Medicina Clinica最新文献

{"title":"Fatal hemoptysis due to massive cavitation of lung metastases in a patient with adenoid cystic carcinoma treated with lenvatinib","authors":"Luis Gorospe , Yolanda Lage-Alfranca , Ainara Soria-Rivas , 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}

{"title":"Platypnea-orthodeoxia syndrome in an elderly patient with undiagnosed patent foramen ovale","authors":"Francisco Epelde","doi":"10.1016/j.medcli.2025.107008","DOIUrl":"10.1016/j.medcli.2025.107008","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 107008"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106687","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 de la timectomía en la evolución de la miastenia gravis: análisis de 21 pacientes","authors":"Sofía Corbaz ,&nbsp;Andrea Savransky ,&nbsp;Nadia Gaeto ,&nbsp;Adolfo Gallo ,&nbsp;Marcelo Barrenechea ,&nbsp;María Soledad Monges","doi":"10.1016/j.medcli.2025.106957","DOIUrl":"10.1016/j.medcli.2025.106957","url":null,"abstract":"<div><h3>Introduction</h3><div>Myasthenia gravis is part of a group of neuromuscular junction disorders. Thymectomy has been shown to be effective for its clinical control. The aim of this study was to assess the usefulness and safety of thymectomy in children with myasthenia gravis.</div></div><div><h3>Methods</h3><div>An analytical, retrospective, longitudinal study was conducted by reviewing the medical records of 21 patients with myasthenia gravis who underwent thymectomy and were followed-up for one year post-surgery. The variables assessed included the Myasthenia Gravis Activities of Daily Living score, pyridostigmine dose, corticosteroid dose, and myasthenia gravis exacerbations immediately before and up to one year after the surgery.</div></div><div><h3>Results</h3><div>The activities of daily living score significantly improved at 12 months (p<!--> <!-->=<!--> <!-->0.002). Crises decreased within 3 months post-surgery; this trend was maintained at 12 months (p<!--> <!-->=<!--> <!-->0.0003). However, the reductions in pyridostigmine (p<!--> <!-->=<!--> <!-->0.147) and corticosteroid therapy (p<!--> <!-->=<!--> <!-->0.11) at 12 months did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>Thymectomy showed benefits, including improved scores on the Myasthenia Gravis Activities of Daily Living Scale and a reduction in the frequency of myasthenia gravis exacerbations/crises. These findings show that thymectomy is a safe and valid option to consider for pediatric patients who have not responded to the first-line treatment.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106957"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114967","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":"Helicobacter pylori y enfermedad gástrica","authors":"Javier P. Gisbert","doi":"10.1016/j.medcli.2025.106974","DOIUrl":"10.1016/j.medcli.2025.106974","url":null,"abstract":"<div><div>The infection caused by <em>Helicobacter pylori</em> is the most common on the planet, affecting half of the global population. It is usually transmitted during childhood and persists for life if untreated. It is the primary cause of chronic gastritis, peptic ulcer, and gastric cancer. In young dyspeptic patients without alarm symptoms, the test-and-treat strategy (detection of <em>H. pylori</em> through a non-invasive test and subsequent eradication) is the preferred approach. The causal role of the infection in the development of gastric adenocarcinoma provides an opportunity to implement preventive strategies. The infection can be diagnosed through invasive methods (requiring endoscopy, such as the rapid urease test or histology) and non-invasive methods (such as the breath test or stool antigen test). The treatment for <em>H. pylori</em> combines a proton pump inhibitor with several antibiotics or bismuth salts.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106974"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106009","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":"Diferencias en el perfil clínico entre hombres y mujeres con apneas obstructivas del sueño","authors":"Nuria Roger-Casals ,&nbsp;Ana Maria Muñoz-Fernández ,&nbsp;Cristina Muñoz-Pindado","doi":"10.1016/j.medcli.2025.106975","DOIUrl":"10.1016/j.medcli.2025.106975","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106975"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116871","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":"Utilidad pronóstica de valores extremos de NT-proBNP en pacientes ingresados por insuficiencia cardíaca","authors":"Miguel Yebra Yebra ,&nbsp;Alejandro Sáenz de Urturi Rodríguez ,&nbsp;Sergio González García ,&nbsp;Paula de Peralta García ,&nbsp;Maria Asenjo Martínez ,&nbsp;Jose Antonio Rueda Camino ,&nbsp;Raquel Barba Martín","doi":"10.1016/j.medcli.2025.106990","DOIUrl":"10.1016/j.medcli.2025.106990","url":null,"abstract":"<div><h3>Background and objective</h3><div>To evaluate the prognostic value of extreme levels of the N-terminal pro-brain natriuretic peptide (NT-proBNP) measured at any time during hospitalization for heart failure (HF).</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study including patients hospitalized for HF in a secondary-level hospital with at least one NT-proBNP measurement. Two groups were defined: patients with extreme NT-proBNP levels (&gt;<!--> <!-->50,000<!--> <!-->pg/mL) and those with elevated NT-proBNP levels (&gt;<!--> <!-->1800<!--> <!-->pg/mL and &lt;<!--> <!-->20,000<!--> <!-->pg/mL). The primary outcome was a composite of (1) in-hospital mortality; (2) HF readmission, and (3) 6-month mortality. Cox survival models were used for analysis.</div></div><div><h3>Results</h3><div>A total of 83 patients with extreme NT-proBNP levels and 100 with elevated NT-proBNP levels were included; 61% were women, with a median age of 87 years. Comorbidity burden was high and similar between groups (median Charlson index: 8). The primary outcome was more frequent in patients with extreme NT-proBNP levels: 25.02 vs. 10.53 events per 100 patient-months (HR 2.07; 95% CI: 1.37-3.14). Both in-hospital and 6-month mortality were significantly higher in the extreme NT-proBNP group, while HF readmissions were numerically higher but not statistically significant. These results remained consistent after multivariable adjustment.</div></div><div><h3>Conclusions</h3><div>Patients hospitalized for HF with NT-proBNP levels<!--> <!-->&gt;<!--> <!-->50,000<!--> <!-->pg/mL have a worse prognosis than those with NT-proBNP<!--> <!-->&lt;<!--> <!-->20,000<!--> <!-->pg/mL, representing a high-risk subgroup with short-term mortality.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106990"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105856","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":"Endobronchial squamous papilloma","authors":"Milko Terranova Ríos,&nbsp;Ana María Andrés Blanco,&nbsp;Tomás Ruiz Albi","doi":"10.1016/j.medcli.2025.106956","DOIUrl":"10.1016/j.medcli.2025.106956","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106956"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106775","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":"The relationship between trajectories of serum lipids and cognitive impairment in middle aged and elderly: A 6-year prospective cohort study in Xi’an, China","authors":"Ningwei Hu ,&nbsp;Yulu Yan ,&nbsp;Shan Wei ,&nbsp;Hong Lv ,&nbsp;Liangjun Dang ,&nbsp;Ling Gao ,&nbsp;Jin Wang ,&nbsp;Xiaojuan Guo ,&nbsp;Jingyi Wang ,&nbsp;Qiumin Qu ,&nbsp;Suhang Shang","doi":"10.1016/j.medcli.2025.106959","DOIUrl":"10.1016/j.medcli.2025.106959","url":null,"abstract":"<div><h3>Background</h3><div>Hyperlipidemia has been linked to cognitive impairment (CogI) caused by Alzheimer's disease and vascular disease. Nevertheless the relationship between long-term trajectories of serum lipids and the risk of developing CogI is still lacking.</div></div><div><h3>Methods</h3><div>Research enrolled participants aged 40 years or older in the suburbs of Xi’an, China and conducted follow-ups every two years from 2014 to 2020. Fasting serum lipid (including total cholesterol, TC; triglyceride, TG; high density lipoprotein, HDL-c; low density lipoprotein, LDL-c) levels were tested. Those with normal cognition at baseline and diagnosed with MCI or dementia during follow-up were defined as having new-onset CogI. We used group-based trajectory model for serum lipid trajectory classification, and multivariable logistic regression models to investigate the relationship between long-term serum lipids trajectories and CogI.</div></div><div><h3>Results</h3><div>Our final sample included 1268 participants. There were 33 (2.6%) new-onset CogI of whom 20 met the criteria for MCI and 13 met the criteria for dementia during the follow-up. Trajectories of TC and LDL-c were divided into three categories (low, medium and high level) respectively; lgTG and HDL-c were divided into low and high level respectively. Univariate analysis showed that the incidence rate of CogI in low TC group (3.4%) or high TC group (4.3%) was higher than that in medium TC group (1.5%). Multivariable logistic regression analysis showed that compared to medium level, the risk of developing CogI was increased for both low TC level (OR<!--> <!-->=<!--> <!-->2.679 [95% CI, 1.140–6.295]) and high TC level (OR<!--> <!-->=<!--> <!-->2.828 [95% CI, 0.927–8.624]). Other lipid trajectory levels were not associated with the risk of developing CogI.</div></div><div><h3>Conclusions</h3><div>Long-term low or high TC levels may be a predictive factor for the risk of CogI.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 2","pages":"Article 106959"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114969","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":"Transdiferenciación celular tras inmunoterapia anti-CD19 en leucemia aguda linfoblástica","authors":"Itziar de Aguirre ,&nbsp;Vitor Botafogo ,&nbsp;José Tomás Navarro","doi":"10.1016/j.medcli.2025.106995","DOIUrl":"10.1016/j.medcli.2025.106995","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"165 1","pages":"Article 106995"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105855","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}