Revista clinica espanola最新文献_第2页

El registro RICA-2: diseño y características basales de los primeros 1.000 pacientes RICA-2 登记：首批 1,000 名患者的设计和基线特征

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.010

{"title":"El registro RICA-2: diseño y características basales de los primeros 1.000 pacientes","authors":"","doi":"10.1016/j.rce.2024.06.010","DOIUrl":"10.1016/j.rce.2024.06.010","url":null,"abstract":"<div><h3>Background and objective</h3><div>Heart failure (HF) is a syndrome of epidemic proportions and one of the main reasons for hospital admission. Patient registries provide real-world clinical practice information which is complementary to clinical trials. RICA-2 is a registry of the Spanish Society of Internal Medicine. Its main goal is to know the clinical and epidemiological characteristics and prognostic factors of patients with HF treated in Internal Medicine Departments. The objective of this study is to present the design of the RICA-2, the baseline characteristics of the first 1000 patients included and their comparison with those of the historical cohort of the RICA registry.</div></div><div><h3>Methods</h3><div>Observational, multicentre and prospective study of patients with HF with the following inclusion criteria: age equal to or greater than 18 years old, diagnosis of HF according to the European Guidelines, indistinct inclusion in decompensation or stable phase, of patients with <em>de novo</em> HF or chronic HF, regardless of left ventricular ejection fraction, aetiology and comorbidities.</div></div><div><h3>Results</h3><div>RICA-2 patients have advanced age (83 years old) and 51% are women. The comorbidity burden is higher than in the RICA registry (5 points in the Charlson comorbidity index), with predominating chronic decompensated HF (74%), hypertensive aetiology (39%) and preserved ejection fraction (52%). Most patients are pre-frail or vulnerable and are at risk of malnutrition.</div></div><div><h3>Conclusion</h3><div>The RICA-2 represents a contemporary cohort of patients that will provide us with clinical, epidemiological and prognostic information on patients with acute and chronic HF treated in Internal Medicine.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417249","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

Factores de riesgo de mortalidad en pacientes con enfermedad del coronavirus 2019 con hipoxemia silente 2019 年冠状病毒病无声低氧血症患者死亡的风险因素

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.004

{"title":"Factores de riesgo de mortalidad en pacientes con enfermedad del coronavirus 2019 con hipoxemia silente","authors":"","doi":"10.1016/j.rce.2024.06.004","DOIUrl":"10.1016/j.rce.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the predictors of mortality in hospitalized patients with severe acute respiratory syndrome (SARS) due to COVID-19 presenting with silent hypoxemia.</div></div><div><h3>Material and methods</h3><div>Retrospective cohort study of hospitalized patients with SARS due to COVID-19 and silent hypoxemia at admission, in Brazil, from January to June 2021. The primary outcome of interest was in-hospital death. Multivariable logistic regression analysis was performed.</div></div><div><h3>Results</h3><div>Of 46,102 patients, the mean age was 59±16years, and 41.6% were female. During hospitalization, 13,149 patients died. Compared to survivors, non-survivors were older (mean age, 66 vs. 56 years; <em>P</em>  <0.001), and more likely to have comorbidities (74.3% vs. 56.8%; <em>P</em>  <0.001) and intensive care unit admission (56.9% vs 20%; <em>P</em>  <!-->0.001) compared to survivors. In the multivariable regression analysis, advanced age (OR: 1.04; 95%CI: 1.037-1.04), presence of comorbidities (OR: 1.54; 95%CI: 1.47-1.62), cough (OR: 0.74; 95%CI: 0.71-0.79), respiratory distress (OR: 1.32; 95%CI: 1.26-1.38), and need for non-invasive respiratory support (OR: 0.37; 95%CI: 0.35-0.40) remained independently associated with death.</div></div><div><h3>Conclusions</h3><div>Advanced age, presence of comorbidities, and respiratory distress were independent risk factors for mortality, while cough and requirement for non-invasive respiratory support were independent protective factors against mortality in hospitalized patients with SARS due to COVID-19 with silent hypoxemia at presentation.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417145","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

Predicción eficaz de la diabetes de novo con velocidad estimada de onda de pulso (ePWV) e índice de masa corporal (IMC) 利用估计脉搏波速度 (ePWV) 和体重指数 (BMI) 有效预测新发糖尿病。

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.007

{"title":"Predicción eficaz de la diabetes de novo con velocidad estimada de onda de pulso (ePWV) e índice de masa corporal (IMC)","authors":"","doi":"10.1016/j.rce.2024.06.007","DOIUrl":"10.1016/j.rce.2024.06.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Estimated pulse wave velocity (ePWV) and body mass index (BMI) are significant predictors of new-onset diabetes. This study aims to evaluate the impact and predictive value of combining ePWV and BMI on the incidence of new-onset diabetes.</div></div><div><h3>Methods</h3><div>A secondary analysis was conducted on a cohort study by Rich Healthcare (China), involving 211,833 eligible participants. Logistic regression analysis identified factors influencing diabetes occurrence, while ROC curve analysis assessed the predictive value of ePWV, BMI, and their combination for new-onset diabetes.</div></div><div><h3>Results</h3><div>Over a mean follow-up period of 3.12 years, 3,000 men (1.41%) and 1,174 women (0.55%) were diagnosed with diabetes. Logistic regression revealed that BMI, triglycerides, alanine aminotransferase, blood urea nitrogen, creatinine clearance rate, ePWV, and family history of diabetes are high-risk factors for new-onset diabetes. The combination of ePWV and BMI provided a higher area under the ROC curve (0.822) compared to ePWV or BMI alone.</div></div><div><h3>Conclusion</h3><div>Elevated levels of ePWV and BMI are independent risk factors for new-onset diabetes. Combining these measures enhances predictive accuracy compared to using either indicator alone.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417144","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

¿Cómo evoluciona el riesgo de malnutrición en pacientes mayores al año del alta hospitalaria? Resultados de una cohorte prospectiva 老年患者出院一年后营养不良的风险如何变化？前瞻性队列研究结果

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.009

引用次数: 0

Miedo a la enfermedad en La metamorfosis de Kafka 卡夫卡《变形记》中的疾病恐惧

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.003

引用次数: 0

Consumo de alcohol en las personas mayores. ¿Cuál es la magnitud real del problema? 老年人饮酒--问题的真实程度如何？

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.005

引用次数: 0

Asociación entre las cadenas ligeras de neurofilamento en suero (sNfL) y los trastornos neurológicos en una muestra representativa de adultos en los Estados Unidos: un estudio transversal 美国代表性成人样本中血清神经丝蛋白轻链 (sNfL) 与神经系统疾病之间的关系：一项横断面研究。

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.008

{"title":"Asociación entre las cadenas ligeras de neurofilamento en suero (sNfL) y los trastornos neurológicos en una muestra representativa de adultos en los Estados Unidos: un estudio transversal","authors":"","doi":"10.1016/j.rce.2024.06.008","DOIUrl":"10.1016/j.rce.2024.06.008","url":null,"abstract":"<div><h3>Background</h3><div>While increased neurofilament light chain (NfL) in serum concentrations are linked to the progression of several neurological conditions, their distribution and implications within the general adult population remain largely unexplored. The current research aims to clarify the relationship among serum NfL levels and neurological disorders in a broad and representative population sample.</div></div><div><h3>Methods</h3><div>We utilized information gathered from 1,751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, including depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems.</div></div><div><h3>Results</h3><div>After adjusting for confounders, we found that higher serum NfL concentrations were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (<em>P</em><.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and subjective memory deficits.</div></div><div><h3>Conclusion</h3><div>Our research shows that higher serum NfL levels are strongly related to an elevated risk for several neurological disorders. These findings highlight the role of serum NfL serving as a critical marker for early detection and monitoring of neurological conditions, emphasizing its importance in both clinical and public health settings.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417143","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

Prevalencia y características de la anemia en personas con diabetes mellitus de 50 años o más en un área sanitaria de Cádiz (España) 加的斯（西班牙）一个健康地区 50 岁及以上糖尿病患者贫血症的患病率和特征。

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.05.007

{"title":"Prevalencia y características de la anemia en personas con diabetes mellitus de 50 años o más en un área sanitaria de Cádiz (España)","authors":"","doi":"10.1016/j.rce.2024.05.007","DOIUrl":"10.1016/j.rce.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><p>Anemia is a common comorbidity in patients with diabetes mellitus (DM), particularly in older adults. However, there is a lack of data on the prevalence and the characteristics of anemia in this population in Spain.</p></div><div><h3>Objective</h3><p>To describe the prevalence and the characteristics of anemia in patients with DM aged 50 or older (PDM50) in a healthcare district in the province of Cádiz.</p></div><div><h3>Methods</h3><p>A retrospective cross-sectional study was conducted that included outpatient's laboratory tests (OLT) performed over 30 months at PDM50.</p></div><div><h3>Results</h3><p>The prevalence of anemia was 29.9% (95% CI: 28.7-31.1%), predominating in women (33.3% vs 26.7%; p<0.01), in older people stratified by decades (61.7% in 9th decade vs 12% in 5th decade; p<0.01), and in those with kidney disease (44.7% vs 28%; p<0.01). Most cases were mild (68.3%), normocytic (78.7%), and hypochromic (52%). Similarly, moderate-to-severe anemia was more frequent in women (39% vs 23%), their prevalence increased with age (45% in the 9th decade vs 24% in the 5th decade), and with the progression of kidney damage, either measured by a decreased glomerular filtration rate (GFR) (49% in G4 vs 25% in G1), or the presence of albuminuria (p<0.01). No association was found between DM control, based on glycated hemoglobin (HbA1c), and anemia in either sex (p=0.887).</p></div><div><h3>Conclusion</h3><p>This study describes a high prevalence of anemia in PDM50, particularly in women, in the most advantageous people and in the presence of kidney disease, even in early stages, highlighting the clinical importance of this coexistence.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713732","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

Bronquiectasias, adenopatías relacionadas con la sobreexpresión del factor activador de los linfocitos B perteneciente a la familia del factor de necrosis tumoral y cistitis linfoplasmocítica como eventos adversos asociados al uso prolongado de rituximab en enfermedades reumáticas autoinmunes sistémicas 支气管扩张、与肿瘤坏死因子家族的 B 淋巴细胞活化因子（B 淋巴细胞活化因子）过度表达有关的腺病以及淋巴细胞性膀胱炎是全身性自身免疫性风湿病患者长期使用利妥昔单抗引起的不良反应。

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.04.015

引用次数: 0

Espectro etiológico y desafíos diagnósticos de la fiebre de corta duración en Bengala Occidental (India): un estudio transversal en un centro de atención terciaria 印度西孟加拉邦短程发热的病原谱和诊断难题：在一家三级医疗中心进行的横断面研究。

IF 2.3 4区医学

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.06.002

{"title":"Espectro etiológico y desafíos diagnósticos de la fiebre de corta duración en Bengala Occidental (India): un estudio transversal en un centro de atención terciaria","authors":"","doi":"10.1016/j.rce.2024.06.002","DOIUrl":"10.1016/j.rce.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The scarcity of epidemiological data on acute febrile illnesses from South Asia impairs evidence-based clinical decision-making. Our study aimed to explore the etiological spectrum of short-duration fever in patients admitted to a tertiary care hospital in West Bengal, India.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study from May 2021 to April 2022 involving 150 adult patients presenting with a fever lasting less than two weeks at Burdwan Medical College and Hospital (West Bengal, India). We performed comprehensive clinical assessments, including microbiological, serological, and other specific investigations, to identify the causes of the fever.</p></div><div><h3>Results</h3><p>The demographic profile predominantly included individuals aged 21-40 years, with a male-to-female ratio of 1.9:1; 60.7% of participants were from rural areas. The primary etiological agents identified were scrub typhus (25.3%), dengue (15.3%), and enteric fever (13.3%). Notably, 80% of patients presented with non-localizing symptoms, while 14.7% had respiratory symptoms. Blood cultures pinpointed <em>Salmonella typhi</em> and <em>Staphylococcus aureus</em> in a minority of cases (3.3%); malaria, primarily <em>Plasmodium vivax</em>, was diagnosed in 12% of the cases.</p></div><div><h3>Conclusion</h3><p>Our findings highlight the complexity of diagnosing short-duration fevers, dominated by a wide range of etiological agents, with a notable prevalence of scrub typhus. These results underscore the urgent need for enhanced diagnostic facilities, including the availability of scrub typhus testing at primary healthcare centers. We recommend empirical doxycycline therapy for suspected cases and emphasize the need for further research to develop management guidelines for acute febrile illnesses. This study also highlights the importance of raising both community and clinician awareness to prevent irrational antibiotic use.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691898","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