Medicina Clinica最新文献

{"title":"Platypnea-orthodeoxia syndrome from aortic distortion","authors":"Adrián Muinelo-Paúl, Jose Manuel Martínez-Comendador, Jose Joaquin Cuenca-Castillo","doi":"10.1016/j.medcli.2025.107197","DOIUrl":"10.1016/j.medcli.2025.107197","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107197"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154684","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":"Clinical factors influencing the systolic blood pressure benefits of once-weekly semaglutide in patients with type 2 diabetes","authors":"Jorge Gabriel Ruiz-Sánchez ,&nbsp;Roberto Miguel Sierra Poyatos ,&nbsp;Bogdana Luiza Luca ,&nbsp;Begoña Sánchez-Lechuga ,&nbsp;Naiara Modroño Móstoles ,&nbsp;Teresa Montoya Álvarez ,&nbsp;Diego Meneses ,&nbsp;Raquel Sánchez-Lopez ,&nbsp;Carlos Casado Cases ,&nbsp;Víctor Pérez de Arenaza Pozo ,&nbsp;Clotilde Vázquez ,&nbsp;Jersy Jair Cárdenas-Salas","doi":"10.1016/j.medcli.2025.107179","DOIUrl":"10.1016/j.medcli.2025.107179","url":null,"abstract":"<div><h3>Introduction</h3><div>Type 2 diabetes mellitus (T2DM), a major cardiovascular risk, is often associated with obesity and hypertension. Once-weekly subcutaneous semaglutide (OWS-Sema) can improve these conditions, but factors influencing blood pressure (BP) effects are not well studied. This study aimed to assess the impact of OWS-Sema on systolic BP (SBP) and identify clinical factors associated with its reduction in patients with T2DM.</div></div><div><h3>Methods</h3><div>Sub-analysis of the REALSEM-SP study involving OWS-Sema-naïve patients with T2DM. Changes in SBP and diastolic BP (DBP) and influencing factors were analyzed over 12 months.</div></div><div><h3>Results</h3><div>One hundred seventy-eight patients were included (mean age 61<!--> <!-->±<!--> <!-->10 years, 43.8% female, 79.2% with hypertension). Median baseline SBP and DBP were 132 [122–145] and 80 [72–88]<!--> <!-->mmHg, respectively. SBP decreased by −4<!--> <!-->mmHg at 6 months and −2<!--> <!-->mmHg at 12 months (<em>p</em> <!-->=<!--> <!-->0.014), while DBP showed no significant change (<em>p</em> <!-->=<!--> <!-->0.395). Factors independently associated with SBP reduction at 6 months included uncontrolled BP and a glomerular filtration rate ≥60<!--> <!-->mL/min/1.73<!--> <!-->m², while at 12 months, only uncontrolled BP remained significant. A SBP ≥10<!--> <!-->mmHg reduction was associated with uncontrolled BP, dyslipidemia and renal function at 6-month, and only with uncontrolled BP at 12-month.</div></div><div><h3>Conclusion</h3><div>OWS-Sema was associated with significant reductions in office SBP in T2DM patients, especially those with uncontrolled baseline BP, independent of BMI changes or dose. Patients with baseline uncontrolled BP appear to benefit the most.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107179"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154680","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":"Intramural esophageal hematoma secondary to the spontaneous rupture of a parathyroid adenoma","authors":"Laia Mas Maresma ,&nbsp;Laia Casamitjana Espuña ,&nbsp;Santiago Barcons Vilaplana","doi":"10.1016/j.medcli.2025.107182","DOIUrl":"10.1016/j.medcli.2025.107182","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107182"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154681","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":"Comentario a «Triaje en urgencias basado en inteligencia artificial: una herramienta prometedora»","authors":"Josep Gómez-Jiménez","doi":"10.1016/j.medcli.2025.107172","DOIUrl":"10.1016/j.medcli.2025.107172","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 5","pages":"Article 107172"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154513","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":"Transformación de un hospital: de especialidades departamentales a áreas de conocimiento integradas. Un análisis de resultados en salud y experiencia de pacientes y profesionales","authors":"Montserrat Martínez Muñoz ,&nbsp;Maria Ángeles Barba Flores ,&nbsp;María José Abadias Medrano ,&nbsp;Albert Salazar Soler ,&nbsp;en representación del grupo ACI-VH (Áreas de Conocimiento Integradas - Vall d’Hebron)","doi":"10.1016/j.medcli.2025.107174","DOIUrl":"10.1016/j.medcli.2025.107174","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 5","pages":"Article 107174"},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154512","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":"Ribavirina como tratamiento de hepatitis E aguda grave sobre hepatopatía crónica: experiencia clínica","authors":"Alba Rabadán Mata,&nbsp;María Dolores Antón Conejero,&nbsp;José María Paredes Arquiola","doi":"10.1016/j.medcli.2025.107187","DOIUrl":"10.1016/j.medcli.2025.107187","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107187"},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154685","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":"Coexistencia de vasculitis primaria del sistema nervioso central y una mutación en heterocigosis del gen HTRA1 asociada a una entidad clínicamente relacionada con CARASIL","authors":"Esteban Fernando Noroña Vásconez ,&nbsp;Andrea Viñas Barros ,&nbsp;Alicia Viñas Barros","doi":"10.1016/j.medcli.2025.107195","DOIUrl":"10.1016/j.medcli.2025.107195","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107195"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117802","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":"Crusted scabies","authors":"Gonzalo Alonso-Fernández ,&nbsp;Fernando Navarro-Blanco ,&nbsp;Rafael Fayos-Gregori ,&nbsp;Miguel Mansilla-Polo","doi":"10.1016/j.medcli.2025.107178","DOIUrl":"10.1016/j.medcli.2025.107178","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107178"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117805","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":"Point-of-care ultrasound in pulmonary and pleural infections","authors":"José M. Porcel ,&nbsp;Laura Porcel ,&nbsp;Ricardo Campo-Linares","doi":"10.1016/j.medcli.2025.107191","DOIUrl":"10.1016/j.medcli.2025.107191","url":null,"abstract":"<div><div>Point-of-care ultrasound (POCUS) is a rapid bedside imaging modality available to clinicians for the diagnosis of pleuropulmonary infections. Compared with chest radiography, POCUS is more sensitive in identifying pneumonia and its complications (parapneumonic pleural effusions, necrosis, and abscesses). The most common sonographic features of pneumonia are consolidation (with irregular margins and dynamic air bronchograms), B-lines, and pleural effusion. POCUS also has prognostic applications, for example, to determine the severity of COVID-19 pneumonia or to predict residual pleural thickening in a tuberculous effusion. Finally, the presence of a complex septated ultrasound pattern in the context of pleural infection is indicative of the need for drainage, which is performed using a thoracostomy tube and instillation of intrapleural enzyme therapy.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 5","pages":"Article 107191"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117671","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":"Real-world use of nintedanib for the treatment of interstitial lung disease with progressive pulmonary fibrosis","authors":"Eva Cabrera César ,&nbsp;Javier López Garcia ,&nbsp;Miguel Benitez Cano Gamonoso ,&nbsp;Cecilia López Ramirez ,&nbsp;Beatriz Jiménez Rodriguez ,&nbsp;Ana Dolores Romero Ortiz ,&nbsp;Zulema Palacios Hidalgo ,&nbsp;David Fole Vázquez ,&nbsp;Patricia Guerrero Zamora ,&nbsp;Natalia Mena Vázquez ,&nbsp;Antonio Hidalgo Molina ,&nbsp;Inés De La Cruz Morón ,&nbsp;Francisco Espildora Hernández ,&nbsp;Antonio Cruz Medina ,&nbsp;Celia Lacarcel Bautista ,&nbsp;Adriana Vegas Viñas ,&nbsp;José Luis Velasco Garrido","doi":"10.1016/j.medcli.2025.107169","DOIUrl":"10.1016/j.medcli.2025.107169","url":null,"abstract":"<div><h3>Background</h3><div>Patients with non-idiopathic interstitial lung diseases can develop progressive pulmonary fibrosis (PPF-ILD). The study objectives were to define the profile of patients with PPF-ILD treated with nintedanib and to assess the effectiveness and safety of this drug in a real-world setting.</div></div><div><h3>Methods</h3><div>This was a multicenter, prospective, observational study of adult patients with PPF-ILD that initiated treatment with nintedanib in ten Andalusian hospitals (Spain). Demographic data, smoking habit, underlying disease, and diagnosis criteria were recorded. Pulmonary function test results, the dyspnea scale score, and the number of hospitalizations related to PPF-ILD were evaluated at baseline and after 6 and 12 months. Adverse events were recorded.</div></div><div><h3>Results</h3><div>Between July 2021 and March 2023, a total of 145 patients entered the study and were followed up until March 2024; 55% were men and the mean age was 66.6<!--> <!-->±<!--> <!-->11.5 years. PPF-ILD was diagnosed based on clinical, radiological and pulmonary function test findings in 97 patients (66.9%). The mean<!--> <!-->±<!--> <!-->SD duration of nintedanib therapy was 13.3<!--> <!-->±<!--> <!-->10.1 months. Dyspnea improved, although the difference was not statistically significant. FVC % and <em>D</em>_LCO % stabilized. The number of hospitalizations related to PPF-ILD was reduced (<em>p</em> <!-->&lt;<!--> <!-->0.0001) after 12 months of therapy. Diarrhea was the most common adverse event.</div></div><div><h3>Conclusions</h3><div>In this real-world study, the profile of PPF-ILD patients treated with nintedanib was consistent with the approved therapeutic indications. Nintedanib reduced the decline in pulmonary function and the number of hospitalizations, and it was well tolerated. At 12 months, 75.1% of patients remained on treatment; treatment discontinuation occurred in 24.9% due to adverse events, death, or lung transplantation.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 6","pages":"Article 107169"},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117799","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}