Medicina Clinica最新文献

Clinical spectrum and therapeutic strategies of fibromuscular dysplasia and segmental arterial mediolysis: A cohort study 纤维肌肉发育不良和节段性动脉介质溶解的临床谱和治疗策略：一项队列研究

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-26 DOI: 10.1016/j.medcli.2025.107119

Víctor Manuel Martínez-Castilla , Marina Valenzuela-Espejo , Yaiza Díaz-Castillo , Marta Bacete-Cebrián , Rubén Alonso-Beato , Arturo Álvarez-Luque , Luís Antonio Álvarez-Sala Walther , Francisco Galeano-Valle

{"title":"Clinical spectrum and therapeutic strategies of fibromuscular dysplasia and segmental arterial mediolysis: A cohort study","authors":"Víctor Manuel Martínez-Castilla , Marina Valenzuela-Espejo , Yaiza Díaz-Castillo , Marta Bacete-Cebrián , Rubén Alonso-Beato , Arturo Álvarez-Luque , Luís Antonio Álvarez-Sala Walther , Francisco Galeano-Valle","doi":"10.1016/j.medcli.2025.107119","DOIUrl":"10.1016/j.medcli.2025.107119","url":null,"abstract":"<div><h3>Introduction</h3><div>Segmental arterial mediolysis (SAM) and fibromuscular dysplasia (FMD) are rare vasculopathies. Differentiating between them is difficult due to its similarities. The aim is to describe and compare the clinical characteristics, presenting symptoms, diagnostic tests, treatment, and outcomes.</div></div><div><h3>Patients and methods</h3><div>Single center retrospective review of patients diagnosed with FMD or SAM between 2016 and 2023.</div></div><div><h3>Results</h3><div>Four patients with SAM and 18 with FMD were included. SAM predominated in males with abdominal pain (75%), while FMD in young women (61.1%) with neurological manifestations (66.6%). Anticoagulation was the main treatment for SAM, and antiplatelet therapy for FMD. Surgical treatment was performed in 25% and 22.2%, while percutaneous intervention was performed in none and 27.7% of patient, respectively. During follow-up (median 3.4 years), mortality was similar in both groups (10%).</div></div><div><h3>Conclusion</h3><div>There are key differences in clinical presentation, management, and outcomes that may help guide the treatment of both conditions.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 4","pages":"Article 107119"},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Agonistas del receptor GLP-1 y co-agonistas GIP/GLP-1 en el tratamiento de la obesidad en adolescentes y ancianos 治疗青少年和老年人肥胖的GLP-1受体激动剂和GIP/GLP-1联合激动剂

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-26 DOI: 10.1016/j.medcli.2025.107122

Gilberto Pérez López

{"title":"Agonistas del receptor GLP-1 y co-agonistas GIP/GLP-1 en el tratamiento de la obesidad en adolescentes y ancianos","authors":"Gilberto Pérez López","doi":"10.1016/j.medcli.2025.107122","DOIUrl":"10.1016/j.medcli.2025.107122","url":null,"abstract":"<div><div>Obesity represents a global public health challenge, with specific characteristics and needs in adolescent and elderly populations. GLP-1 (glucagon-like peptide-1) receptor agonists such as liraglutide and semaglutide, as well as the GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptor co-agonist tirzepatide, have emerged as promising therapeutic options for obesity management. This review analyzes the clinical development, efficacy, safety, and tolerability of these drugs specifically in adolescents and the elderly, populations typically underrepresented in initial clinical trials. Findings from pivotal clinical studies and real-world data are detailed, showing that these medications offer significant benefits in weight reduction, albeit with particular safety considerations for each age group. Additionally, emerging GLP-1 molecules in clinical development with potential application in these special populations are explored. The conclusions emphasize the need for a personalized approach considering the specific pathophysiological, pharmacokinetic, and pharmacodynamic differences of each population group.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 4","pages":"Article 107122"},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Caracterización clínica e impacto de la hipofosfatasia en España: análisis observacional de la cohorte española incluida en el Global HPP Registry 西班牙低磷酸血症的临床特征和影响：全球HPP登记西班牙队列的观察分析

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-25 DOI: 10.1016/j.medcli.2025.107120

Carolina Tornero , Gabriel Á. Martos-Moreno , Núria Guañabens , Helena Flórez , Anna Ribera , Pilar Aguado

{"title":"Caracterización clínica e impacto de la hipofosfatasia en España: análisis observacional de la cohorte española incluida en el Global HPP Registry","authors":"Carolina Tornero , Gabriel Á. Martos-Moreno , Núria Guañabens , Helena Flórez , Anna Ribera , Pilar Aguado","doi":"10.1016/j.medcli.2025.107120","DOIUrl":"10.1016/j.medcli.2025.107120","url":null,"abstract":"<div><h3>Background</h3><div>The Global HPP Registry, an observational, prospective, multinational registry of patients with hypophosphatasia (HPP) (<span><span>NCT02306720</span><svg><path></path></svg></span>; EUPAS13514), was initiated in 2015. The aim of this study is to assess the symptomatology and impact of the disease in patients included in the national registry.</div></div><div><h3>Methods</h3><div>Baseline characteristics of patients included in the Registry by national centres were analysed (5/11/2015-4/03/2024).</div></div><div><h3>Results</h3><div>Of the 83 patients, 16 (19.3%) were under 18 years of age and 67 (80.7%) were adults. Median time to diagnosis was 4.8 (minimum: 0; maximum: 49.9) years. In paediatric patients, median age at symptom onset was 4 (minimum: 1.2; maximum: 11.8) years and the most prevalent symptoms were dental (37.5%), neurological (25%), and skeletal (18.8%). 23.7% of adults started with HPP-related symptoms before the age of 18 years and the most frequent symptoms were pain (64.2%), dental (50.7%), and skeletal (32.8%). Heterozygous <em>ALPL</em> variants were found in 96.3% of patients and the most frequent were c.343_348dup, c.334G>C, and c.407G>A. In adult patients, patient-reported outcomes (median [Q1; Q3]) on the quality of life questionnaire (SF-36v2) (scales 0-100) were 44.8 (34.5;50.2) for the physical component and 50.4 (38.9;56.5) for the mental component.</div></div><div><h3>Conclusions</h3><div>There is a significant delay in the diagnosis of HPP. The most frequent manifestations were dental in paediatric patients and pain in adults, with a relevant impact on quality of life.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 5","pages":"Article 107120"},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Burnout en adjuntos de Oncología Médica y Radioterápica 医学肿瘤学和放射治疗助理的倦怠

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-21 DOI: 10.1016/j.medcli.2025.107116

Melinda González Concepción , Eva Rodríguez Bruzos , Tomas Blasco Blasco

引用次数: 0

Biomarker-driven diagnosis of Alzheimer's disease: Toward precision neurology 生物标志物驱动的阿尔茨海默病诊断：迈向精确神经学

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-21 DOI: 10.1016/j.medcli.2025.107105

Miren Altuna

引用次数: 0

Impacto pronóstico de las alteraciones citogenéticas en la leucemia aguda mieloide de nuevo diagnóstico tratada con protocolos adaptados al riesgo 采用风险调整方案治疗的新诊断急性髓系白血病细胞遗传改变的预后影响

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-21 DOI: 10.1016/j.medcli.2025.107106

Neus Ruiz-Xivillé , Mireia Morgades , Laura Blanco , Dolors Costa , Blanca Espinet , Elisabet Talavera , Emma Triviño , Margarita Ortega , Eva Villamon , Lurdes Zamora , José Tomás Navarro , Montserrat Arnan , Susana Vives , Jordi Esteve , Jorge Sierra , Josep-Maria Ribera , Isabel Granada

{"title":"Impacto pronóstico de las alteraciones citogenéticas en la leucemia aguda mieloide de nuevo diagnóstico tratada con protocolos adaptados al riesgo","authors":"Neus Ruiz-Xivillé , Mireia Morgades , Laura Blanco , Dolors Costa , Blanca Espinet , Elisabet Talavera , Emma Triviño , Margarita Ortega , Eva Villamon , Lurdes Zamora , José Tomás Navarro , Montserrat Arnan , Susana Vives , Jordi Esteve , Jorge Sierra , Josep-Maria Ribera , Isabel Granada","doi":"10.1016/j.medcli.2025.107106","DOIUrl":"10.1016/j.medcli.2025.107106","url":null,"abstract":"<div><h3>Background and objective</h3><div>In acute myeloid leukemia (AML), cytogenetic alterations have influence on treatment response and are essential for risk stratification, although some have uncertain prognostic relevance. In this study, the prognostic impact of cytogenetic alterations was analyzed in a series of newly diagnosed AML patients treated with risk-adapted protocols.</div></div><div><h3>Patients and method</h3><div>The cytogenetic profile of 1417 adult patients diagnosed with de novo AML (without t(15;17) or <em>PML</em>::<em>RARA</em>) enrolled in the CETLAM cooperative group protocols from 1994 to 2012 was studied, and its impact on survival was evaluated.</div></div><div><h3>Results</h3><div>Multivariable analysis showed that anomalies such as t(8;21) and inv(16)/t(16;16) predict a favorable prognosis, with no significant effect of additional anomalies on outcome. In contrast, abnormalities like monosomy of chromosome7, structural alterations of chromosome1, complex karyotype (5 or more abnormalities), and monosomal karyotype were associated with worse outcomes. Patients were classified into three prognostic groups based on their cytogenetic alterations, which demonstrated the effectiveness of the proposed system in predicting prognosis.</div></div><div><h3>Conclusion</h3><div>This study confirms the prognostic impact of cytogenetic alterations in AML and their usefulness in stratifying patients into risk groups.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 4","pages":"Article 107106"},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The severity and outcomes in acute pancreatitis do not differ between the elderly and non-elderly patients: Experience in a clinical tertiary center 急性胰腺炎的严重程度和结局在老年和非老年患者之间没有区别：临床三级中心的经验

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-19 DOI: 10.1016/j.medcli.2025.107112

María-Lourdes Ruiz-Rebollo , María-Fe Muñoz-Moreno

{"title":"The severity and outcomes in acute pancreatitis do not differ between the elderly and non-elderly patients: Experience in a clinical tertiary center","authors":"María-Lourdes Ruiz-Rebollo , María-Fe Muñoz-Moreno","doi":"10.1016/j.medcli.2025.107112","DOIUrl":"10.1016/j.medcli.2025.107112","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis can affect elderly people. Conflicting results have been published regarding the role of age in the course of this life-threatening disease.</div></div><div><h3>Aim</h3><div>To assess the clinical outcomes of acute pancreatitis in geriatric population compared to younger patients.</div></div><div><h3>Patients and methods</h3><div>retrospective observational study which includes patients admitted for acute pancreatitis to our Unit between 2014 and 2022. Two groups were created and compared, elderly patients (≥65 years) and young patients (<65 years). Clinical, demographic, analytical and radiological data were obtained from both cohorts. Primary endpoint was comparison of severity among both groups. Secondary endpoints included organ failure, local and systemic complications, length of hospital stay, intensive care unit admission, procedural interventions and mortality. Univariate and logistic regression were performed. A propensity score analysis was also used to minimize selection bias.</div></div><div><h3>Results</h3><div>We analysed 832 patients (546 ≥65 years and 286 patients <65 years). A higher mortality rate (4.95% vs. 1.05%, <em>p</em>  =0.004) and systemic complications (21.25% vs. 14.34%, <em>p</em>  <!-->0.016) were observed in the elderly group on univariate analysis; however, multivariate logistic regression analysis and propensity score matched analysis failed to detect any differences among both groups.</div></div><div><h3>Conclusions</h3><div>In our series patients ≥65 years-old did not suffered from more severe episodes of acute pancreatitis. In our study, age was not associated with worse clinical outcomes.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 4","pages":"Article 107112"},"PeriodicalIF":2.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trastorno por consumo oculto de alcohol 隐性酒精使用障碍

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-19 DOI: 10.1016/j.medcli.2025.107102

Ignacio Novo Veleiro , Iván Fernández Castro , Grupo de Trabajo sobre Alcohol y Otras Drogas. Sociedad Española de Medicina Interna

引用次数: 0

Cáncer de origen desconocido: diagnóstico, tratamiento y avances tecnológicos 来源不明的癌症：诊断、治疗和技术进步

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-07-18 DOI: 10.1016/j.medcli.2025.107118

Ferran Losa Gaspà , Raquel Legido Díaz , Sheila Sánchez Pérez

引用次数: 0

Retraso diagnóstico en infecciones por Strongyloides stercoralis 硬核链球菌感染的诊断延迟