Abstract：
INTRODUCTION:There is little information on the limitation of therapeutic effort (LTE) in patients admitted to hospital internal medicine units. OBJECTIVES:To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them. PATIENTS AND METHODS:An observational, descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid. The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months. RESULTS:The study included 382 patients with a mean age of 85±10 years; 204 were women (53.4%) and 222 (58.1%) came from their homes. Some 51.1% of the patients were terminal, 43.2% had moderate to severe dementia, and 95.5% presented at least moderate comorbidity. Some type of LTE was performed in 318 patients (83.7%); the most common orders were "No cardiopulmonary resuscitation" (292 patients, 76.4%; 95% CI 72.1-80.8), "Do not use aggressive measures" (113 patients, 16.4%; 95% CI 13.7-19.4) and "Do not transfer to an intensive care unit" (102 cases, 14.8%, 95% CI 12.3-17.7). Some type of LTE was performed in 318 patients (83.7%); the most common orders were "No cardiopulmonary resuscitation" (292 patients, 76.4%; 95% CI 72.1-80.8), "Do not use aggressive measures" (113 patients, 16.4%; 95% CI 13.7-19.4) and "Do not transfer to an intensive care unit" (102 cases, 14.8%, 95% CI 12.3-17.7). CONCLUSIONS:LTE is common among patients who die in Internal Medicine. The most widely used regimens were "No CPR" and the unspecific statement "Do not use aggressive measures". The patients were elderly and had significant comorbidity, terminal illness and advanced dementia.
journal_name
Rev Clin Espjournal_title
Revista clinica espanolaauthors
García Caballero R,Herreros B,Real de Asúa D,Gámez S,Vega G,García Olmos Ldoi
10.1016/j.rce.2017.10.001subject
Has Abstractpub_date
2018-01-01 00:00:00pages
1-6issue
1eissn
0014-2565issn
1578-1860pii
S0014-2565(17)30235-7journal_volume
218pub_type
杂志文章abstract：:The validity of estimates of energy intake in a group of young women, and the influence of body mass index (BMI) and concern over bodyweight on such estimates, were determined with the aid of a food record intake. The study subjects were a group of female university students between 20 and 32 years of age. Participant...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：:The present design is a descriptive study in which people bitten by animals, rabies treatment used and the reactions to it are described. The frequency of adverse effects to the vaccine and to the serum are pointed out. The forms of clinical presentation and the clinical symptoms of the reactions observed in the Ciego...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13058826
更新日期：2004-03-01 00:00:00
abstract：:The aim or our study was to evaluate the main clinical and etiological features or primary acute pericarditis with severe pericardial effusion without cardiac tamponade. Our experience included 35 patients with this problem diagnosed in the last 5 years. Patients with a previous potential etiology for acute pericardit...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(06)72744-8
更新日期：2006-03-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:Atrial fibrillation (AF) is the most common type of arrhythmia. The purpose of this study was to determine the prevalence of atrial fibrillation and its relationship with cardiovascular risk factors in Spain. METHODOLOGY:Cross-sectional study based on a grouped analysis of 17,291 randomized i...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2014.06.006
更新日期：2014-12-01 00:00:00
abstract：UNLABELLED:An inappropriate hospital use, defined as hospital utilization that could have been occurred at a lower attending level or in less time, increases costs, creates inefficient management and influences on attending quality. The objective of this work was to evaluate the appropriateness and inappropriateness of...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：2000-12-01 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. In 1997, The Fourth International Workshop-Conference on Gestational Diabetes Mellitus (GDM) recommended the use of Carpenter and Coustan diagnostic criteria instead of those of Sullivan and Mahan used until then. The objective of this work was to study the incidence of GDM in the southeast Madrid area by ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(02)71008-4
更新日期：2002-03-01 00:00:00
abstract：:Since the beginning of the 20th century, there has been a progressive increase in the Earth's temperature. This warming of the Earth's surface is largely due to the so-called green house effect that can alter the natural behavior of some natural phenomena such as El Niño. Several articles on climate change have been p...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/s0014-2565(09)71240-8
更新日期：2009-05-01 00:00:00
abstract：:Correct functioning of the Ethics Committee (EC) guarantees respect to the rights of the subjects participating in clinical research. The European transposition of the clinical trial guidelines by the Royal Decree (RD) 223/2004 February 6 speeds up and simplifies the administrative procedures for the authorization of ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13079764
更新日期：2005-10-01 00:00:00
abstract：:Cyclophosphamide is used both in the treatment of malignant and non-malignant diseases. Urinary neoplasms secondary to its use have been described. We discuss the case of a patient with panarteritis nodosa treated with cyclophosphamide during 63 months, with a total dose of 210 grams, and that showed a bladder neoplas...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
abstract：OBJECTIVES:To evaluate the scientific output in Biomedicine and Health Sciences in Andalusia in the context of the published works on the national scientific output in the last few years. MATERIAL:Descriptive study with seven different information sources: a) final Report of the Experts Committee on Documentation from...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVES:To describe the evolution of smoking habits in the general population of Barcelona from 1983 to 1992 and motivation of smokers and the perceived social pressure to leave smoking in 1992. DESIGN:Cross-sectional descriptive study of trends. PLACE AND PARTICIPANTS: From 1983 to 1992 two health surveys were con...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1996-06-01 00:00:00
abstract：:Deep vein thrombosis (DVT) is part of the clinical spectrum of venous thromboembolism disease (VTE), whose estimated annual incidence rate is 1-2 episodes per 1000 individuals and represents the third leading cause of cardiovascular mortality in developed countries. Establishing an accurate diagnosis of DVT is essenti...
journal_title：Revista clinica espanola
pub_type： 杂志文章,评审
doi：10.1016/j.rce.2020.03.009
更新日期：2020-06-27 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：OBJECTIVES:Celiac disease is a chronic immune-mediated disease of the small intestine. It has been known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with celiac disease. The aim of the study was to assess Tp-e interval and Tp-e/QT ratio in patients with celiac ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2017.09.001
更新日期：2017-11-01 00:00:00
abstract：:We discuss 19 cases of infection due to Cryptococcus neoformans diagnosed in 438 AIDS patients admitted to our center (4%). Fourteen of them showed meningitis confirmed by culture of C. neoformans in CSF. Clinical features were rather unspecific and disorders in CSF parameters were non striking. The diagnostic techniq...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-05-01 00:00:00
abstract：:Inflammatory pseudotumor (IP) is a rare pathological entity. Although, the pulmonary affection is the most frequent, any other organ can be involved. Its etiopathology is unknown. The disease is considered as a reactive process constituted by chronic inflammatory elements and a benign behavior. The lack of a specific ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1991-12-01 00:00:00
abstract：OBJECTIVE:Miglitol belongs to the group of the inhibitors of the alpha-glucosidases and in several studies has demonstrated its usefulness in the improvement of the glycemic control in the different types of diabetic patients. The goal of our study was to analyze the usefulness of miglitol in the blood glucose and lipi...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1157/13056791
更新日期：2004-01-01 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：:Malign small cell tumors in the thoracopulmonary region is a tumor of neuroectodermic origins with polymorphous and infrequent presentation. It is mostly found among young people, developing an aggressive and severe course. It is a small cell tumor involving small quantities of cytoplasm without glucogen, round or ova...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：OBJECTIVE:Descriptive study of severe respiratory infections caused by Pseudomonas aeruginosa in patients with HIV infection. METHODS:Review of clinical records of HIV-positive patients admitted in a tertiary hospital from 1-1-1990 to 9-30-1995. The patients included in this study were those with P. aeruginosa recover...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：:Comparative performance of four methods (IFI, IgM anti-VCA, Organon Teknika; ELISA, IgM anti VCA, Incstar Corp and Pharmacia Diagnostic Inc; ELISA IgM against a group of several antigens which principal component is EBNA, Behring Institute) to detect antibodies (Abs) against Epstein-Barr virus in 180 patients (group 1...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1992-10-01 00:00:00
abstract：:We have studied ambulatory hypertensive patients by means of a survey protocol, in order to observe the possible causes of inadequate control. In 8% of patients, hygienic and dietetic measures were applied, specially low-salt diet and weight loss. This percentage is very low compared to that reported by other authors....
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
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：:An open and multicentric study was conducted with 66 patients with mild to severe diastolic arterial hypertension and echocardiographic left ventricular hypertrophy, the evolution of diastolic function, by means of doppler transmitral flow echocardiography, under treatment with ramipril, an angiotensin converting enzy...
journal_title：Revista clinica espanola
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：1998-01-01 00:00:00
abstract：:Vascular disease is currently a major health problem, not only for its high prevalence but also for the considerable morbidity, mortality and disability that it entails. Medical internists play a central role in diagnosing and treating vascular disease and controlling the cardiovascular risk factors (CRFs) that cause ...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：10.1016/j.rce.2019.11.014
更新日期：2020-02-25 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：:Streptococcal gangrene, an unusual form of necrotizing fasciitis with fatal outcome, has been recently rediscovered and has gained popularity with the name "disease of flesh eating bacteria". The incidence of this and other severe diseases caused by Streptococcus pneumoniae has been suggested to be increasing. Only th...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1999-02-01 00:00:00
abstract：:The antibiotherapy resistance evolution and the appearance of new enterobacter in our ICU's flora have been studied. A total of 638 bacterial samples were studied. The most frequent isolated pathogens were: Pseudomonas aeruginosa (182 strands), Escherichia coli (108 strands), Staphylococcus epidermidis (99 strands) an...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1990-04-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The pleural fluid/serum cholinesterase ratio (PF/S) is the most efficient parameter to differentiate transudates from exudates. The objective of this study was to evaluate whether its determination might yield additional diagnostic information in pleural exudates. MATERIALS AND METHODS:A tota...
journal_title：Revista clinica espanola
pub_type： 杂志文章
doi：
更新日期：1997-06-01 00:00:00
