Medicina Clinica最新文献

{"title":"Ventricular extrasystoles secondary to mitral valve prolapse as an initial manifestation of cardiac sarcoidosis. A case report","authors":"Javier del Cid Lemus , Carlos Feijoo-Massó , Daniel Valcarcel-Paz","doi":"10.1016/j.medcli.2025.106976","DOIUrl":"10.1016/j.medcli.2025.106976","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106976"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116873","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":"Effect of cholecalciferol on 25-hydroxyvitamin D in people living with HIV and vitamin D deficiency: A prospective observational study","authors":"Cristina Tomás ,&nbsp;Ángeles Muñoz ,&nbsp;Carlos Báguena ,&nbsp;Antonia Alcaraz ,&nbsp;Rodrigo Martínez-Rodríguez ,&nbsp;María Dolores Hernández ,&nbsp;María Isabel Martínez ,&nbsp;Rubén Corral-San-Miguel ,&nbsp;Eduardo Pons-Fuster López ,&nbsp;Eva García-Villalba ,&nbsp;Salvador Valero ,&nbsp;Eva Oliver Galera ,&nbsp;Elena Guijarro Westermeyer ,&nbsp;Román González Hipólito ,&nbsp;Concepción Corbalán Dólera ,&nbsp;María del Carmen García Ros ,&nbsp;Enrique Bernal","doi":"10.1016/j.medcli.2025.106972","DOIUrl":"10.1016/j.medcli.2025.106972","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effect of oral cholecalciferol 50,000<!--> <!-->IU monthly administered in people living with HIV (PLHIV) and 25(OH)D deficiency followed over 48 weeks.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in a cohort of 110 PLHIV with 25(OH)D levels<!--> <!-->&lt;<!--> <!-->20<!--> <!-->ng/mL. Changes in 25(OH)D levels were evaluated at 3, 6, and 12 months of treatment. The percentages of patients who achieved 25(OH)D levels<!--> <!-->&gt;<!--> <!-->20 and &gt;30<!--> <!-->ng/mL and changes in bone mineral density (BMD) were assessed.</div></div><div><h3>Results</h3><div>One hundred ten PLHIV (79% men, mean age 49.46 years) were included. The mean (standard deviation, SD) time on antiretroviral treatment was 10.69 (8.31) years and all patients had a viral load<!--> <!-->&lt;<!--> <!-->50<!--> <!-->copies/mL. The mean 25(OH)D levels of 15.10<!--> <!-->±<!--> <!-->3.22<!--> <!-->ng/mL at baseline increased significantly (<em>P</em> <!-->&lt;<!--> <!-->0.001) to 27.89<!--> <!-->±<!--> <!-->7.79<!--> <!-->ng/mL at 3 months, 28.53<!--> <!-->±<!--> <!-->8.45<!--> <!-->ng/mL at 6 months and 27.89<!--> <!-->±<!--> <!-->7.92<!--> <!-->ng/mL at 12 months. A total of 87.27% had normal 25(OH)D levels at 12 months (&gt;30<!--> <!-->ng/mL in 36.1% of patients and &gt;20<!--> <!-->ng/mL in 51.5%). Parathormone levels (PTH) also decreased significantly. Treatment was safe and well tolerated. On the other hand, no significant changes were observed in BMD.</div></div><div><h3>Conclusions</h3><div>Monthly administration of 50,000<!--> <!-->IU of cholecalciferol was effective in normalizing 25(OH)D deficiency in 87% of PLHIV, without observing changes in bone mineral density.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106972"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115866","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":"COVID de larga duración","authors":"Anabel Franco-Moreno,&nbsp;Juan Torres-Macho","doi":"10.1016/j.medcli.2025.107009","DOIUrl":"10.1016/j.medcli.2025.107009","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 107009"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114968","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":"Efectividad y seguridad de remdesivir y nirmatrelvir-ritonavir en la COVID-19 leve-moderada en los servicios de urgencia hospitalaria españoles","authors":"Cristóbal M. Rodríguez-Leal ,&nbsp;Juan González del Castillo ,&nbsp;Martín Sebastián Ruiz Grinspan ,&nbsp;Rosario Susi García ,&nbsp;Teresa Pérez Pérez ,&nbsp;en nombre del grupo de estudio COVID CODE SPAIN","doi":"10.1016/j.medcli.2025.106912","DOIUrl":"10.1016/j.medcli.2025.106912","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Remdesivir and nirmatrelvir-ritonavir (NTV/r) are the antiviral drugs available in Spain to prevent progression of mild-moderate COVID-19 in vulnerable populations. The pivotal clinical trials of both were conducted under different epidemiological conditions than the current ones. Therefore, their effect in the current setting is uncertain.</div></div><div><h3>Patients and methods</h3><div>A retrospective, multicentre, observational cohort study was conducted in 16 Spanish hospital emergency departments (ED). Data were collected from all patients with mild to moderate COVID-19 who presented to an ED in the first seven days after symptom onset between 1^st January and 31^st August 2022. The incidence of hospitalisation or death from any cause at 30 days (composite endpoint) after discharge from the ED was assessed, as was the occurrence of serious adverse drug reactions (ADRs). Data were analysed using Cox multiple regression and standardised survival curves.</div></div><div><h3>Results</h3><div>A total of 2533 patients were included. The use of NTV/r was associated with a reduced risk of the combined endpoint compared to standard of care (SOC): adjusted hazard ratio (aHR) 0.528, 97.5% confidence interval (97.5%CI): 0.330-0.845; number of patients to treat to avoid an event, 24 (97,5%CI 13-283). No difference was detected between remdesivir and SOC: aHR 0.835: 97,5%CI: 0.524-1.394. No serious ADRs were identified.</div></div><div><h3>Conclusion</h3><div>Early use of NTV/r was associated with less risk of progression of mild to moderate COVID-19 in vulnerable patients, while no differences were found between remdesivir and SOC. Their use was safe.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106912"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123931","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":"Acute organophosphorus pesticide poisoning with hepatic portal venous gas","authors":"Xinsen Chen ,&nbsp;Ting Jiang ,&nbsp;Lu Zhang","doi":"10.1016/j.medcli.2025.106967","DOIUrl":"10.1016/j.medcli.2025.106967","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 3","pages":"Article 106967"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115882","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":"Diagnostic value of blood coagulation index in obstetric antiphospholipid syndrome and its subtypes","authors":"Xuan Qi ,&nbsp;Xiaomeng Li ,&nbsp;Yan Han ,&nbsp;Lingyan Lei ,&nbsp;Huifang Guo","doi":"10.1016/j.medcli.2025.106997","DOIUrl":"10.1016/j.medcli.2025.106997","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize blood coagulation index in obstetric antiphospholipid syndrome (OAPS) and its subtypes, analyzing correlations with immunological indices and diagnostic value.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on OAPS patients treated at the Department of Rheumatology and Immunology, Second Hospital of Hebei Medical University, from September 2023 to March 2024. Healthy women of the same age range were matched for comparison.</div></div><div><h3>Results</h3><div>A total of 102 OAPS patients and 80 matched healthy controls were included. OAPS patients exhibited significantly lower levels of complement factors C3 and C4, coagulation factors V and VII activities, and protein S activity (<em>p</em> <!-->&lt;<!--> <!-->0.05). Conversely, they had elevated levels of anti-β2 glycoprotein I antibodies, platelets, thrombin–antithrombin complex (TAT), thromboelastographic reaction time (R), maximum amplitude (MA), clot formation index (CI), von Willebrand factor activity, coagulation factor VIII activity, and activated partial thromboplastin time (APTT) (<em>p</em> <!-->&lt;<!--> <!-->0.05). Among OAPS patients, criteria OAPS cases showed significantly higher anti-β2-GPI antibodies and anticardiolipin antibody levels (<em>p</em> <!-->&lt;<!--> <!-->0.01), with more spontaneous abortions and fetal deaths in this group (<em>p</em> <!-->&lt;<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>Correlations were found between immunological indices (ANA, complement C3, anti-β2-GPI) and coagulation indices (TAT, APTT). ANA, complement C3, anti-β2-GPI antibodies, and TAT were identified as risk factors for predicting OAPS. Blood coagulation and immune indices correlate in OAPS. Detecting these indices may provide diagnostic value for OAPS and its subtypes.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106997"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106008","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":"Relapsing polychondritis","authors":"Makram Tbini ,&nbsp;Ines Riahi ,&nbsp;Chaima Ben Ammar ,&nbsp;Mamia Ben Salah","doi":"10.1016/j.medcli.2025.106985","DOIUrl":"10.1016/j.medcli.2025.106985","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106985"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106688","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":"Whipple's disease mimicking systemic lupus erythematosus","authors":"Laia de Daniel ,&nbsp;Xavier Sanjuan ,&nbsp;Javier Narváez","doi":"10.1016/j.medcli.2025.106960","DOIUrl":"10.1016/j.medcli.2025.106960","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106960"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105398","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":"Fatal hemoptysis due to massive cavitation of lung metastases in a patient with adenoid cystic carcinoma treated with lenvatinib","authors":"Luis Gorospe ,&nbsp;Yolanda Lage-Alfranca ,&nbsp;Ainara Soria-Rivas ,&nbsp;Abel González-Huete","doi":"10.1016/j.medcli.2025.106955","DOIUrl":"10.1016/j.medcli.2025.106955","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 3","pages":"Article 106955"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106164","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":"Prevalencia de enfermedad vascular subclínica en función del riesgo vascular estimado y la presencia de síndrome metabólico","authors":"José María Mostaza ,&nbsp;Carlos Lahoz ,&nbsp;Miguel A. Salinero-Fort ,&nbsp;Eva Estirado ,&nbsp;Francisca García-Iglesias ,&nbsp;Teresa González Alegre ,&nbsp;Víctor Cornejo ,&nbsp;en representación de los investigadores del estudio ESPREDIA","doi":"10.1016/j.medcli.2025.106987","DOIUrl":"10.1016/j.medcli.2025.106987","url":null,"abstract":"<div><div>Most vascular complications occur in persons with a low or moderate calculated vascular risk. We have evaluated the added prediction of the metabolic syndrome (MS) to the presence of subclinical vascular disease (SVD), beyond that estimated by the cardiovascular risk calculation.</div></div><div><h3>Patients and methods</h3><div>Cross-sectional population-based study, in 1,061 subjects aged 45 to 75 years, without diabetes or known vascular disease, randomly selected from the Primary Care registries of Madrid (Spain). Vascular risk was calculated using SCORE2 and SCORE2-OP, the presence of MS was determined, and the prevalence of SVD was established by quantification of carotid plaques and ankle-brachial index.</div></div><div><h3>Results</h3><div>Of the included population, 40.2% was at low/moderate risk, 54.5% at high risk and 5.3% at very high risk. A total of 36.1% met the criteria for MS. The prevalence of SVD was 27.7, 50.1 and 71.4% in subjects at low/moderate, high and very high risk without MS, and 42.5, 62.6 and 78.6% if they had MS, respectively. The association of MS with the presence of EVS was independent of its separate components. A total of 23.1% of the participants were receiving statin treatment. Statin use was independent of the calculated cardiovascular risk and much higher in subjects with MS (38.6 vs. 12.8%).</div></div><div><h3>Conclusion</h3><div>Subjects with MS have a high prevalence of SVD, independent of the estimated risk. The use of statins is more prevalent in subjects with the MS, and is independent of the estimated cardiovascular risk.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106987"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106683","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}