproducibility of Results ; Hypertension/diagnosis ; Blood Pressure Determination/methods
    Language English
    Publishing date 2022-09-13
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 1989-4805
    ISSN (online) 1989-4805
    DOI 10.1016/j.hipert.2022.07.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Trombosis y COVID-19: Atención Primaria clave en el abordaje interdisciplinar./ [Thrombosis and COVID-19: Key primary care in the interdisciplinary approach]

    Piera Carbonell, A / García Lerín, A / García Vallejo, O / Frías Vargas, M / Cabrera Ferriols, M A

    Semergen

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #548572
    Database COVID19

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  8. Article ; Online: Trombosis y COVID-19

    Piera Carbonell, A. / García Lerín, A. / García Vallejo, O. / Frías Vargas, M. / Cabrera Ferriols, M.A.

    Medicina de Familia. SEMERGEN

    Atención Primaria clave en el abordaje interdisciplinar

    2020  Volume 46, Page(s) 93–94

    Keywords Family Practice ; Public Health, Environmental and Occupational Health ; covid19
    Language Spanish
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 1138-3593
    DOI 10.1016/j.semerg.2020.06.002
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: COVID-19 y tromboprofilaxis: recomendaciones para nuestra práctica clínica en Atención Primaria.

    Piera Carbonell, A / Frías Vargas, M / García Vallejo, O / García Lerín, A / Cabrera Ferriols, M A / Peiró Morant, J / Carrasco Carrasco, E

    Semergen

    2020  Volume 46, Issue 7, Page(s) 479–486

    Abstract: The new coronavirus (SARS-CoV-2) is responsible for a severe acute respiratory syndrome. Among its manifestations, it can develop a thrombotic disease, both venous and arterial, due to excessive inflammation that affects the vascular system, with ... ...

    Title translation COVID-19 and thromboprophylaxis: Recommendations for our clinical practice in Primary Care.
    Abstract The new coronavirus (SARS-CoV-2) is responsible for a severe acute respiratory syndrome. Among its manifestations, it can develop a thrombotic disease, both venous and arterial, due to excessive inflammation that affects the vascular system, with platelet activation and endothelial dysfunction, among other mechanisms. Thrombosis is associated with SARS-CoV-2 infection, increasing its severity and conferring a worse prognosis. Our performance as Family Physicians can contribute important actions in the management and control of this severe complication. Considering that many of our patients already receive antithrombotic or anticoagulant therapy, the fact that they may develop a COVID-19 infection will have implications for the choice, dosage and control of their treatment. In this document we review, with the information currently available, the relationship between disease caused by SARS-CoV-2 and thrombosis, as well as its management with a focus on Primary Care.
    MeSH term(s) Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/therapy ; Family Practice/methods ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Primary Health Care/methods ; Risk Assessment ; SARS-CoV-2 ; Thrombosis/prevention & control ; Thrombosis/virology ; Venous Thromboembolism/prevention & control ; Venous Thromboembolism/virology
    Chemical Substances Anticoagulants
    Keywords covid19
    Language Spanish
    Publishing date 2020-09-18
    Publishing country Spain
    Document type Consensus Development Conference ; Journal Article ; Practice Guideline
    ISSN 1578-8865
    ISSN (online) 1578-8865
    DOI 10.1016/j.semerg.2020.07.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: PICO Questions and DELPHI Methodology for the Management of Venous Thromboembolism Associated with COVID-19.

    Riera-Mestre, Antoni / Jara-Palomares, Luis / Lecumberri, Ramón / Trujillo-Santos, Javier / Grau, Enric / Blanco-Molina, Angeles / Piera Carbonell, Ana / Jiménez, Sonia / Frías Vargas, Manuel / Fuset, Mari Paz / Bellmunt-Montoya, Sergi / Monreal, Manuel / Jiménez, David / On Behalf Of The Covilax Project

    Viruses

    2021  Volume 13, Issue 11

    Abstract: Patients with coronavirus disease 2019 (COVID-19) have a higher risk of venous thromboembolic disease (VTE) than patients with other infectious or inflammatory diseases, both as macrothrombosis (pulmonar embolism and deep vein thrombosis) or ... ...

    Abstract Patients with coronavirus disease 2019 (COVID-19) have a higher risk of venous thromboembolic disease (VTE) than patients with other infectious or inflammatory diseases, both as macrothrombosis (pulmonar embolism and deep vein thrombosis) or microthrombosis. However, the use of anticoagulation in this scenario remains controversial. This is a project that used DELPHI methodology to answer PICO questions related to anticoagulation in patients with COVID-19. The objective was to reach a consensus among multidisciplinary VTE experts providing answers to those PICO questions. Seven PICO questions regarding patients with COVID-19 responded with a broad consensus: 1. It is recommended to avoid pharmacological thromboprophylaxis in most COVID-19 patients not requiring hospital admission; 2. In most hospitalized patients for COVID-19 who are receiving oral anticoagulants before admission, it is recommended to replace them by low molecular weight heparin (LMWH) at therapeutic doses; 3. Thromboprophylaxis with LMWH at standard doses is suggested for COVID-19 patients admitted to a conventional hospital ward; 4. Standard-doses thromboprophylaxis with LMWH is recommended for COVID-19 patients requiring admission to Intensive Care Unit; 5. It is recommended not to determine D-Dimer levels routinely in COVID-19 hospitalized patients to select those in whom VTE should be suspected, or as a part of the diagnostic algorithm to rule out or confirm a VTE event; 6. It is recommended to discontinue pharmacological thromboprophylaxis at discharge in most patients hospitalized for COVID-19; 7. It is recommended to withdraw anticoagulant treatment after 3 months in most patients with a VTE event associated with COVID-19. The combination of PICO questions and DELPHI methodology provides a consensus on different recommendations for anticoagulation management in patients with COVID-19.
    MeSH term(s) Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use ; COVID-19/complications ; Delphi Technique ; Duration of Therapy ; Heparin, Low-Molecular-Weight/administration & dosage ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Venous Thromboembolism/complications ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/prevention & control
    Chemical Substances Anticoagulants ; Heparin, Low-Molecular-Weight
    Language English
    Publishing date 2021-10-22
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2516098-9
    ISSN 1999-4915 ; 1999-4915
    ISSN (online) 1999-4915
    ISSN 1999-4915
    DOI 10.3390/v13112128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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