Revista clinica espanola最新文献

{"title":"Características clínicas y manejo de los pacientes españoles adultos con fenilcetonuria","authors":"M.A. Martínez Olmos ,&nbsp;E. Venegas Moreno ,&nbsp;M. Morales Conejo ,&nbsp;L. Ceberio Hualde ,&nbsp;B. Pérez ,&nbsp;M. de Tallo Forga ,&nbsp;F.J. Pérez-Sádaba ,&nbsp;P. Correcher Medina","doi":"10.1016/j.rce.2025.502356","DOIUrl":"10.1016/j.rce.2025.502356","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the sociodemographic and clinical characteristics and management of patients with phenylketonuria (PKU) followed in centres, services, and reference units (CSUR) or clinical excellence units specialised in inborn errors of metabolism (IEM). Additionally, to determine patients’ health-related quality of life (HRQoL).</div></div><div><h3>Methods</h3><div>Observational, cross-sectional, descriptive study conducted with Spanish PKU patients attending CSUR centres or clinical excellence units specialised in IEM during the study period.</div></div><div><h3>Results</h3><div>The study included 55 patients (54 adults and one teenager) with different PKU phenotypes. The mean (SD) age was 32.1 (9.7) years, with 69.1% women. The most frequent phenotype at diagnosis was classical PKU (67.3%). Mean (SD) plasma Phe levels at diagnosis were 901.9 (606.1) μmol/L and 422.8 (288.9) μmol/L in the last year. Neurological symptoms were present in 23.6% of patients, the most frequent being intellectual disability (21.8%). Psychological symptoms were present in 34.5% of patients, the most frequent being anxiety (14.5%) and depression (12.7%). Of the patients, 85.5% responded to the EQ-5D-5L questionnaire. Of these, 44.7% of patients reported no anxiety or depression, while 34.0% had mild anxiety or depression. The mean (SD) EQ-VAS value was 80.9 (15.2). Forty-one (74.5%) patients responded to the PKU-QoL questionnaire. The results indicated that PKU patients perceived the impact of their disease to be moderate across all domains included in the questionnaire.</div></div><div><h3>Conclusions</h3><div>Adults with PKU may experience neurological or psychological symptoms including intellectual disability, anxiety, and depression. However, their HRQoL was found to be good and comparable to that of the general population.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502356"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189773","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":"Desde la obesidad a las comorbilidades: una propuesta de atención integral para ganar en salud de la Sociedad Española de Medicina Interna","authors":"J. Carretero Gómez ,&nbsp;J.M. Fernández Rodríguez ,&nbsp;A. Michan Doña ,&nbsp;J.P. Miramontes González ,&nbsp;J.J. González Soler ,&nbsp;M.I. Pérez Soto ,&nbsp;F.J. Carrasco Sánchez ,&nbsp;F. Gómez Delgado ,&nbsp;J.C. Arévalo Lorido ,&nbsp;P. Pérez Martínez ,&nbsp;en representación del grupo de trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna (SEMI)","doi":"10.1016/j.rce.2025.502352","DOIUrl":"10.1016/j.rce.2025.502352","url":null,"abstract":"<div><div>Obesity is currently recognized as a chronic, progressive, and relapsing disease, and constitutes a major global public health challenge. This document, promoted by the Spanish Society of Internal Medicine through its Working Group on Diabetes, Obesity, and Nutrition, outlines a comprehensive, multidisciplinary approach to care, with a specific focus on obesity-related comorbidities. Excess adipose tissue is conceptualized as a systemic pathogenic agent that actively contributes to the pathophysiology of numerous complications, including cardiovascular disease, heart failure, chronic kidney disease, osteoarthritis, obstructive sleep apnea, and metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, the document reviews the current evidence base regarding pharmacological interventions for obesity, addressing both their overall efficacy in weight management and their specific therapeutic impact in the context of the distinct obesity-associated comorbidities for which clinical benefit has been demonstrated.</div><div>The document endorses the implementation of the Edmonton Obesity Staging System (EOSS) as a pivotal framework for the clinical stratification of risk in individuals with obesity, facilitating a more nuanced and personalized therapeutic approach that prioritizes the functional, metabolic, and prognostic dimensions of the disease. In this context, the document proposes a paradigm shift in the therapeutic objectives for obesity management, moving beyond a sole reliance on anthropometric metrics, such as body mass index (BMI) or absolute weight reduction. Instead, it emphasizes a pathophysiological and patient-centered approach focused on the prevention of obesity-related complications, the early detection and management of its comorbid conditions, and the sustained improvement of both quality-adjusted and overall life expectancy, while simultaneously promoting the elimination of stigma and discrimination.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502352"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189783","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":"Signo del macarrón y arteritis de Takayasu: utilidad de la ecografía clínica","authors":"M.A. Cornejo-Saucedo,&nbsp;J.M. Aparicio-Oliver,&nbsp;D. García-Gil","doi":"10.1016/j.rce.2025.502354","DOIUrl":"10.1016/j.rce.2025.502354","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502354"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189780","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":"Significado de la calcificación del arco aórtico como marcador de riesgo cardiovascular: análisis de una cohorte de pacientes hospitalizados en Medicina Interna","authors":"A. García Tellado ,&nbsp;A. Castillo Leonet ,&nbsp;J. Queipo Menéndez ,&nbsp;M. de la Fuente Vázquez ,&nbsp;E. Julián Gómez ,&nbsp;C. Valero ,&nbsp;C. García Ibarbia ,&nbsp;J. Pardo Lledias ,&nbsp;J.L. Hernández Hernández","doi":"10.1016/j.rce.2025.502350","DOIUrl":"10.1016/j.rce.2025.502350","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortic arch calcification (AAC) is an underestimated marker of cardiovascular risk, associated with a higher incidence of major cardiovascular events and mortality.</div></div><div><h3>Materials and methods</h3><div>This retrospective, descriptive study included 292 patients admitted in May 2021 to the Internal Medicine Department of Marqués de Valdecilla University Hospital. The presence of AAC was assessed via chest X-rays, alongside clinical data, risk factors, and previous and 12-month cardiovascular events.</div></div><div><h3>Results</h3><div>AAC was present in 51% of patients. Age over 65, dyslipidemia, and smoking were independent predictors (<em>P</em> <!-->&lt;<!--> <!-->.05). AAC was significantly associated with a higher prevalence of cardiovascular events: stroke (23.3% vs. 13.3%; OR: 1.9, 95%<!--> <!-->CI: 1.07-3.6), acute coronary syndrome (23.3% vs. 8.5%; OR: 3.2, 95%<!--> <!-->CI: 1.6-6.4), and peripheral arterial disease (20.9% vs. 7.3%; OR: 3.3, 95%<!--> <!-->CI: 1.6-6.9). At 12-month follow-up, patients with AAC had a higher incidence of new cardiovascular events (22.5% vs. 10.9%; OR: 2.3, 95%<!--> <!-->CI 1.2-4.9; <em>P</em> <!-->=<!--> <!-->.007). Although overall survival was lower in this group, only age and chronic kidney disease were independent predictors of mortality.</div></div><div><h3>Conclusions</h3><div>AAC is a common finding among hospitalized patients and is associated with increased cardiovascular risk. Its detection on chest X-rays may serve as an accessible tool for risk stratification in high-risk populations.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502350"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189781","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":"Uso de fármacos hipolipemiantes en pacientes con alto y muy alto riesgo cardiovascular en España: un año de seguimiento de la subpoblación española del estudio europeo SANTORINI","authors":"J.M. Mostaza ,&nbsp;C. Lahoz ,&nbsp;M. García de Yébenes Castro ,&nbsp;J.M. Rubio Campal ,&nbsp;E. Velásquez ,&nbsp;A. Ibarra Gutiérrez ,&nbsp;J.F. Díaz ,&nbsp;N. Plana ,&nbsp;M. Rodríguez-Mañero ,&nbsp;J.D. de Dios García-Díaz ,&nbsp;F. Martínez Debén ,&nbsp;I. Pavón de Paz ,&nbsp;A.L. Catapano ,&nbsp;G. Díaz Moya ,&nbsp;K.K. Ray ,&nbsp;en representación del grupo de investigadores de SANTORINI España","doi":"10.1016/j.rce.2025.502344","DOIUrl":"10.1016/j.rce.2025.502344","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world studies evaluating the impact of 2019 European Societies of Cardiology (ESC) and Atherosclerosis (EAS) guidelines on the use of lipid-lowering treatments (LLTs) are scarce. This manuscript shows baseline and 1-year follow-up data on LLT usage and low-density lipoprotein cholesterol (LDL-C) goal attainment in the Spanish subpopulation from SANTORINI study and put them in perspective with the European cohort without Spanish participants.</div></div><div><h3>Methods</h3><div>SANTORINI was a multinational, prospective, non-interventional study. The Spanish subpopulation involved up to 1018 patients at high and very high cardiovascular (CV) risk.</div></div><div><h3>Results</h3><div>Of 956 patients in LDL-C dataset, mean LDL-C levels decreased from baseline (82.7<!--> <!-->±<!--> <!-->40.6<!--> <!-->mg/dL) to 1-year follow-up (72.3<!--> <!-->±<!--> <!-->32.6<!--> <!-->mg/dL), in patients at high and very high risk. The percentage of patients who achieved 2019 ESC/EAS LDL-C goals increased from 26.5% at baseline to 34.1% at 1-year follow-up, in patients at high (23.1% versus 27.3%) and very high risk (27.9% versus 37.0%). Attainment to LDL-C targets improved while initiating treatment with a LLT in patients not receiving it at baseline or following change to a combination therapy in those who were receiving it. During the follow-up, seven patients died due to CV causes, and 46 and 24 had at least one four- or three-component major adverse CV events, respectively.</div></div><div><h3>Conclusions</h3><div>Follow-up data from SANTORINI Spain show that LLT usage increased from baseline, including monotherapy and combination therapy. Despite recommendations, patients at highest CV risk continue not receiving the most adequate LLT for reducing LDL-C levels in routine clinical practice.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502344"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189699","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":"Atención Integral a Médicas Víctimas de Violencia Machista: el modelo del Colegio de Médicos de Barcelona","authors":"Laura Aragonès Rodríguez ,&nbsp;Elvira Bisbe Vives","doi":"10.1016/j.rce.2025.502353","DOIUrl":"10.1016/j.rce.2025.502353","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502353"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189779","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 de la amplitud de distribución de monocitos en el diagnóstico de sepsis en pacientes críticos","authors":"C. Morales Indiano ,&nbsp;A. Herraiz Ruiz ,&nbsp;P. Marcos Neira ,&nbsp;R. Roig Pineda ,&nbsp;B. Catalán Eraso ,&nbsp;A. Martínez Iribarren ,&nbsp;A. Leis Sestayo ,&nbsp;F. Arméstar Rodríguez","doi":"10.1016/j.rce.2025.502357","DOIUrl":"10.1016/j.rce.2025.502357","url":null,"abstract":"<div><h3>Background</h3><div>The incidence and mortality of sepsis remain high in the intensive care units (ICU). WBC, CRP and PCT are frequently used as tools for sepsis detection; however, none of them is specific to sepsis. The aim of the current study was to evaluate whether monocyte distribution width (MDW) is useful for early sepsis detection in critically ill patients.</div></div><div><h3>Methods</h3><div>Prospective cohort study was conducted in a critical care unit. MDW, CRP, PCT and WBC were evaluated for sepsis detection at the time of intensive care unit admission.</div></div><div><h3>Results</h3><div>There were 344 critically ill patients enrolled consecutively and categorized as no sepsis (200), sepsis (76) and septic shock (68). MDW in patients with sepsis diagnoses in ICU was notably higher than non-sepsis group (29.7 [24.7-35.7] vs 20.4 [18.6-22.7]; <em>P</em> <!-->&lt;<!--> <!-->.001) under the assumption of no mean difference between the groups. Compared to other parameters, MDW was the best to discriminate sepsis from all other conditions (area under curve [AUC]: 0.877; 95%<!--> <!-->CI: 0.841 0.914), sensitivity 80.6, specificity 84.5 at a cut-off point of 24. MDW adjusted for age, sex and SOFA score was associated with mortality (OR: 1.056; 95%<!--> <!-->CI: 1.004-1.09; <em>P</em> <!-->&lt;<!--> <!-->.01).</div></div><div><h3>Conclusion</h3><div>The measurement of MDW is a tool that can help in the early diagnosis of sepsis in ICU settings and its value is a factor associated with the prognosis of septic patients.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502357"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189778","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":"Anemia en la sensibilidad al gluten no celíaca: una revisión sistemática","authors":"N. Correa-Ventura","doi":"10.1016/j.rce.2025.502351","DOIUrl":"10.1016/j.rce.2025.502351","url":null,"abstract":"<div><h3>Background</h3><div>Non-celiac gluten sensitivity (NCGS) is characterized by a combination of intestinal and extra-intestinal symptoms triggered by gluten consumption, without evidence of celiac disease or wheat allergy. Anemia, as an extra-intestinal manifestation, has been little studied in this context.</div></div><div><h3>Main objective</h3><div>To synthesize the available evidence on the association between NCGS and anemia.</div></div><div><h3>Secondary objective</h3><div>To evaluate studies applying the Salerno criteria as a diagnostic method.</div></div><div><h3>Methods</h3><div>Between November and December 2024, a search for scientific articles was conducted in the PubMed, Scopus, and Google Scholar databases, using the following terms: «anemia AND non-celiac gluten sensitivity»; «non-celiac gluten sensitivity AND clinical manifestations»; «non-celiac gluten sensitivity AND Salerno Experts.» Studies were included that either reported data on anemia in NCGS and/or used the Salerno criteria for the diagnosis of NCGS. The methodological quality of observational studies was assessed using the STROBE checklist, and the review was structured according to PRISMA 2020.</div></div><div><h3>Results</h3><div>A total of 18 studies were selected. The frequency of anemia in patients with NCGS ranged from 15% to 43%. Improvement in hemoglobin levels was reported after a gluten-free diet. Only 6 studies were developed according to the Salerno criteria.</div></div><div><h3>Conclusions</h3><div>NCGS should be considered in the differential diagnosis of anemia. The methodological quality of studies needs to be improved, ideally through double-blind controlled trials applying the Salerno criteria.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502351"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189782","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":"Actualización de las guías de manejo de la osteoporosis de la SEIOMM: abaloparatida","authors":"J.A. Riancho ,&nbsp;M. Martín Millán ,&nbsp;P. Peris ,&nbsp;G. Martínez ,&nbsp;en nombre de la Comisión de Redacción de las Guías de Osteoporosis de la SEIOMM","doi":"10.1016/j.rce.2025.502338","DOIUrl":"10.1016/j.rce.2025.502338","url":null,"abstract":"<div><h3>Introduction</h3><div>Osteoporosis is a highly prevalent condition. SEIOMM has published guidelines for managing these patients in 2022. The recent introduction of a new drug in Europe, abaloparatide, makes it advisable to consider its role among therapeutic options.</div></div><div><h3>Objective and results</h3><div>This article summarizes the existing information on the efficacy and safety of abaloparatide and it updates the therapeutic algorithms proposed in the guidelines.</div></div><div><h3>Conclusion</h3><div>Abaloparatide is an osteoanabolic drug with efficacy and safety similar to teriparatide. It represents a new option for treating patients with severe osteoporosis and a very high risk of fracture.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502338"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189784","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":"El poder del comedor escolar como herramienta de salud: sinergias entre la política pública y el programa E-DUCASS","authors":"P. Pérez-Martínez ,&nbsp;E. Porras-Pérez ,&nbsp;J.L. Romero-Cabrera","doi":"10.1016/j.rce.2025.502355","DOIUrl":"10.1016/j.rce.2025.502355","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502355"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189635","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}