Revista clinica espanola最新文献

{"title":"Análisis de la expresión del gen SERPINA1 en la infección por SARS-CoV-2: estudio de un nuevo biomarcador","authors":"M. Pintanel-Raymundo ,&nbsp;S. Menao-Guillén ,&nbsp;J.J. Perales-Afán ,&nbsp;A. García-Gutiérrez ,&nbsp;I. Moreno-Gázquez ,&nbsp;M. Julián-Ansón ,&nbsp;M. Ramos-Álvarez ,&nbsp;S. Olivera-González ,&nbsp;I. Gutiérrez-Cía ,&nbsp;M.A. Torralba-Cabeza","doi":"10.1016/j.rce.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.rce.2024.03.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The <em>SERPINA1</em> gene encodes the protein Alpha-1 Antitrypsin (AAT1). Possible imbalances between the concentrations of proteases and antiproteases (AAT1) can lead to the development of serious pulmonary and extrapulmonary pathologies. In this work we study the importance of this possible imbalance in patients with COVID-19.</p></div><div><h3>Objectives</h3><p>To correlate the severity of the symptoms of SARS-CoV-2 infection with the AAT1 concentrations at diagnosis of the disease.</p></div><div><h3>Methods</h3><p>An observational, prospective, cross-sectional, non-interventional, analytical study was carried out where 181 cases with COVID-19 admitted to the “Lozano Blesa” University Clinical Hospital of Zaragoza were selected. The concentration of AAT1 was studied in all of them and this was correlated with the clinical aspects and biochemical parameters at hospital admission.</p></div><div><h3>Results</h3><p>141 cases corresponded to patients with severe COVID and 40 patients with mild COVID. AAT1 levels were positively correlated with the days of hospitalization, severity, C-Reactive Protein, ferritin, admission to Intensive Care, and death, and presented a negative correlation with the number of lymphocytes/mm3. AAT1 concentrations higher than 237.5<!--> <!-->mg/dL allowed the patient to be classified as “severe” (S72%; E78%) and 311.5<!--> <!-->mg/dL were associated with the risk of admission to Intensive Care or Exitus (S67%;E79%).</p></div><div><h3>Conclusions</h3><p>Levels of the SERPINA1 gene expression product, AAT1, correlate with the severity of COVID-19 patients at diagnosis of the disease, being useful as a prognostic biomarker.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823542","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":"Impacto de la hipocloremia como factor pronóstico en pacientes con insuficiencia cardíaca, estudio de cohortes retrospectivo","authors":"P. de Peralta García ,&nbsp;M. Bolzoni ,&nbsp;M. Yebra Yebra ,&nbsp;M. Asenjo Martinez ,&nbsp;M. Arrondo Turrado ,&nbsp;M.A. Domínguez Sepúlveda ,&nbsp;J.A. Rueda Camino ,&nbsp;R. Barba Martín","doi":"10.1016/j.rce.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.rce.2024.03.004","url":null,"abstract":"<div><h3>Background</h3><p>Some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation.</p></div><div><h3>Materials and methods</h3><p>Retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypochloremia (chloride &lt;<!--> <!-->98<!--> <!-->mmol/L) and normochloremic patients (chloride &gt;<!--> <!-->98<!--> <!-->mmol/L) in the initial assessment within the first month after discharge. The rate of intravenous diuretic rescue, emergency department visits, readmission for HF and cardiovascular (CV) death are compared using a Cox proportional hazards model.</p></div><div><h3>Results</h3><p>165 patients were included (59% women, mean age 85<!--> <!-->years), with 60 (36%) having hypochloremia. Both groups were comparable in terms of baseline characteristics, except for female sex, presence of peripheral artery disease, moderate-to-severe liver disease (more prevalent in the hypochloremia group), PROFUND index, and baseline furosemide dose (higher in patients with hypochloremia). The incidence of the primary event was higher in subjects with hypochloremia than in normochloremic subjects (HR: 1.59; 95%<!--> <!-->CI: 0.97-2.62), mainly due to the need for intravenous diuretic rescue (HR: 1.86; 95%<!--> <!-->CI: 1.07-3.24).</p></div><div><h3>Conclusions</h3><p>Hypochloremia following admission for HF decompensation is associated with a greater need for intravenous diuretic rescue therapy and probably worse overall prognosis across the spectrum of the disease, regardless of left ventricular ejection fraction (LVEF).</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823537","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":"Diagnóstico y tratamiento de la trombosis venosa profunda de las extremidades inferiores y superiores. Recomendaciones del grupo de enfermedad tromboembólica de la Sociedad Española de Medicina Interna 2024","authors":"A. Gil Díaz ,&nbsp;J. Martín Guerra ,&nbsp;P. Parra Caballero ,&nbsp;G. Puche Palao ,&nbsp;N. Muñoz Rivas ,&nbsp;N. Ruiz-Giménez Arrieta","doi":"10.1016/j.rce.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.rce.2024.03.003","url":null,"abstract":"<div><p>Deep vein thrombosis (DVT) of the limbs is a common disease and causes significant morbidity and mortality. It is frequently the prelude to pulmonary embolism (PE), it can recur in 30% of patients and in 25-40% of cases they can develop post-thrombotic syndrome (PTS), with a significant impact in functional status and quality of life. This document contains the recommendations on the diagnosis and treatment of acute DVT from the Thromboembolic Disease group of the Spanish Society of Internal Medicine (SEMI).</p><p>PE and thrombosis of unusual venous territories (cerebral, renal, mesenteric, superficial, etc.) are outside its scope, as well as thrombosis associated with catheter and thrombosis associated with cancer, which due to their peculiarities will be the subject of other positioning documents of the Thromboembolic Disease group of the Spanish Society of Internal Medicine (SEMI).</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823543","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":"Trombosis venosa cerebral","authors":"L. Ordieres-Ortega ,&nbsp;S. Moragón-Ledesma ,&nbsp;P. Demelo-Rodríguez","doi":"10.1016/j.rce.2024.02.004","DOIUrl":"10.1016/j.rce.2024.02.004","url":null,"abstract":"<div><p>Cerebral venous thrombosis is part of the so-called thrombosis in unusual sites. It is defined as an occlusion in the cerebral venous territory. Its incidence is progressively increasing, especially in developing countries. It is more frequently observed in young women, with hormonal factors such as pregnancy or hormonal contraception being significant risk factors in the development of this condition. The clinical presentation will depend fundamentally on the topography of the thrombosis, with a confirmatory diagnosis based mainly on imaging tests. The treatment generally consists of anticoagulation, and other options may be considered depending on the severity of the case. Overall, the prognosis is better than that of other intracranial vascular disorders. This review describes the current evidence available regarding cerebral venous thrombosis.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279814","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":"Infección por virus del Nilo Occidental: primer caso humano autóctono en la Comunidad Valenciana","authors":"A. Carmena de la Asunción,&nbsp;I. Jiménez Pérez de Heredia,&nbsp;A. Belda Mira","doi":"10.1016/j.rce.2023.12.004","DOIUrl":"10.1016/j.rce.2023.12.004","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277717","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":"Carta al editor analizando un estudio sobre diabetes mellitus","authors":"E. Urízar Ursúa,&nbsp;Alicia Aldea,&nbsp;María Bayona,&nbsp;Patricia M. Oliván","doi":"10.1016/j.rce.2023.11.015","DOIUrl":"10.1016/j.rce.2023.11.015","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283225","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":"Caso clínico: presentación de un caso de viruela del mono en el embarazo","authors":"L. García Hernández ,&nbsp;A. Hernández-Aceituno ,&nbsp;R.J. Moreno Saavedra ,&nbsp;E. Larumbe-Zabala","doi":"10.1016/j.rce.2023.11.014","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.014","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344740","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":"¿Cómo detectar a los pacientes mayores no institucionalizados en riesgo de malnutrición durante su hospitalización? Comparación de 8 herramientas de cribado de malnutrición o de riesgo nutricional","authors":"I. García-Fuente ,&nbsp;L. Corral-Gudino ,&nbsp;M. Gabella-Martín ,&nbsp;V.E. Olivet-de-la-Fuente ,&nbsp;J. Pérez-Nieto ,&nbsp;P. Miramontes-González","doi":"10.1016/j.rce.2024.02.006","DOIUrl":"10.1016/j.rce.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection.</p></div><div><h3>Objective</h3><p>To assess the concordance of different nutritional scales in hospitalized patients.</p></div><div><h3>Methods</h3><p>Prospective study in non-institutionalized patients over 65<!--> <!-->years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN<!--> <!-->3, 8 and 14) were compared. As gold standard we use the Global Leadership Initiative for Malnutrition (GLIM) definition of malnutrition.</p></div><div><h3>Results</h3><p>Eighty-five patients (37% female, median age 83<!--> <!-->years) were included. Forty-eight percent (95%<!--> <!-->CI: 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN<!--> <!-->3 scale was the most sensitive (93%; 95%<!--> <!-->CI: 87-98) and MUST the most specific (91%; 95%<!--> <!-->CI: 85-99). The most effective scale for excluding suspected malnutrition was SCREEN<!--> <!-->3 (LR− 0.17; 95%<!--> <!-->CI: 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95%<!--> <!-->CI: 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465.</p></div><div><h3>Conclusions</h3><p>A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256524000626/pdfft?md5=98c82139741530d5e1e0ca205af50523&pid=1-s2.0-S0014256524000626-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalencia de anticuerpos neutralizantes frente al SARS-CoV-2 inducidos tras 2 dosis de vacuna BNT162b2 (Pfizer–BioNTech) en trabajadores sanitarios","authors":"A.C. Montagud ,&nbsp;J. Llenas-García ,&nbsp;R. Moragues ,&nbsp;A. Pérez-Bernabeu ,&nbsp;M.J. Alcocer Pertegal ,&nbsp;F.J. García Gómez ,&nbsp;A.M. Gamayo Serna ,&nbsp;H. García Morante ,&nbsp;P. Caballero ,&nbsp;J. Tuells","doi":"10.1016/j.rce.2024.01.009","DOIUrl":"10.1016/j.rce.2024.01.009","url":null,"abstract":"<div><h3><em>Aim</em></h3><p>To study the prevalence of neutralizing antibodies in healthcare workers and healthcare support personnel after the administration of the second dose of the BNT162b2 vaccine (Pfizer-BioNTech).</p></div><div><h3><em>Materials and methods</em></h3><p>In December 2021, we undertook a study in the Health Department in Orihuela, Alicante (Spain), which consists of 1500 workers. We collected demographic variables about the study participants, and we performed a «point-of-care» immunochromatography <em>test</em> to measure the presence of neutralizing antibodies (OJABIO® SARS-CoV-2 Neutralizing Antibody Detection Kit, manufactured by Wenzhou OJA Biotechnology Co., Ltd. Wenzhou, Zhejiang, China) before the administration of the third dose of the vaccine.</p></div><div><h3><em>Results</em></h3><p>We obtained complete information about 964 (64%) workers, which consisted of 290 men and 674 women. The average age was 45,8 years (min. 18, max. 68) and the average time since the last dose of the vaccine was 40,5 weeks (min. 1,71, max. 47,71). A total of 131 participants (13,5%) had suffered infection by SARS-CoV-2 confirmed using RT-PCR. The proportion of participants who showed presence of neutralizing antibodies was 38,5%. In the multivariable analysis, the time since the last dose of the vaccine (aOR week: 1,07; 95%<span>C</span>I: 1,04; 1,09) and previous infection by SARS-CoV-2 (aOR: 3,7; 95CI: 2,39; 5,63) showed a statistically significant association with the presence of neutralizing antibodies.</p></div><div><h3><em>Conclusions</em></h3><p>The time since the administration of the last dose of the vaccine and the previous infection by SARS-CoV-2 determined the presence of neutralizing antibodies in 38,5% of the healthcare workers and support workers.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256524000419/pdfft?md5=e9d7d92a3e73db21cf526712b981bf99&pid=1-s2.0-S0014256524000419-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalencia de la enfermedad pulmonar esclerodermia-intersticial limitada frente a la extensa en el momento del diagnóstico de SSc-EPID según los criterios de Goh et al. Revisión sistemática y metaanálisis","authors":"M. Rubio-Rivas ,&nbsp;M. Pestaña-Fernández","doi":"10.1016/j.rce.2024.02.002","DOIUrl":"10.1016/j.rce.2024.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Goh et al. proposed in 2008 a classificatory algorithm of limited or extensive SSc-ILD. The prevalence of both at the time of diagnosis of SSc-ILD is not known with exactitude.</p></div><div><h3>Methods</h3><p>The review was undertaken by means of MEDLINE and SCOPUS from 2008 to 2023 and using the terms: “systemic”, “scleroderma” or “interstitial lung disease” [MesH]. The Newcastle-Ottawa Scale was used for the qualifying assessment for observational studies and the Jadad scale for clinical trials. The inverse variance-weighted method was performed.</p></div><div><h3>Results</h3><p>Twenty-seven studies were initially included in the systematic review and meta-analysis (SRMA). Of these, 17 studies had no overlapping data. They reported data from 2,149 patients, 1,369 (81.2%) were female. The mean age was 52.4 (SD 6.6) years. 45.2% of the patients had the diffuse subtype and 54.8% had the limited or sine scleroderma subtype. A total of 38.7% of the patients showed positive antitopoisomerase antibodies and 14.2% positive anticentromere antibodies. The mean percentage of forced vital capacity at baseline was 80.5% (SD 6.9) and of diffusing capacity of the lungs for carbon monoxide was 59.1% (SD 9.6). Twelve studies presented SSc-ILD extension data adjusted for PFTs and were included in the meta-analysis. The 10 observational cohort studies were analyzed separately. The overall percentage of limited extension was estimated at 63.5% (95%<span>C</span>I 55.3–73; p<!--> <!-->&lt;<!--> <!-->0.001) using the random-effects model. Heterogeneity between studies (I²) was 9.8% (95%CI 0–68.2%) with the random-effects model. Extensive pulmonary involvement was estimated at 34.3% (95%CI 26–45.4; p<!--> <!-->&lt;<!--> <!-->0.001). Heterogeneity between studies (I²) was 0% (95%CI 0–61.6%) with the random-effects model.</p></div><div><h3>Conclusion</h3><p>The overall percentage of limited SSc-ILD at the time of diagnosis of SSc-ILD was estimated at 63.5% and extensive at 34.3%.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270749","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}