Medicina Clinica最新文献

{"title":"Sedación paliativa","authors":"Cristina Lojo-Cruz, Juan Mora-Delgado","doi":"10.1016/j.medcli.2025.106937","DOIUrl":"10.1016/j.medcli.2025.106937","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106937"},"PeriodicalIF":2.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834408","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}

{"title":"Miocarditis aguda en la enfermedad de Shoshin","authors":"Juan Manuel Serrano Marcos, José Antonio Fernández-Sánchez, Lucia Carnero Montoro","doi":"10.1016/j.medcli.2025.106919","DOIUrl":"10.1016/j.medcli.2025.106919","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 10","pages":"Article 106919"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829544","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}

{"title":"Comparison of the efficacy of pharmacological interventions for the prevention of delirium: A systematic review and network meta-analysis","authors":"Xiangwu Zhou ,&nbsp;Chengguo Yin","doi":"10.1016/j.medcli.2025.106918","DOIUrl":"10.1016/j.medcli.2025.106918","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, many pharmacological agents for the prevention of delirium have emerged; however, the efficacy of these agents in preventing delirium remains unclear.</div></div><div><h3>Objective</h3><div>To compare and rank the efficacy of different pharmacological interventions for the prevention of delirium.</div></div><div><h3>Design</h3><div>A systematic review and network meta-analysis.</div></div><div><h3>Methods</h3><div>Relevant randomized controlled trials on drug prevention of delirium were extracted from three electronic databases. A network meta-analysis was then conducted to assess the relative efficacy of drug interventions in preventing delirium. The quality of the data was evaluated using the Cochrane Risk of Bias tool.</div></div><div><h3>Results</h3><div>A total of 80 randomized controlled trials on drug interventions were included in the final analysis. Treatment with dexmedetomidine can prevent delirium.</div></div><div><h3>Conclusion</h3><div>Dexmedetomidine treatment can prevent delirium and reduce patient suffering. Healthcare professionals should be encouraged to use dexmedetomidine for delirium prevention.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106918"},"PeriodicalIF":2.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826050","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}

{"title":"Enfermedad de Tarui y rabdomiólisis sin insuficiencia renal","authors":"Roberto Hurtado-García ,&nbsp;Javier Martínez Elvira ,&nbsp;Inmaculada González-Cuello","doi":"10.1016/j.medcli.2025.106931","DOIUrl":"10.1016/j.medcli.2025.106931","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106931"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820420","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}

{"title":"Síndrome de patera en migrantes africanos. Una entidad clínica emergente","authors":"Elena Pisos-Álamo ,&nbsp;José-Luis Pérez-Arellano","doi":"10.1016/j.medcli.2025.01.001","DOIUrl":"10.1016/j.medcli.2025.01.001","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 8","pages":"Pages 418-420"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821137","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}

{"title":"Impacto de la valoración geriátrica en el resultado del reemplazo percutáneo de la válvula aórtica","authors":"Cristina de la Rubia-Molina ,&nbsp;Andrez Felipe Cubides-Novoa ,&nbsp;María Teresa Madrid-López ,&nbsp;Elisa Patín-González ,&nbsp;Verónica Merchán-Ordoñez ,&nbsp;Martín Negreira-Caamaño ,&nbsp;Javier Gil-Moreno ,&nbsp;Alfonso Freites ,&nbsp;Ignacio Sánchez-Pérez ,&nbsp;Virginia Mazoteras-Muñoz ,&nbsp;Jesús Piqueras-Flores","doi":"10.1016/j.medcli.2025.106936","DOIUrl":"10.1016/j.medcli.2025.106936","url":null,"abstract":"<div><h3>Introduction</h3><div>Comprehensive geriatric assessment (CGA) prior to transcatheter aortic valve replacement implantation (TAVI) for severe aortic stenosis (AS) may improve the selection of patients targeted for this strategy. Despite the fact that CGA includes multiple scales, comparative data among them are limited. Our aim was to evaluate the discriminative capacity of different scales used in CGA on the decision of suitability for TAVI implantation and the influence on prognosis after TAVI implantation.</div></div><div><h3>Methods</h3><div>Single-center prospective observational study including consecutive patients with severe AS referred for TAVI implantation. A CGA was performed in all patients including scales of functionality, frailty, cognitive impairment and comorbidities. The predictive capacity of each of the scales was evaluated. The development of major adverse cardiovascular events (MACE: cardiovascular mortality, heart failure [HF] and stroke) was analyzed during follow-up.</div></div><div><h3>Results</h3><div>A total of 142 patients were selected as candidates for TAVI (80.2%), and 121 were finally implanted. The mean age was 83<!--> <!-->±<!--> <!-->4.9 years. Patients who were candidates for TAVI had less valvular area, less atrial fibrillation (AF), less cognitive impairment, more autonomy and less frailty. The SPPB frailty and Barthel functional assessment scales were the main scales of the CGA for the TAVI candidacy decision. After TAVI implantation, 21.5% presented a MACE event, with an overall mortality of 19.8% (6.6% cardiovascular). Patients with a higher rate of events and mortality had more AF, HF, renal disease and malnutrition, as well as less family coverage.</div></div><div><h3>Conclusions</h3><div>In elderly patients with severe AS, the CGA is a determining factor in the selection of candidates for TAVI, with frailty and functional assessment being the most important aspects. Family support and nutritional status have a high impact on the prognosis of patients after TAVI.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 12","pages":"Article 106936"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823985","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}

{"title":"Ciencia y Medicina: aliadas para aplicar la mejor evidencia a la práctica clínica","authors":"Tomás Cobo Castro ,&nbsp;María Rosa Arroyo Castillo ,&nbsp;José Ramón Repullo Labrador","doi":"10.1016/j.medcli.2025.106938","DOIUrl":"10.1016/j.medcli.2025.106938","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106938"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820419","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}

{"title":"Effectiveness and immunogenicity of SARS-CoV-2 booster vaccine in immunosuppressed systemic autoimmune disease patients: A prospective study","authors":"Carolina Teles ,&nbsp;Ana Borges ,&nbsp;Ana Magalhães ,&nbsp;Cátia Barra ,&nbsp;Isabel Silva ,&nbsp;Patrícia Tomé ,&nbsp;Jorge Crespo ,&nbsp;Artur Paiva ,&nbsp;Lèlita Santos","doi":"10.1016/j.medcli.2025.106920","DOIUrl":"10.1016/j.medcli.2025.106920","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Patients with systemic autoimmune rheumatic disease (SARD) are a vulnerable population for severe COVID-19 and worse response to vaccination, prompting the need of a booster vaccine. Data regarding its response is limited and inconsistent. The aim of this study was to assess the effectiveness and immunogenicity of the third dose of the SARS-CoV-2 vaccine in immunosuppressed SARD patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a prospective study in immunosuppressed SARD Portuguese patients, who received a SARS-CoV-2 booster vaccine, from October 2021 to August 2022. We evaluated COVID-19 incidence in the following 6 months, as well as vaccine immunogenicity through anti-Spike IgG titers and T-cell reactivity to the Spike protein.</div></div><div><h3>Results</h3><div>We included 131 patients with a mean age of 54.9<!--> <!-->±<!--> <!-->12.2 years. Almost 40% (<em>n</em> <!-->=<!--> <!-->52) developed COVID-19 within 6 months after the booster, but 51 (98.1%) were mild infections. Median post-booster antibody levels and antibody variation were 9540.7 (14,724) and 8937.9 (11,561.3)<!--> <!-->AU/mL, respectively, and 73.3% (<em>n</em> <!-->=<!--> <!-->96) of the patients showed post-booster T-cell reactivity. Antibody variation was significantly lower in the COVID group (<em>p</em> <!-->=<!--> <!-->0.015). Although post-booster antibody levels and T-cell reactivity were statistically significantly lower in the patients under biologic DMARD, there was not a significant increase in COVID-19 incidence.</div></div><div><h3>Conclusions</h3><div>This study shows that a booster vaccine elicits strong immunogenicity and reduces COVID-19 severity, highlighting its importance in immunosuppressed SARD patients. Larger and more homogeneous cohorts are needed to guide periodic booster administration in this susceptible population.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 12","pages":"Article 106920"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815508","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}

{"title":"Tuberous sclerosis complex","authors":"Qiang Tong ,&nbsp;Jianghong Zheng ,&nbsp;Sheng-Ming Dai","doi":"10.1016/j.medcli.2025.106929","DOIUrl":"10.1016/j.medcli.2025.106929","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 12","pages":"Article 106929"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815525","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}

{"title":"Plasmacytoma surrounding a total shoulder prosthesis","authors":"Gökhan Tonkaz ,&nbsp;Esra İbiş ,&nbsp;Duygu Erkal ,&nbsp;Mehmet Tonkaz","doi":"10.1016/j.medcli.2025.106933","DOIUrl":"10.1016/j.medcli.2025.106933","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106933"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817336","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}