Medicina Clinica最新文献

{"title":"Síndrome de patera en migrantes africanos. Una entidad clínica emergente","authors":"Elena Pisos-Álamo , 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}

{"title":"Encefalitis autoinmune y ganglionopatía sensitiva asociada a síndrome de Sjögren primario","authors":"Alicia Viñas Barros ,&nbsp;Esteban Fernando Noroña Vásconez ,&nbsp;Andrea Viñas Barros","doi":"10.1016/j.medcli.2025.106932","DOIUrl":"10.1016/j.medcli.2025.106932","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 10","pages":"Article 106932"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143814844","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":"Effects of exercise intervention on exercise capacity and cardiopulmonary function in patients with atrial fibrillation: A randomized controlled trial systematic review and meta-analysis","authors":"Zhang Shuai ,&nbsp;Mao Su Jie ,&nbsp;Xiao Kai Wen ,&nbsp;Hong Xu ,&nbsp;Lu Yuan","doi":"10.1016/j.medcli.2025.106908","DOIUrl":"10.1016/j.medcli.2025.106908","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a common cardiac arrhythmia that significantly impacts the cardiopulmonary function and quality of life of patients. Despite various treatment strategies, non-pharmacological interventions, particularly exercise interventions, have gained attention in recent years.</div></div><div><h3>Objective</h3><div>Through systematic review and meta-analysis, this study explores the impact of physical activity on the exercise capacity and quality of life of AF patients. It assesses the safety, clinical outcomes, and physiological mechanisms of exercise intervention in the treatment of AF.</div></div><div><h3>Methods</h3><div>The systematic review and individual patient data (IPD) meta-analysis method were employed, following the PRISMA-IPD guidelines, for literature selection, data extraction, and quality assessment. The analysis focused on the impact of exercise on the cardiopulmonary function and quality of life of AF patients in randomized controlled trials.</div></div><div><h3>Results</h3><div>A total of 12 randomized controlled trials involving 287 AF patients were included. Meta-analysis demonstrated a significant improvement in the 6-minute walk test capacity (SMD<!--> <!-->=<!--> <!-->87.87, 95% CI [42.23, 133.51]), static heart rate improvement (SMD<!--> <!-->=<!--> <!-->−7.63, 95% CI [−11.42, −3.85]), and cardiopulmonary function enhancement (SMD<!--> <!-->=<!--> <!-->2.37, 95% CI [0.96, 3.77]) due to exercise. There was also a significant improvement in the quality of life (SMD<!--> <!-->=<!--> <!-->0.720, 95% CI [0.038, 1.402]).</div></div><div><h3>Conclusion</h3><div>Exercise has a significant effect on improving exercise capacity and cardiopulmonary function in patients with atrial fibrillation. Particularly, high-intensity exercise training has a more significant impact on improving cardiopulmonary function and exercise capacity, emphasizing the importance of personalized exercise plans in enhancing the cardiopulmonary health of AF patients. Further research is needed to explore the effects of exercise on improving the quality of life in the future.</div><div>PROSPERO ID: CRD2023493917.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106908"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817689","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":"Leucemia aguda de linaje ambiguo: diagnóstico, pronóstico y tratamiento","authors":"Anna Torrent ,&nbsp;Vitor Botafogo ,&nbsp;Josep Maria Ribera","doi":"10.1016/j.medcli.2025.106917","DOIUrl":"10.1016/j.medcli.2025.106917","url":null,"abstract":"<div><div>Acute leukemias of ambiguous lineage (ALAL) are an infrequent subtype of acute leukemias without clear evidence of differentiation to a one single cell lineage. Despite their rarity constitute a recognized subgroup in the recent international classifications, such as the WHO (World Health Organization) classification. Their diagnosis require highly specialized flow cytometry technology, and also cytogenetics and molecular techniques. The low frequency of the disease has made it difficult to find the best therapeutic strategy, due both to the lack of prospective studies and randomized trials, and to the heterogeneity of the published retrospective studies on follow-up and treatment. The group of ALAL has bad prognosis, and usually requires intensive strategies that include consolidation with allogeneic stem cell transplant as part of the treatment. The objective of this review was to analyze diagnosis, treatment and prognosis of this rare subtype of leukemias.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 12","pages":"Article 106917"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815509","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":"Situación profesional de los médicos formados en países extracomunitarios en Barcelona","authors":"Gustavo Andrés Tolchinsky Wiesen ,&nbsp;Ana Graciela Angulo Menéndez ,&nbsp;Carles Martin-Fumadó","doi":"10.1016/j.medcli.2025.106930","DOIUrl":"10.1016/j.medcli.2025.106930","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 11","pages":"Article 106930"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817335","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}