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Angina bullosa hemorrhagica an enigmatic oral disease

World Journal of Stomatology 2015年第1期4卷 1-7页

作者： javier Alberdi-Navarro maría Luisa Gainza-Cirauqui maría Prieto-Elías José Manuel Aguirre-Urizar Oral Medicine and Oral and Maxillofacial Pathology Units Dental Clinic Service Master in Oral Pathology Department of Stomatology II UFI 11/25 University of the Basque Country/EHU48950 Leioa Spain Department of Dental Surgery Faculty of Dental Surgery University of Malta 2080 Msida Malta

Angina bullosa hemorrhagica(ABH) is an enigmatic oral disorder described for the first time by Badham in 1967 to define blisters with a hematic content in the oralcavity and oropharynx unrelated to any hematological, dermatological or systemic disease. The ABH is an uncommon disease of the oral cavity distinctively affecting adults, with the highest incidence over the 5th decade of life. This process is considered nowadays to have a multifactorial etiopathogenesis, where mild oral traumatisms can trigger the blisters in susceptible individuals. Certain association on the onset of the lesion with the chronic use of inhaled steroids and, more controversially, with triggering systemic disorders, such as, diabetes or hypertension has been described. Characteristically, the ABH blisters are acute and are located on the lining mucosa, more frequently on the soft palate. Usually, the lesions are solitary and rupture easily, resulting in a superficial ulceration that heals quickly without scarring. The histopathological analysis shows a subepithelial blister containing blood and direct immunofluorescence on the epithelium is negative. The differential diagnosis should consider all oral vesiculobullous disorders with hematic content, including mucocutaneos, hematological or cystic pathology. The diagnosis of ABH is clearly clinical, although the biopsy might be helpful on atypical or abnormally recurrent cases. The general prognosis of ABH is good and the treatment is symptomatic.

关键词： Angina Bullosa Hemorrhagica Traumatic Blister

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Management of oligometastatic non-small cell lung cancer patients:Current controversies and future directions

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World Journal of Clinical Oncology 2019年第10期10卷 318-339页

作者： Felipe Counago javier Luna Luis Leonardo Guerrero Blanca Vaquero maría Cecilia Guillén-Sacoto Teresa González-Merino Begona Taboada Verónica Díaz Belén Rubio-Viqueira Ana Aurora Díaz-Gavela Francisco Josémarcos Elia del Cerro Department of Radiation Oncology Hospital Universitario Quirónsalud MadridPozuelo de AlarcónMadrid 28223Spain Department of Radiation Oncology Hospital La LuzMadrid 28003Spain Clinical Department Faculty of BiomedicineUniversidad EuropeaMadrid 28223Spain Department of Radiation Oncology Hospital Fundación Jiménez DíazMadrid 28040Spain Department of Medical Oncology Hospital La LuzMadrid 28003Spain Department of Radiation Oncology Complexo Hospitalario Universitario Santiago de CompostelaSantiago de Compostela 15706Spain Department of Radiation Oncology Hospital Universitario Puerta del MarCádiz 11009Spain Department of Medical Oncology Hospital Universitario Quirónsalud MadridPozuelo de AlarcónMadrid 28223Spain

Oligometastatic non-small cell lung cancer(NSCLC)describes an intermediate stage of NSCLC between localized and widely-disseminated *** stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor ***,the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery)that targets the metastatic lesions and the primary tumor to achieve disease *** approach offers the potential to achieve prolonged survival in patients who,in the past,would have only received palliative *** optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous)remain *** the lack of head-to-head studies comparing radiotherapy to surgery in these patients,the decision to apply surgery or radiotherapy(with or without systemic treatment)must be based on prognostic factors that allow us to classify *** classification will allow us to select the most appropriate therapeutic strategy on an individualized *** the future,the molecular or microRNA profiles will likely improve the treatment selection *** objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC,focusing on the role of radiotherapy and *** also discuss areas of controversy and future directions.

关键词： Non-small cell lung cancer Metastasectomy Oligometastases Stereotactic ablative radiotherapy Stereotactic body radiation therapy Radiosurgery

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Management of primary achalasia: The role of endoscopy

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World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 593-605页

作者： marisol Luján-Sanchis Patricia Suárez-Callol Ana Monzá-Gallego Inmaculada Bort-Pérez Lydia Plana-Campos Luis Ferrer-Barceló Laura Sanchis-Artero maría Llinares-Lloret Juan Antonio Tuset-Ruiz javier Sempere-Garcia-Argüelles Pilar Canelles-Gamir Enrique Medina-Chuliá Digestive Diseases Unit General University Hospital of Valencia

Achalasia is an oesophageal motor disorder which leads to the functional obstruction of the lower oesophageal sphincter(LES) and is currently incurable. The main objective of all existing therapies is to achieve a reduction in the obstruction of the distal oesophagus in order to improve oesophageal transit, relieve the symptomatology, and prevent long-term complications. The most common treatments used are pneumatic dilation(PD) and laparoscopic Heller myotomy, which involves partial fundoplication with comparable shortterm success rates. The most economic non-surgical therapy is PD, with botulinum toxin injections reserved for patients with a higher surgical risk for whom the former treatment option is unsuitable. A new technology is peroral endoscopic myotomy, postulated as a possible non-invasive alternative to surgical myotomy. Other endoluminal treatments subject to research more recently include injecting ethanolamine into the LES and using a temporary self-expanding metallic stent. At present, there is not enough evidence permitting a routine recommendation of any of these three novel methods. Patients must undergo follow-up after treatment to guarantee that their symptoms are under control and to prevent complications. Most experts are in favour of some form of endoscopic follow-up, however no established guidelines exist in this respect. The prognosis for patients with achalasia is good, although a recurrence after treatment using any method requires new treatment.

关键词： Achalasia Endoscopic treatment Dilation Botulinum toxin Myotomy

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GOECP/SEOR clinical recommendations for lung cancer radiotherapy during the COVID-19 pandemic

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World Journal of Clinical Oncology 2020年第8期11卷 510-527页

作者： Felipe Couñago Arturo Navarro-martin javier Luna Nuria Rodríguez de Dios Aurora Rodríguez Francesc Casas Rafael García Antonio Gómez-Caamaño Jorge Contreras javier Serrano Department of Radiation Oncology Hospital Universitario Quirónsalud MadridPozuelo de AlarcónMadrid 28223Spain Clinical Department Hospital La LuzMadridFaculty of BiomedicineUniversidad EuropeaMadrid 28223Spain Department of Radiation Oncology Institut Catalád’OncologiaL’Hospitalet de LlobregatBarcelona 08908Spain Department of Radiation Oncology Hospital Fundación Jiménez DíazMadrid 28040Spain Department of Radiation Oncology Hospital del MarBarcelona 08003Spain Department of Radiation Oncology Hospital Ruber InternacionalMadrid 28034Spain Department of Radiation Oncology Thoracic UnitHospital ClínicBarcelona 08036Spain Department of Radiaiton Oncology Hospital Ruber InternacionalMadrid 28034Spain Department of Radiation Oncology Hospital Clínico Universitario Santiago de CompostelaA Coruña 15706Spain Department of Radiation Oncology Hospital Regional Universitario de Málaga29010Spain Department of Radiation Oncology Clínica Universidad de NavarraMadrid 28027Spain

The coronavirus disease 2019 crisis has had a major and highly complex impact on the clinical practice of radiation oncology *** is one of the countries hardest hit by the virus,with devastating *** is an urgent need to share experiences and offer guidance on decision-making with regard to the indications and standards for radiation therapy in the treatment of lung *** the present article,the Oncological Group for the Study of Lung Cancer of the Spanish Society of Radiation Oncology reviews the literature and establishes a series of consensus-based recommendations for the treatment of patients with lung cancer in different clinical scenarios during the present pandemic.

关键词： Lung cancer COVID-19 Pandemic Radiotherapy Recommendations

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Temperature changes in the root ecosystem affect plant functionality

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Plant Communications 2023年第3期4卷 197-214页

作者： mary Paz González-García Carlos M.Conesa Alberto Lozano-Enguita Victoria Baca-González Bárbara Simancas Sara Navarro-Neila maría Sánchez-Bermúdez Isai Salas-González Elena Caro Gabriel Castrillo Juan C.del Pozo Centro de Biotecnología y Genómica de Plantas(UPM-INIA/CSIC) Universidad Politécnica de Madrid(UPM)-Instituto Nacional de Investigación y Tecnología Agrariay Alimentaria-CSIC(INIA/CSIC)Campus Montegancedo28223 Pozuelo de Alarcón(Madrid)Spain Departamento de Biotecnología-Biología Vegetal Escuela Técnica Superior de Ingeniería AgronómicaAlimentaria y de BiosistemasUniversidad Politécnica de Madrid(UPM)28040 MadridSpain Undergraduate Program in Genomic Sciences Center for Genomics SciencesUniversidad Nacional Autonóma de MéxicoAv.Universidad s/n.Col.ChamilpaCuernavaca 62210MorelosMéxico Future Food Beacon of Excellence&School of Biosciences University of NottinghamSutton BoningtonUK

Climate change is increasing the frequency of extreme heat events that aggravate its negative impact on plant development and agricultural *** experiments designed to study plant adaption to heat stress apply homogeneous high temperatures to both shoot and ***,this treatment does not mimic the conditions in natural fields,where roots grow in a dark environment with a descending temperature *** high temperatures severely decrease cell division in the root meristem,compromising root growth,while increasing the division of quiescent center cells,likely in an attempt to maintain the stem cell niche under such harsh ***,we engineered the TGRooZ,a device that generates a temperature gradient for in vitro or greenhouse growth *** root systems of plants exposed to high shoot temperatures but cultivated in theTGRooZ grow efficiently and maintain their functionality to sustain proper shoot growth and ***,gene expression and rhizosphere or root microbiomecomposition are significantly less affected in TGRooZ-grown roots than in high-temperature-grown roots,correlating with higher root *** data indicate that use of the TGRooZ in heat-stress studies can improve our knowledge of plant response to high temperatures,demonstrating its applicability from laboratory studies to the field.

关键词： heat stress root temperature gradient nutrition gene expression microbiome

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ECG after near-drowning mimicking acute coronary syndrome with left main coronary artery involvement

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World Journal of Emergency Medicine 2013年第1期4卷 75-76页

作者： Alfredo Vidal García javier Lacunza Ruiz José maría Lpez Ayala mariano Valdés Department of Cardiology Hospital Virgen ArrixacaCtraMurcia-Cartagena s/nEl Palmar(Murcia)30120Spain

We present the case of a 74-year-old man with diabetes and hypertension who had to be rescued owing to a near-drowning syndrome at *** he was rescued,he complained of dyspnea and chest *** electrocardiogram(ECG)suggested acute coronary syndrome(ACS)affecting the left main coronary ***,he was referred to our hospital for urgent coronary angiography.

关键词： ECG after near-drowning mimicking acute coronary syndrome with left main coronary artery involvement ACS left

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MicroRNAs: New players in endometriosis

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World Journal of Obstetrics and Gynecology 2016年第1期5卷 28-38页

作者： Josep marí-Alexandre Moisés Barceló-Molina maría Olcina-Guillem javier García-Oms Aitana Braza-Bo?ls Juan Gilabert-Estellés Grupo de Hemostasia TrombosisAterosclerosisy Biología Vascular Instituto de Investigación Sanitaria La Fe área Maternoinfantil Hospital General Universitario University of Valencia

Endometriosis is an estrogen-dependent inflammatory disorder that limits the quality of life of affected women. This pathology affects 10% of reproductive-age women, although the prevalence in those patients experiencing pain, infertility or both is as high as 35%-50%. Endometriosis is characterized by endometrial-like tissue outside the uterus, primarily on the pelvic peritoneum, ovaries and the pouch of Douglas. Despite extensive research endeavours, a unifying theory regarding the exact etiopathogenic mechanism of this high prevalent and incapacitating condition is still lacking, although it has been suggested that epigenetics could be involved. Micro RNAs(mi RNAs), one of the epigenetic players, are small non-coding RNAs that can act as post-transcriptional regulators of gene expression, reducing the expression of their target m RNAs either inhibiting its translation or promoting its degradation. Mi RNA expression profiles are specific of tissue and cell type. Abnormal mi RNA expression has been described in different pathological conditions, such as a myriad of oncological, cardiovascular and inflammatory diseases and gynecological pathologies. In endometriosis, mi RNA expression patterns of eutopic endometrium from patients and control women and from different endometriotic lesions have been described. These small non-coding molecules have become attractive candidates as novel biomarkers for an early non-invasive diagnosis of the disease, which could suppose a valuable benefit to the patients in terms of improvement of prognosis and reduction of the ratio of recurrence. In this systematic review we will focus on the role of mi RNAs in the pathophisiology of endometriosis.

关键词：雌激素炎症治疗方法临床分析

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Liver fat deposition and mitochondrial dysfunction in morbid obesity:An approach combining metabolomics with liver imaging and histology

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World Journal of Gastroenterology 2015年第24期21卷 7529-7544页

作者： Nahum Calvo Raúl Beltrán-Debón Esther Rodríguez-Gallego Anna Hernández-Aguilera maria Guirro Roger mariné-Casadó Lidón Millá Josep M Alegret Fàtima Sabench Daniel del Castillo maría Vinaixa Miguelàngel Rodríguez Xavier Correig Roberto García-álvarez javier A Menendez Jordi Camps Jorge Joven Unitat de Recerca Biomèdica Hospital Universitari de Sant JoanInstitut d’Investigacio Sanitària Pere VirgiliUniversitat Rovira i VirgiliCampus of International Excellence Southern Catalonia Servei de Cirurgia General i de l’Aparell Digestiu Hospital Universitari de Sant Joan de ReusUniversitat Rovira i Virgili Metabolomics Platform Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas AsociadasIISPVUniversitat Rovira i Virgili Research and Collaborations General Electric Healthcare Metabolism and Cancer Group Transla-tional Research LaboratoryCatalan Institute of OncologyGirona Biomedical Research Institute

AIM: To explore the usefulness of magnetic resonance imaging(MRI) and spectroscopy(MRS) for assessment of non-alcoholic fat liver disease(NAFLD) as compared with liver histological and metabolomics findings. METHODS: Patients undergoing bariatric surgery following procedures involved in laparoscopic sleeve gastrectomy were recruited as a model of obesityinduced NAFLD in an observational, prospective, singlesite, cross-sectional study with a pre-set duration of 1 year. Relevant data were obtained prospectively and surrogates for inflammation, oxidative stress and lipid and glucose metabolism were obtained through standard laboratory measurements. To provide reliable data from MRI and MRS, novel procedures were designed to limit sampling variability and other sources of error using a 1.5T Signa HDx scanner and protocols acquired from the 3D or 2D Fat SAT FIESTA prescription manager. We used our previously described 1H NMRbased metabolomics assays. Data were obtained immediately before surgery and after a 12-mo period including histology of the liver and measurement of metabolites. Values from 1H NMR spectra obtained after surgery were omitted due to technical ***: MRI data showed excellent correlation with the concentration of liver triglycerides, other hepatic lipid components and the histological assessment, w h i c h e xc l u d e d t h e p r e s e n c e o f n o n-a l c o h o l i c steatohepatitis(NASH). MRI was sufficient to follow up NAFLD in obese patients undergoing bariatric surgery and data suggest usefulness in other clinical situations. The information provided by MRS replicated that obtained by MRI using the-CH3 peak(0.9 ppm), the-CH2- peak(1.3 ppm, mostly triglyceride) and the-CH=CH- peak(2.2 ppm). No patient depicted NASH. After surgery all patients significantly decreased their body weight and steatosis was virtually absent even in patients with previous severe disease. Improvement was also observed in the serum concentrations of selected

关键词： Fatty liver disease Magnetic resonanceimaging Lipids Magnetic resonance spectroscopy Metabolomics Mitochondrial function Morbid obesity Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis

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Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

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World Journal of Gastroenterology 2016年第25期22卷 5800-5813页

作者： Antonio Ríos Ana Isabel López-Navas Ana Isabel López-López Francisco javier Gómez Jorge Iriarte Rafael Herruzo Gerardo Blanco Francisco javier Llorca Angel Asunsolo Pilar Sánchez-Gallegos Pedro Ramón Gutiérrez Ana Fernández maría Teresa de Jesús Laura martínez-Alarcón Alberto Lana Lorena Fuentes Juan Ramón Hernández Julio Virseda José Yelamos José Antonio Bondía Antonio Miguel Hernández marco Antonio Ayala Pablo Ramírez Pascual Parrilla International Collaborative Donor Project ('Proyecto Colaborativo Internacional Donante' 30007 Casillas Murcia Spain Department of Surgery Paediatrics Obstetrics and Gynaecology University of Murcia Avenida de las Fuerzas Armadas 30800 Espinardo Murcia Spain Transplant Unit Surgery Service IMIB - Virgen de la Arrixaca University Hospital Carretera Madrid-Cartagena s/n 30120 El Palmar Murcia Spain Regional Transplant Centre Consejeria de Sanidad y Consumo de la Region de Murcia 30008 Ronda de Levante Murcia Spain Hospital Clinico Universitario Virgen de la Arrixaca Departamento de Cirugia General y del Aparato Digestivo Unidad de Trasplantes 30007 Casillas Murcia Spain Department of Psychology Universidad Catolica San Antonio (UCAM) Avenida de los Jeronimos 30107 Guadalupe Murcia Spain Department of Urology San Juan University Hospital of Alicante 03010 Calle Pintor Baeza Alicante Spain Universidad de Granada Avenida del Hospicio s/n 18010 Granada Spain Universidad de Navarra Campus Universitario 31080 Pamplona Navarra Spain Universidad Autonoma de Madrid Ciudad Universitaria de cantoblanco 28049 Madrid Spain Servicio de Cirugia HBP y Trasplante Hepatico Complejo Hospitalario Universitario de Badajoz Hospital Infanta Cristina Avenida Elvas s/n 06006 Badajoz Spain Universidad de Cantabria Avenida los Castros s/n 39005 Santander Cantabria Spain Departamento de Cirugia Ciencias Medicas y Sociales Facultad de Medicina y Ciencias de la Salud Universidad de Alcala Campus Cientifico-Tecnologico Plaza de San Diego s/n 28801 Alcala de Henares Madrid Spain Facultad de Medicina Universidad de Malaga 29071 Avenida de Cervantes Malaga Spain Servicio de Urologia (Complejo Hospitalario Universitario de Canarias CHUC) y Departamento de Cirugia (Universidad de La Laguna ULL) Calle Molinos de Agua s/n 38207 San Cristobal de La Laguna Santa Cruz de Tenerife Spain Departamento de Ciencias Biomedicas Basicas Facultad de Ciencias Biomedicas Universidad Europea de

AIM: To analyze the attitude of Spanish medical students toward living liver donation(LLD) and to establish which factors have an influence on this ***: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain(n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire(PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student′s t test, χ2 test and logistic regression ***: The completion rate was 95.7%(n = 9275). 89%(n = 8258) were in favor of related LLD, and 32%(n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude:(1) age(P = 0.008);(2) sex(P < 0.001);(3) academic year(P < 0.001);(4) geographical area(P = 0.013);(5) believing in the possibility of needing a transplant oneself in the future(P < 0.001);(6) attitude toward deceased donation(P < 0.001);(7) attitude toward living kidney donation(P < 0.001);(8) acceptance of a donated liver segment from a family member if one were needed(P < 0.001);(9) having discussed the subject with one's family(P < 0.001) and friends(P < 0.001);(10) a partner's opinion about the subject(P < 0.001);(11) carrying out activities of an altruistic nature; and(12) fear of the possible mutilation of the body after donation(P < 0.001).CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

关键词： Attitude Living liver donation Medical students Transplantation Organ donation Psychosocial variable

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Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

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World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： maria Jesús Fernández-Luque Luis maría Sánchez-Gómez Vicente Pastor y Aldeguer Carmen Suárez-Fernández Belén Sierra-García Soledad Mayayo-Vicente marta Ruiz-López ángela Gallego-Arenas Rosa Sánchez Alcalde Pilar Loeches-Belinchón javier López-González Francisco Rodríguez-Salvanés Blanca Novella-Arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías Sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases

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