Medicina Clinica最新文献_第2页

El internista como experto en ecografía invasiva: rompiendo barreras

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-28 DOI: 10.1016/j.medcli.2024.12.007

José M. Porcel

引用次数: 0

Crescents and CKD progression in diabetic nephropathy.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-28 DOI: 10.1016/j.medcli.2024.11.007

Xia Gu, Danyang Zhang, Shimin Jiang, Wenge Li

{"title":"Crescents and CKD progression in diabetic nephropathy.","authors":"Xia Gu, Danyang Zhang, Shimin Jiang, Wenge Li","doi":"10.1016/j.medcli.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.medcli.2024.11.007","url":null,"abstract":"<p><strong>Objectives: </strong>Crescents play important roles in the pathophysiology of patients with biopsy-proven diabetic nephropathy (DN). However, their relationship to disease severity and progression has not been fully clarified.</p><p><strong>Methods: </strong>We assessed 142 participants in a retrospective cohort study of biopsy-proven DN. We determined associations of crescent formation with CKD progression event, defined as a sustained decrease from baseline of at least 40% in the eGFR or ESRD, using Cox proportional hazards models. A prognostic nomogram was constructed to predict 1-, 3-, and 5-year renal survival for patients with DN.</p><p><strong>Results: </strong>Glomerular crescent formation negatively correlated with eGFR (Spearman's ρ=-0.33, P=0.01), whereas there was no significant correlation between crescents and 24-hour proteinuria, KW nodules, capillary microaneurysms, and C3 deposition. After adjustment for traditional risk factors (demographics, eGFR, proteinuria, and pathologic score), the crescents were independently associated with a CKD progression event (HR, 1.71; 95% CI, 1.07-2.76; P=0.024). Moreover, the risk of CKD progression events was greater with a higher proportion of crescents but reached a plateau when the crescent proportion was 20%.</p><p><strong>Conclusions: </strong>In patients with DN, crescents were associated with CKD progression events independent of clinical and pathologic characteristics.</p>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066075","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

Infecciones de piel y partes blandas en las personas que migran por vía marítima a Canarias: estudio de 23 casos

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-27 DOI: 10.1016/j.medcli.2024.11.025

Pedro Laynez-Roldán , María Pilar Gómez Álvarez , Onán Pérez Hernández

{"title":"Infecciones de piel y partes blandas en las personas que migran por vía marítima a Canarias: estudio de 23 casos","authors":"Pedro Laynez-Roldán , María Pilar Gómez Álvarez , Onán Pérez Hernández","doi":"10.1016/j.medcli.2024.11.025","DOIUrl":"10.1016/j.medcli.2024.11.025","url":null,"abstract":"<div><h3>Introduction</h3><div>People migrating to the Canary Islands by sea frequently suffer from potentially severe skin and soft tissue infections (SSTIs) for which optimal empirical antibiotic therapy is not well defined.</div></div><div><h3>Methods</h3><div>This descriptive retrospective observational study assess a case series of newly arrived maritime migrants to the Canary Islands who were diagnosed with clinical and microbiological SSTIs and admitted to the Nuestra Señora de La Candelaria Hospital in Tenerife between January 2020 and December 2023. Clinical data, bacterial species, resistance profiles, and choice of empirical treatments were analysed.</div></div><div><h3>Results</h3><div>A total of 23 patients with SSTIs were analysed, with 21 (91.3%) presenting lesions in the gluteal–sacral region. Thirty-seven community-acquired pathogenic microorganisms were isolated, including seven from blood cultures. The isolated bacteria included <em>Staphylococcus aureus</em> (<em>n</em>  =9/37; 24.3%), marine bacteria (<em>n</em>  =6/37; 16.2%), and other gram-positive cocci (<em>n</em>  =11/23; 47.8%).</div></div><div><h3>Conclusions</h3><div>The study suggests that, in addition to the importance of bacteria such as <em>S. aureus</em>, consideration should be given to <em>Enterobacterales</em>, marine bacteria, and gram-negative non-fermenting bacteria (such as <em>Pseudomonas aeruginosa</em>) when choosing empirical antibiotic therapy for SSTIs in maritime migrants.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"164 7","pages":"Pages 369-373"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059767","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

Cognitive dysfunction in systemic lupus erythematosus: Its relationship with intracerebral volumes and antiphospholipid antibody profile. Case series.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-27 DOI: 10.1016/j.medcli.2024.11.009

Julian A Naranjo-Millán, Alex Echeverri, David Aguirre-Valencia, Ana M Granados-Sánchez, Isabella Moreno-Arango, Valentina Mejía-Quiñones, Juan F Orejuela-Zapata

{"title":"Cognitive dysfunction in systemic lupus erythematosus: Its relationship with intracerebral volumes and antiphospholipid antibody profile. Case series.","authors":"Julian A Naranjo-Millán, Alex Echeverri, David Aguirre-Valencia, Ana M Granados-Sánchez, Isabella Moreno-Arango, Valentina Mejía-Quiñones, Juan F Orejuela-Zapata","doi":"10.1016/j.medcli.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.medcli.2024.11.009","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of cognitive compromise in systemic lupus erythematosus is variable; it presents early and is usually asymptomatic. Our study evaluated the frequency of cognitive impairment in patients without a previous diagnosis of neuropsychiatric lupus and compared the differences in intracerebral size in subgroups with cognitive alterations and positive autoantibodies.</p><p><strong>Methods: </strong>This is a cross-sectional study. Patients with systemic lupus erythematosus without a previous diagnosis of neuropsychiatric lupus treated between July 2018 and October 2019 were included. Neuropsychological tests and brain imaging were performed by magnetic resonance imaging (MRI) measuring brain volumes. The variables, including antiphospholipid syndrome (APS) antibodies, were compared between subgroups of patients with and without neuropsychological alterations.</p><p><strong>Results: </strong>Six patients were included. Patients who tested positive in more than two abnormal neuropsychiatric assessments showed reduced brain volumes in the right (6.1 versus 5.31) and left (6.2 versus 5.38) frontal lobes, the right (0.66 versus 0.65) and left (0.67 versus 0.6) cingulate cortices, the right (3.63 versus 3.38) and left (3.67 versus 3.4) temporal lobes, the right (3.96 versus 3.8) and left (3.87 versus 3.7) parietal lobes, and the right (0.49 versus 0.41) and left (0.46 versus 0.42) insula. A comparison of median normalized brain volumes revealed that most patients testing positive for antiphospholipid antibodies had reduced brain volumes.</p><p><strong>Conclusions: </strong>A relationship was observed between neurocognitive compromise, antiphospholipid antibodies and brain volumes measured by cerebral magnetic resonance. These findings occur in asymptomatic neuropsychiatric patients.</p>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059754","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

Idiopathic inflammatory myopathy.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-27 DOI: 10.1016/j.medcli.2024.12.008

Albert Selva-O'Callaghan, Ernesto Trallero-Araguás, Albert Gil-Vila

引用次数: 0

Decisions at the end of life in health professionals.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-27 DOI: 10.1016/j.medcli.2024.11.015

Yanira Aranda Rubio, Beatriz Corrales González

引用次数: 0

Monitoring of adverse effects and quality of life during chemotherapy treatment through the EMMA Salud mobile App in patients with colorectal cancer.

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-25 DOI: 10.1016/j.medcli.2024.12.003

Pau Riera, Berta Martín-Cullell, Anna de Dios, Anna C Virgili, Lucía Ramírez, David Páez

{"title":"Monitoring of adverse effects and quality of life during chemotherapy treatment through the EMMA Salud mobile App in patients with colorectal cancer.","authors":"Pau Riera, Berta Martín-Cullell, Anna de Dios, Anna C Virgili, Lucía Ramírez, David Páez","doi":"10.1016/j.medcli.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.medcli.2024.12.003","url":null,"abstract":"<p><strong>Background and aim: </strong>One third of patients with colorectal cancer (CRC) undergoing chemotherapy develop serious adverse effects. The aim was to monitor toxicities, evaluate quality of life and the usefulness of the EMMA Salud mobile App in these patients.</p><p><strong>Patients and methods: </strong>Prospective single-center study including patients with CRC who started fluoropyrimidine-based chemotherapy treatment between 02/2022 and 02/2023. Through the mobile application, patients could record adverse effects, interact with healthcare professionals and answer quality of life (EORTC-CRC) and anxiety/depression (HADS) questionnaires.</p><p><strong>Results: </strong>A total of 31 patients were included. Regarding the use of the App, 10 patients (32.2%) recorded variables of interest, 11 (35.5%) recorded toxicities and 10 (32.2%) sent direct messages to healthcare professionals. Many patients (48%) also used the telephone consultation from the nurse case manager. The response rate to HADS and EORTC-CRC was 30% at baseline and 10% at approximately 6 months.</p><p><strong>Conclusions: </strong>Monitoring toxicities through a mobile application can improve communication in motivated patients who adhere to new technologies. However, the role of the nurse case manager continues to be a valuable resource.</p>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047242","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

Trombosis venosa superficial: una entidad compleja y con riesgo subestimado 浅静脉血栓：风险被低估的复杂实体。

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-25 DOI: 10.1016/j.medcli.2024.11.005

Alejandro Díez-Vidal

引用次数: 0

Importancia del estudio genético en la hiperoxaluria primaria tipo 1. Estudio de un caso 原发性高草酸尿症 1 型遗传研究的重要性。病例报告。

IF 2.6 4区医学

Medicina Clinica Pub Date : 2025-01-24 DOI: 10.1016/j.medcli.2024.07.027

María Molina-Zayas , María del Mar del Águila García , Rafael J. Esteban de la Rosa

引用次数: 0

Nistagmo vertical secundario a malformación de Chiari tipo i 奇拉氏畸形 I 型导致的垂直性眼球震颤。