Abstract：
:The limitation of the therapeutic effort (LTE) consists in not applying extraordinary or disproportionate measures for therapeutic purposes that are proposed for a patient with poor life prognosis and/or poor quality of life. There are two types. The first is to not initiate certain measures or to withdraw them when they are established. A decision of the LTE should be based on some rigorous criteria, so that we make the following proposal. First, it is necessary to know the most relevant details of the case to make a decision: the preferences of the patient, the preferences of the family when pertinent, the prognosis (severity), the quality of life and distribution of the limited resources. After, the decision should be made. In this phase, participatory deliberation should be established to clarify the end of the intervention. Finally, if it is decided to perform an LTE, it should be decided how to do it. Special procedures, disproportionate measures, that are useless and vain should not be initiated for the therapeutic objective designed (withdraw them if they have been established). When it has been decided to treat a condition (interim measures), the treatment should be maintained. This complex phase may need stratification of he measures. Finally, the necessary palliative measures should be established.
journal_name
Rev Clin Espjournal_title
Revista clinica espanolaauthors
Herreros B,Palacios G,Pacho Edoi
10.1016/j.rce.2011.04.016subject
Has Abstractpub_date
2012-03-01 00:00:00pages
134-40issue
3eissn
0014-2565issn
1578-1860pii
S0014-2565(11)00312-2journal_volume
212pub_type
杂志文章abstract：INTRODUCTION:Obesity is a chronic, complex and multifactorial metabolic disease involved in the development of chronic noncommunicable diseases such as type 2 diabetes mellitus, cardiovascular disease and cancer. The care of individuals with obesity is an essential part of the holistic approach provided by internal med...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2020.06.008
更新日期：2020-07-25 00:00:00
abstract：:Despite its high frequency, there is not a consensus for the management of a patient with mild head trauma. In this prospective study we analyzed wether the transient loss of consciousness was associated with a higher risk of cranioencephalic injury in function of patient's age. Fifty-two patients with a Glasgow score...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1999-10-01 00:00:00
abstract：:Fibromyalgia or fibromyalgic syndrome (FMS) is a clinical picture of unknown origin that is characterized by generalized, incapacitating and chronic pain together with the demonstration in the physical examination of previously defined points in which moderate pressure causes pain, called fibromyalgia tender points (F...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13077119
更新日期：2005-07-01 00:00:00
abstract：:In this clinical observation, we make a small summary of the current state of pharmacological treatment of obesity. The interest in the use of drugs in the treatment of obesity has grown in recent years, upon our knowledge of the biological basis of obesity having increased, and also because non-pharmacological treatm...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13074165
更新日期：2005-04-01 00:00:00
abstract：BACKGROUND:To estimate the use of resources and costs of health care to patients infected with the human immunodeficiency virus (HIV). METHODS:Prospective study in university hospital in Catalonia including 166 patients. AIDS was defined following 1987 criteria of the Centers for Disease Control. AIDS phase was divide...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1998-07-01 00:00:00
abstract：:Sarcoidosis is a disease which presents important clinical differences according to its geographical distribution. Thus, the objective of this study was to evaluate the epidemiologic, clinical, radiologic, and diagnostic characteristics in a series of 30 sarcoidosis patients in the province of Salamanca (representing ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-09-01 00:00:00
abstract：:215 cases diagnosed of human leptospirosis in the Camagüey Province, Cuba, are studied, for the period between 1986 and 1990. The clinical and epidemiological features are studied, together with the anatomopathological study of the decreased. The most frequent complications and the treatment employed, including prophy...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-05-01 00:00:00
abstract：BACKGROUND:The RS3PE syndrome is a recently described uncommon disorder in the elderly patient; in the initial reports, it was characterized by an excellent prognosis with total remission. In contrast with rheumatoid arthritis and polymyalgia rheumatic, it has been related to HLA B7. Further works have questioned its b...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1999-12-01 00:00:00
abstract：:One hundred and thirty six patients presenting pleural effusion and whose diagnosis was obtained by clinical, biochemical, bacteriological, cytological and histological methods have been studied and classified into seven groups: 20 transudates, 29 inflammatory, 25 tuberculosis, 25 non adenocarcinoid neoplasias, 24 ade...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
abstract：OBJECTIVE:Several studies have reported that a higher degree of hemoconcentration in patients admitted for the treatment of acute heart failure (HF) constitutes a favorable prognostic factor in the year following the index episode. The objective of this study was to evaluate whether the highest degree of hemoconcentrat...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2018.07.003
更新日期：2019-01-01 00:00:00
abstract：:Central venous catheters are essential in modern-day medical practice, particularly in intensive care units. Although such catheters provide necessary vascular access, their use puts patients at risk of mechanical and infectious complications. Unfortunately, these complications are associated with an increase of the m...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：10.1157/13084771
更新日期：2006-01-01 00:00:00
abstract：:Patobiographic data of four brilliant painters who lived in three different centuries (Goya [XVIII], Fortuny and Van Gogh [XIX] and Portinari [XX]), were examined in search for a suspected lead poisoning. It is concluded that Goya's disease and deafness was probably caused by lead poisoning. Fortuny's death was probab...
journal_title：Revista clinica espanola
pub_type： 传,历史文章,杂志文章
doi：10.1016/s0014-2565(06)72707-2
更新日期：2006-01-01 00:00:00
abstract：:Laughter is associated to many physiological and psychological benefits. Although women laugh more than men do, the daily frequency of laughter does not seem to differ. Laughter in all its forms and manifestations is an indicator of family vitality and healthy couples. Laughter is very attractive at the interpersonal ...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：10.1016/j.rce.2010.10.013
更新日期：2011-07-01 00:00:00
abstract：:Pancreas transplantation offers the possibility of preventing the development and progression of diabetic lesions by adequate control of hydrocarbon metabolism. Moreover, the diabetic patient is freed from dietary and physical restrictions, as well as from insulin treatment. However, this is achieved at the expense of...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：
更新日期：1989-07-01 00:00:00
abstract：OBJECTIVES:To assess the cost-effectiveness of a nucleic acid amplification test (FluoroType MTB®) in pleural fluid (PF) and sputum to diagnose tuberculous pleural effusion (TPE). We also analysed the increase in diagnostic yield of a second FluoroType MTB® test, obtained through a new thoracentesis, when the first had...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2020.04.010
更新日期：2020-06-01 00:00:00
abstract：:Diabetes mellitus (DM) is characterized by a hypercoagulability state and many of these disorders are corrected with adequate metabolic control. The goal of this study was to assess diverse hemostatic and fibrinolytic parameters in 12 insulin-dependent (IDDM) metabolically controlled patients without vascular lesions ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：:Metabolic syndrome is a disorder having high prevalence in our society. It is characterized by different proatherogenic disorders (dyslipidemia, arterial hypertension, hydrocarbonated intolerance, prothrombotic and proinflammatory conditions) and predisposing factors (central obesity, sedentary life and genetic factor...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13085362
更新日期：2006-02-01 00:00:00
abstract：:Liver transplant is the first therapeutic choice in most of the advanced liver diseases. Nevertheless, its performance originates a number of complications derived from: a) conservation techniques of the organ (in our study a prolonged time of hot ischemia was significantly associated with); b) surgery (all patients w...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-10-01 00:00:00
abstract：OBJECTIVE:Analyze the effect of AM3, an oral immunomodulator, on the exacerbations and on the use of antibiotics in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Systematic search of controlled clinical trials that used AM3 in some treatment group and that included data on the clinical effects of ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13065976
更新日期：2004-09-01 00:00:00
abstract：:Toxic shock syndrome (TSS) is a potentially fatal acute disease preferentially affecting menstruating women and is related to the use of vaginal tampons seems to be due to an specific exotoxin produced by some Staphylococcus aureus strains. We present here the case of a male patients suffering cavitated pneumonia who ...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:The use of ambulatory monitorization of blood pressure has shown the importance of the alarm reaction or white coat reaction and its conditioning factors in some patients. The influence of place (medical facility or home) and person who performs the procedure (doctor or nurse) on the taking of blood pressure is studie...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:Non insulin antidiabetic drugs are widely used in patients with type 2 diabetes. However, the drugs' effect in terms of reducing cardiovascular risk has been the subject of controversy. In 2008, based on the evidence of cardiovascular risk resulting from the use of a number of non insulin antidiabetic drugs, the US Fo...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2017.02.007
更新日期：2017-11-01 00:00:00
abstract：:Pneumonia due to Pneumocystis carinii (PC) is characterized, in most cases, by the existence of infiltrates of interstitium or bilateral interstitium-alveolar type on the thorax radiography. However atypical radiological findings associated with this type of opportunistic infection are being described more and more fr...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：INTRODUCTION:Anti-phospholipid antibodies (APA) may involve heart and valvular heart disease seems to be the most common clinical manifestation. OBJECTIVES:To study the prevalence and characteristics of valvular heart disease in a large patient population with anti-phospholipid syndrome (APS) and also to analyze the c...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(02)71136-3
更新日期：2002-10-01 00:00:00
abstract：:Polymicrobial endocarditis (PE) is uncommon, whether in series of cases of polymicrobial bacteriemia or of endocarditis. Among the 201 cases of infective endocarditis seen between 1986 and 1995 by an infectious diseases service, 12 patients had PE (6%). Nine were males, mean age was 28 years and ten were active intrav...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1997-04-01 00:00:00
abstract：BACKGROUND:There are no simple and validated instruments for evaluating the training of specialists. OBJECTIVES:To analyze the reliability and validity of a computerized self-assessment method to quantify the acquisition of medical competences during the Internal Medicine residency program. METHODS:All residents of o...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2012.04.004
更新日期：2012-12-01 00:00:00
abstract：:We have screened a population of newborn babies without any previous apparent pathology in order to discover the distribution of alpha 1-anti-trypsin phenotypes (AAT) in our community. The research has been done on 457 babies born in the province of Valladolid, determining the plasma levels of AAT and the correspondin...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：:Results of clinical studies are contradictories, with different results in adults and children. Some studies detected a beneficial effect of Omega 3 (w3) fatty acid dietary intake in the risk of asthma and other studies have demonstrated a beneficial effect on clinical symptoms. In our area, a low intake of w3 fatty a...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：10.1157/13098496
更新日期：2007-01-01 00:00:00
abstract：:Clinical findings and response to treatment in four cases with plasma cell leukemia (PCL) out of 152 patients of multiple myeloma diagnosed at the Hospital La Paz from 1969 to 1988 are studied. Three of the four plasma cell leukemia cases presented a primary form, and one a secondary form. Our cases had a lower incide...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：UNLABELLED:The objective of surgical treatment in ulcerative colitis (UC) and Crohn's disease (CD) differs. Surgery in UC is more aggressive and potentially curative whereas in CD it is more conservative and palliative. OBJECTIVE:To assess the opinion of patients with inflammatory bowel disease who underwent surgery i...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(00)70698-9
更新日期：2000-09-01 00:00:00
