Special article
Consensus document for the training of residents in cardiovascular risk
Documento de consenso para la formación de residentes en riesgo vascular
L. Castilla Guerraa,
, C. Suárez Fernándezb, J.M. Mostazac, P. Valdivielso Felicesd, A. Torres do Regoe, J.F. Gómez Cerezof, on behalf of the Vascular Risk Workgroup of the Spanish Society of Internal Medicine
Corresponding author
a Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain
b Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, Spain
c Servicio de Medicina Interna, Hospital Universitario Carlos III. Madrid, Spain
d Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria. Málaga, Spain
e Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón. Madrid, Spain
f Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, Madrid, Spain
Read
8
Timeswas read the article
3
Total PDF
5
Total HTML
Share statistics
array:24 [ "pii" => "S2254887420301028" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.11.013" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "1784" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:587-91" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0014256520300047" "issn" => "00142565" "doi" => "10.1016/j.rce.2019.11.014" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "1784" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:587-91" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ARTÍCULO ESPECIAL</span>" "titulo" => "Documento de consenso para la formación de residentes en riesgo vascular" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "587" "paginaFinal" => "591" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Consensus document for the training of residents in cardiovascular risk" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Castilla Guerra, C. Suárez Fernández, J.M. Mostaza, P. Valdivielso Felices, A. Torres do Rego, J.F. Gómez Cerezo" "autores" => array:7 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Castilla Guerra" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Suárez Fernández" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Mostaza" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Valdivielso Felices" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Torres do Rego" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Gómez Cerezo" ] 6 => array:1 [ "colaborador" => "en representación del Grupo de Trabajo de Riesgo Vascular de la SEMI" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2254887420301028" "doi" => "10.1016/j.rceng.2019.11.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420301028?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256520300047?idApp=WRCEE" "url" => "/00142565/0000022000000009/v1_202011260630/S0014256520300047/v1_202011260630/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2254887420300321" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.10.011" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "1788" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Rev Clin Esp. 2020;220:592-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Protocol for patients with suspected acute porphyria" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "592" "paginaFinal" => "596" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Protocolo de actuación en pacientes con sospecha de porfiria aguda" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4023 "Ancho" => 2917 "Tamanyo" => 526969 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">xxx.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.J. Castelbón Fernández, I. Solares Fernandez, E. Arranz Canales, R. Enríquez de Salamanca Lorente, M. Morales Conejo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "F.J." "apellidos" => "Castelbón Fernández" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Solares Fernandez" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Arranz Canales" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Enríquez de Salamanca Lorente" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Morales Conejo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256520300229" "doi" => "10.1016/j.rce.2019.10.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256520300229?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300321?idApp=WRCEE" "url" => "/22548874/0000022000000009/v1_202012131457/S2254887420300321/v1_202012131457/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887420300953" "issn" => "22548874" "doi" => "10.1016/j.rceng.2019.11.012" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "1783" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2020;220:583-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special Article</span>" "titulo" => "Neutrophils as instigators of thrombosis: Beyond antimicrobial protection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "583" "paginaFinal" => "586" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neutrófilos como instigadores de trombosis: más allá de la protección antimicrobiana" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.A. Páramo" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Páramo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256520300035" "doi" => "10.1016/j.rce.2019.11.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256520300035?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300953?idApp=WRCEE" "url" => "/22548874/0000022000000009/v1_202012131457/S2254887420300953/v1_202012131457/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Consensus document for the training of residents in cardiovascular risk" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "587" "paginaFinal" => "591" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Castilla Guerra, C. Suárez Fernández, J.M. Mostaza, P. Valdivielso Felices, A. Torres do Rego, J.F. Gómez Cerezo" "autores" => array:7 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Castilla Guerra" "email" => array:1 [ 0 => "castillafernandez@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Suárez Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.M." "apellidos" => "Mostaza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Valdivielso Felices" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Torres do Rego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 5 => array:3 [ "nombre" => "J.F." "apellidos" => "Gómez Cerezo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 6 => array:1 [ "colaborador" => "on behalf of the Vascular Risk Workgroup of the Spanish Society of Internal Medicine" ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Carlos III. Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria. Málaga, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón. Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Documento de consenso para la formación de residentes en riesgo vascular" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cardiovascular diseases are one of the main causes of morbidity and disability, and the leading cause of death worldwide. More than 17 million deaths per year are due to cardiovascular diseases, representing 31% of worldwide mortality. Eighty percent of these deaths are due to ischemic heart disease and cerebrovascular disease.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In Spain, cardiovascular disease is responsible for 28.8% of deaths (263.2 deaths per 100,000 inhabitants), a rate higher than that of cancer (26.7%), and respiratory diseases (12.2%).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Stroke is the leading cause of death in women and the third leading cause in men. The healthcare impact of these diseases is predicted to increase in the coming years.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Spain has a high prevalence of cardiovascular risk factors (CRFs), biological characteristics, and habits that increase the probability of experiencing and/or dying from a cardiovascular disease such as arterial hypertension, diabetes, and hypercholesterolemia. Nevertheless, therapeutic control of the various CRFs is generally suboptimal and has barely improved in recent years.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> Hypertension is a prime example, as it affects approximately 14 million people in Spain, representing somewhat more than 40% of the general adult population, and less than a quarter of these have their blood pressure under control.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Therefore, there are large gaps in the management of cardiovascular disease and, in particular, controlling the CRFs that cause the disease. Specific training on cardiovascular risk (CVR) is therefore essential for improving patients’ healthcare and reducing the likelihood of the onset or recurrence of cardiovascular disease, impaired quality of life, disability and associated mortality. Physicians need to acquire training and expertise necessary to be competent in the clinical, diagnostic, and therapeutic management of cardiovascular disease and CRFs.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Thus, the internist’s inclusive approach (maintaining an overall view of the patient) and their ability to act as a reference for specific diseases<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> offer internists an ideal position from which to respond to this pressing societal need. Numerous data are confirming the strategic role of internists in managing and treating cardiovascular diseases. In the outpatient activity of Internal Medicine, for example, both in general and specialized consultations, more than 90% of patients have some CRF, and approximately half have an established cardiovascular disease, regardless of the type of hospital.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">As stated in the royal decree that governs the training program for the Internal Medicine specialty,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> the clinical care of patients in CVR units is specifically included in the internist’s sphere of action.</p><p id="par0035" class="elsevierStylePara elsevierViewall">However, there are currently no documents that establish the CVR training of Resident physicians in Internal Medicine (RIMs), the content to be taught, the conduct of the training activities, or the training objectives.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Objectives</span><p id="par0040" class="elsevierStylePara elsevierViewall">The objective of this document was to reach a consensus and unify the recommendations for the specific training of RIMs in this health area.</p><p id="par0045" class="elsevierStylePara elsevierViewall">To this end, the Cardiovascular Risk Workgroup of the Spanish Society of Internal Medicine (SEMI) proposed the development of a consensus document among all members of the group. After preparing the initial draft, the document was presented at the 14th group meeting in Madrid and was subsequently submitted to every member of the workgroup (which has more than 800 internists enrolled in the group), for their review and subsequent modification with the reported comments.</p><p id="par0050" class="elsevierStylePara elsevierViewall">As a result, the group developed this document, which specifies the proposed training in CVR for RIMs.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">General objectives</span><p id="par0055" class="elsevierStylePara elsevierViewall">RIMs should acquire… <ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0060" class="elsevierStylePara elsevierViewall">Knowledge of basic concepts of atherogenesis and thrombosis, the CRFs, their repercussion on health, and how to prevent and treat cardiovascular disease.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0065" class="elsevierStylePara elsevierViewall">Experience in the use of diagnostic and therapeutic techniques for CVR.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0070" class="elsevierStylePara elsevierViewall">Study and training habits on CVR issues. Updated knowledge on the clinical practice guidelines and the ability to critically read the literature on CVR.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4</span><p id="par0075" class="elsevierStylePara elsevierViewall">Ability to conduct research on CVR; interpretation and collaboration with clinical trials and other studies on CVR; communication and publication entitled of studies in journals, etc.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5</span><p id="par0080" class="elsevierStylePara elsevierViewall">Skills for participating in the various workgroups, meetings, and congresses on CVR.</p></li></ul></p><p id="par0085" class="elsevierStylePara elsevierViewall">To achieve these objectives, the residents should finalize their training specifically in CVR units that are accredited by SEMI for this purpose. In addition, a specific assessment system for this rotation could be established, with varying levels of accreditation based on achieving these objectives.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Theoretical knowledge</span><p id="par0090" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1</span><p id="par0095" class="elsevierStylePara elsevierViewall">Concept and classification of CRFs.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2</span><p id="par0100" class="elsevierStylePara elsevierViewall">Epidemiology of vascular disease and CRFs.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3</span><p id="par0105" class="elsevierStylePara elsevierViewall">Calculation of CVR. CVR stratification scales. Techniques for improving RF stratification.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">4</span><p id="par0110" class="elsevierStylePara elsevierViewall">Primary and secondary prevention of vascular disease.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">5</span><p id="par0115" class="elsevierStylePara elsevierViewall">Arterial hypertension. Classification. Diagnosis. Treatment. Management of hypertension in special populations.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">6</span><p id="par0120" class="elsevierStylePara elsevierViewall">Dyslipidemia. Classification. Diagnosis. Treatment. Management of dyslipidemia in special populations.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">7</span><p id="par0125" class="elsevierStylePara elsevierViewall">Diabetes mellitus. Classification. Diagnosis. Treatment. Microvascular and macrovascular complications. Management of diabetes in special populations.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">8</span><p id="par0130" class="elsevierStylePara elsevierViewall">Tobacco use. Diagnosing and treating tobacco use.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">9</span><p id="par0135" class="elsevierStylePara elsevierViewall">Obesity and excess weight. Classification. Diagnosis and treatment.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">10</span><p id="par0140" class="elsevierStylePara elsevierViewall">Metabolic syndrome and fatty liver disease. Classification. Diagnosis. Treatment.</p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">11</span><p id="par0145" class="elsevierStylePara elsevierViewall">Physical inactivity. Diagnosis. Treatment.</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">12</span><p id="par0150" class="elsevierStylePara elsevierViewall">Other CRFs. Emerging CRFs.</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">13</span><p id="par0155" class="elsevierStylePara elsevierViewall">Atherogenesis and thrombosis. Diagnosis and treatment.</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">14</span><p id="par0160" class="elsevierStylePara elsevierViewall">Established vascular disease: coronary artery disease, cerebrovascular disease, and peripheral arterial disease. Diagnosis and treatment.</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Practical knowledge. Technical skills</span><p id="par0165" class="elsevierStylePara elsevierViewall">The resident physician should familiarize themselves with the various techniques employed in CVR and be able to establish their indication and interpretation and acquire skills for performing the techniques when available in the CVR unit.</p><p id="par0170" class="elsevierStylePara elsevierViewall">For practical purposes, the various techniques have been divided into six main knowledge areas:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0100"><span class="elsevierStyleLabel">1</span><p id="par0175" class="elsevierStylePara elsevierViewall">Vascular surgery</p></li><li class="elsevierStyleListItem" id="lsti0105"><span class="elsevierStyleLabel">2</span><p id="par0180" class="elsevierStylePara elsevierViewall">Hypertension area</p></li><li class="elsevierStyleListItem" id="lsti0110"><span class="elsevierStyleLabel">3</span><p id="par0185" class="elsevierStylePara elsevierViewall">Lipid area</p></li><li class="elsevierStyleListItem" id="lsti0115"><span class="elsevierStyleLabel">4</span><p id="par0190" class="elsevierStylePara elsevierViewall">Diabetes area</p></li><li class="elsevierStyleListItem" id="lsti0120"><span class="elsevierStyleLabel">5</span><p id="par0195" class="elsevierStylePara elsevierViewall">Tobacco use area</p></li><li class="elsevierStyleListItem" id="lsti0125"><span class="elsevierStyleLabel">6</span><p id="par0200" class="elsevierStylePara elsevierViewall">Obesity area</p></li></ul></p><p id="par0205" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> specifies the various techniques ordered by several areas of knowledge, which, in turn, are divided into two groups: techniques that RIMs should know how to interpret (I) and techniques that RIMs should know how to perform and interpret (P). The latter of these groups can be differentiated into the mandatory and recommended.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Teaching and research activity</span><p id="par0210" class="elsevierStylePara elsevierViewall">Physicians in training should actively participate in all teaching and research activities conducted by the CVR unit.</p><p id="par0215" class="elsevierStylePara elsevierViewall">The RIMs should… <ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0130"><span class="elsevierStyleLabel">1</span><p id="par0220" class="elsevierStylePara elsevierViewall">Conduct sessions (clinical, scientific literature, anatomical-clinical, etc.). The recommendation is for the resident to present at least one clinical/update session on CVR or cardiovascular disease during their rotation.</p></li><li class="elsevierStyleListItem" id="lsti0135"><span class="elsevierStyleLabel">2</span><p id="par0225" class="elsevierStylePara elsevierViewall">Collaborate on the various research lines and projects conducted by the unit.</p></li><li class="elsevierStyleListItem" id="lsti0140"><span class="elsevierStyleLabel">3</span><p id="par0230" class="elsevierStylePara elsevierViewall">Submit oral presentations and posters in national and international meetings and congresses on CVR.</p></li><li class="elsevierStyleListItem" id="lsti0145"><span class="elsevierStyleLabel">4</span><p id="par0235" class="elsevierStylePara elsevierViewall">Participate in the publication of studies in national and international journals.</p></li><li class="elsevierStyleListItem" id="lsti0150"><span class="elsevierStyleLabel">5</span><p id="par0240" class="elsevierStylePara elsevierViewall">Complete their training through attendance in external activities: courses, workshops, updates, etc. The recommendation is for residents to attend the national meeting of the Cardiovascular Risk Workgroup of SEMI during the residents’ year of rotation.</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Duration of the rotation</span><p id="par0245" class="elsevierStylePara elsevierViewall">The recommendation is an average rotation duration of 3 months in the CVR unit of the Internal Medicine department.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="par0250" class="elsevierStylePara elsevierViewall">Cardiovascular disease is currently a major health problem, not only for its high prevalence but also for the considerable morbidity, mortality and disability it entails.</p><p id="par0255" class="elsevierStylePara elsevierViewall">However, there are large gaps in the management of cardiovascular disease and, in particular, controlling the CRFs that cause the disease.</p><p id="par0260" class="elsevierStylePara elsevierViewall">Internists currently play a central role in the approach to this condition. Improving the knowledge of RIMs who will address these patients and updating them on the correct assessment and control of CVR will therefore be key elements in providing an appropriate response to this severe health problem.</p><p id="par0265" class="elsevierStylePara elsevierViewall">This article presents the proposed teaching plan for training in CVR of the Cardiovascular Risk Workgroup of SEMI as s contribution from our society to a specific training need in CVR.</p><p id="par0270" class="elsevierStylePara elsevierViewall">Implementing this proposal would provide an important benefit, not only for medical internists in training but also for society as a whole.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflicts of interest</span><p id="par0275" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p><p id="par0280" class="elsevierStylePara elsevierViewall">No fundings to declare</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1432565" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1307721" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1432566" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1307722" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Objectives" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "General objectives" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Theoretical knowledge" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Practical knowledge. Technical skills" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Teaching and research activity" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Duration of the rotation" ] ] ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-10-28" "fechaAceptado" => "2019-11-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1307721" "palabras" => array:6 [ 0 => "Programme" 1 => "Training" 2 => "Cardiovascular risk" 3 => "Cardiovascular disease" 4 => "Resident" 5 => "Internal Medicine" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1307722" "palabras" => array:6 [ 0 => "Programa" 1 => "Formación" 2 => "Riesgo vascular" 3 => "Enfermedad vascular" 4 => "Residente" 5 => "Medicina Interna" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">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.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Medical internists play a central role in diagnosing and treating vascular disease and controlling the cardiovascular risk factors (CRFs) that cause it. In fact, the clinical care of patients in cardiovascular risk units is a specific characteristic of an internist’s field of action.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This article contains the consensus document for the training of residents in CRFs. This proposal by the Cardiovascular Risk Workgroup of the Spanish Society of Internal Medicine emerged as a response by our society to the specific need for training in CRFs.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Implementing this proposal would provide an important benefit, not only for medical internists in training but also for society as a whole.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En la actualidad la enfermedad vascular (EV) constituye un problema de salud de primer orden, no solo por su elevada prevalencia sino también por la gran morbi-mortalidad y discapacidad que conlleva.</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">El médico internista juega un papel central en el diagnóstico y tratamiento de la EV, así como en el control de los factores de riesgo vascular (RV) que la causan. De hecho, dentro del campo de acción del internista figura específicamente la atención clínica a enfermos en Unidades de RV.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">En este artículo se recoge el documento de consenso para la formación de residentes en RV. Esta propuesta del Grupo de Trabajo de RV de la Sociedad Española de Medicina Interna surge como respuesta de nuestra Sociedad a una necesidad específica formativa en RV.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Pensamos que su implantación supondrá un beneficio importante, no solo para el médico internista en formación, sino también para la sociedad en su conjunto.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castilla Guerra L, Suárez Fernández C, Mostaza JM, Valdivielso Felices P, Torres do Rego A et al. Documento de consenso para la formación de residentes en riesgo vascular. Rev Clin Esp. 2020;220:587–591.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(I) Techniques that clinicians should know how to interpret.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(P) Techniques that clinicians should know how to perform and interpret: (Pm), Mandatory; (Pr), Recommended.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: APOE, apolipoprotein E; CT, computed tomography; Hb, a1cglycated hemoglobin; HOMA, homeostatic model assessment; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vascular area \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Carotid ultrasound: assessing the intima media thickness and the presence of carotid artery plaques (Pr).</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Abdominal ultrasound: screening of abdominal aortic aneurisms. Fatty liver assessment (Pm).</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Other vascular ultrasounds: femoral ultrasound. Echo-Doppler of renal arteries (Pr).</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Ankle-brachial pressure index (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Arterial stiffness study</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pulse wave velocity (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other parameters derived from the pulse wave (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Other techniques: Clinicians should understand the indications and interpret the results of the following techniques:</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Myocardial ischemia: \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stress testing (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stress echocardiography (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Myocardial perfusion studies with radioisotopes (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronary CT (I): anatomy, coronary calcium \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiac MRA (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Coronary angiography (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial MRA and angio-CT (I) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="1" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Hypertension area</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Blood pressure measurement techniques. Self-measured blood pressure at home. Outpatient blood pressure monitoring (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Measurement of central aortic pressure and pulse wave-derived parameters (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Eye fundus. Hypertensive retinopathy (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Renal damage assessment techniques. Creatinine clearance. Albuminuria (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Electrocardiogram. Performance and interpretation technique (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Clinical echocardiography: measurement of interventricular septum, posterior wall, atrial size, E/A wave ratio (Pr)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Chest and abdominal CT (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Brain CT and MRI (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Analytical studies of secondary phases: plasma renin activity/aldosterone, cortisol, catecholamines and metanephrines (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Polysomnography (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Adrenal gland vein catheterization (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="1" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Lipid area</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lipid profile (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Measurement of apolipoproteins (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lipoprotein(a) (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">APOE genotype (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Ultrasensitive C-reactive protein (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="1" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Diabetes area</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Hba<span class="elsevierStyleInf">1c</span> (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">6-point blood glucose profiles (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Oral glucose overload test (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Peptide C (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HOMA index (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Retinography-eye fundus (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Diabetic foot assessment: tonometry, tuning fork, arterial Doppler (Pr)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Continuous glucose monitoring techniques. Flash system (Pr)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="1" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Tobacco use area</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Spirometry (I)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">CO-oximetry (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Assessment of dependence. Fagerström test (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Smoking cessation techniques (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="1" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Obesity area</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Abdominal circumference (Pm)</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Techniques for assessing obesity and body fat: calipers, impedance audiometry (Pr).</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2463171.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Recommended practical knowledge and technical skills for the training of medical internists in cardiovascular risk.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "WHO. Cardiovascular disease. http://www.who.int/cardiovascular_diseases/en/." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Defunciones según la Causa de Muerte" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Instituto Nacional de Estadística" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2017" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors control for primary prevention of cardiovascular disease in men: Evidence from the Aragon Workers Health Study (AWHS)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Aguilar-Palacio" 1 => "S. Malo" 2 => "C. Feja" 3 => "M. Lallana" 4 => "M. León-Latre" 5 => "J.A. Casasnovas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0193541" "Revista" => array:4 [ "tituloSerie" => "PLoS ONE" "fecha" => "2018" "volumen" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30586373" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Control glucémico y de los factores de riesgo cardiovascular en los pacientes con diabetes tipo 2 con enfermedad cardiovascular en España, y su patrón de tratamiento, en función del género: Estudio CODICE" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Millaruelo Trillo" 1 => "F.X. Cos-Claramunt" 2 => "L. Avila Lachica" 3 => "P. Buil Cosiales" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Semergen." "fecha" => "2019" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia, diagnóstico, tratamiento y control de la hipertensión arterial en España. Resultados del estudio Di@bet.es" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Menéndez" 1 => "E. Delgado" 2 => "F. Fernández-Vega" 3 => "M.A. Prieto" 4 => "E. Bordiú" 5 => "A. Calle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cardiol." "fecha" => "2016" "volumen" => "69" "paginaInicial" => "572" "paginaFinal" => "578" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministerio de Sanidad y Consumo (BOE 33 de 7/2/2007). ORDEN SCO/227/2007, de 24 de enero, por la que se aprueba y publica el programa formativo de la especialidad de Medicina Interna." ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Riesgo vascular en las consultas de Medicina Interna. Estudio MICARE" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Peña De la" 1 => "A. Roca-Cusachs" 2 => "C. Suarez" 3 => "S. Bonet" 4 => "en nombre del grupo MICARE" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "2013" "volumen" => "140" "paginaInicial" => "246" "paginaFinal" => "254" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000009/v1_202012131457/S2254887420301028/v1_202012131457/en/main.assets" "Apartado" => array:4 [ "identificador" => "3982" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000009/v1_202012131457/S2254887420301028/v1_202012131457/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420301028?idApp=WRCEE" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 5 | 3 | 8 |
