Revista clinica espanola最新文献

{"title":"La paradoja del Premio Nobel: premios Nobel, no premios nobles","authors":"K. Moustafa","doi":"10.1016/j.rce.2024.02.005","DOIUrl":"10.1016/j.rce.2024.02.005","url":null,"abstract":"<div><p>The Nobel Prize is one of the most sought-after awards in science and society. However, its reputation is not without complexities, including constraints on laureates and biases in nominations. Navigating the delicate balance between recognition and the tangible impacts of awarded contributions should offer insight into the Prize's significance beyond mere prestige and monetary value. While other awards may boast higher financial rewards, they often lack the same level of prestige. The inclusion of public figures as laureates and the extensive media coverage surrounding the Nobel Prize may further elevate its perceived importance, though this may hide a more nuanced reality. Additionally, the positive associations linked to the name “Nobel” resembling the adjective “noble” can enhance the award's prestige. This subtle connection to “nobility” adds a layer of honor and distinction to the Prize, contributing to its perceived significance and prestige. Moreover, the overrepresentation of Nobel laureates from specific countries prompts scrutiny over the fulfillment of Nobel's testament, which prioritizes contributions to global well-being. This discrepancy raises questions about the inclusivity and global impact of the Prize.</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":"140279568","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":"Resumen ejecutivo del documento de consenso sobre el manejo de la anemia perioperatoria en España","authors":"M. Muñoz ,&nbsp;S. Aragón ,&nbsp;M. Ballesteros ,&nbsp;E. Bisbe-Vives ,&nbsp;C. Jericó ,&nbsp;P. Llamas-Sillero ,&nbsp;H.M. Meijide-Míguez ,&nbsp;E. Rayó-Martin ,&nbsp;M.J. Rodríguez-Suárez","doi":"10.1016/j.rce.2024.02.001","DOIUrl":"10.1016/j.rce.2024.02.001","url":null,"abstract":"<div><p>Perioperative anemia is an independent risk factor for postoperative morbidity and mortality. However, conceptual, logistical and administrative barriers persist that hinder the widespread implementation of protocols for their management. The project coordinator convened a multidisciplinary group of 9 experienced professionals to develop perioperative anemia management algorithms, based on a series of key points (KPs) related to its prevalence, consequences, diagnosis and treatment. These KPs were assessed using a 5-point Likert scale, from “strongly disagree [1]” to “strongly agree [5]”. For each KP, consensus was reached when receiving a score of 4 or 5 from at least 7 participants (&gt;75%). Based on the 36 KPs agreed upon, diagnostic-therapeutic algorithms were developed that we believe can facilitate the implementation of programs for early identification and adequate management of perioperative anemia, adapted to the characteristics of the different institutions in our country.</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/S0014256524000390/pdfft?md5=4a5ed55b6bbc33f0b8e8faeab052bdf7&pid=1-s2.0-S0014256524000390-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274683","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":"Aspectos epidemiológicos, manejo clínico y resultados a corto plazo en pacientes mayores diagnosticados de insuficiencia cardiaca aguda en urgencias en España: resultados del estudio EDEN-34","authors":"Ò. Miró ,&nbsp;P. Llorens ,&nbsp;S. Aguiló ,&nbsp;A. Alquézar-Arbé ,&nbsp;C. Fernández ,&nbsp;G. Burillo-Putze ,&nbsp;N. Canadell Marcos ,&nbsp;A. Arce Marañón ,&nbsp;G. Sánchez Oms ,&nbsp;J. González del Castillo ,&nbsp;en representación de los investigadores de la red SIESTA (Spanish Investigators in Emergency Situations TeAm)","doi":"10.1016/j.rce.2024.02.003","DOIUrl":"10.1016/j.rce.2024.02.003","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the incidence of acute heart failure (AHF) diagnosis in elderly patients in emergency departments (ED), diagnostic confirmation in hospitalized patients, and short-term adverse events.</p></div><div><h3>Methods</h3><p>All patients aged ≥<!--> <!-->65 years attended in 52 Spanish EDs during 1 week were included and those diagnosed with AHF were selected. In hospitalized patients, those diagnosed with AHF at discharge were collected. As adverse events, in-hospital and 30-day mortality, and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Adjusted odds ratios (OR) for association of demographic variables, baseline status and constants at ED arrival with mortality and 30-day post-discharge adverse event were calculated.</p></div><div><h3>Results</h3><p>We included 1,155 patients with AHF (annual incidence: 26.5 per 1000 inhabitants ≥<!--> <!-->65 years, 95%<span>C</span>I: 25.0-28.1). In 86% the diagnosis of AHF was known at discharge. Overall 30-day mortality was 10.7% and in-hospital mortality was 7.9%, and the combined event in 15.6%. In-hospital and 30-day mortality was associated with arterial hypotension (adjusted OR: 74.0, 95%CI: 5.39-1015. and 42.6, 3.74-485, respectively and hypoxemia (2.14, 1.27-3.61; and 1.87, 1.19-2.93) on arrival at the ED and requiring assistance with ambulation (2.24, 1.04-4.83; and 2.48, 1.27-4.86) and age (per 10-year increment; 1.54, 1.04-2.29; and 1.60, 1.13-2.28). The combined post-discharge adverse event was not associated with any characteristic.</p></div><div><h3>Conclusions</h3><p>AHF is a frequent diagnosis in elderly patients consulting in the ED. The functional impairment, age, hypotension and hypoxemia are the factors most associated with mortality.</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":"140268104","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":"Exitosa desensibilización a la anakinra en un caso con reacción cutánea inmediata en la enfermedad de Still","authors":"R. Pertusa Mataix ,&nbsp;E. Menéndez Rivero ,&nbsp;C. Hernández Quiles ,&nbsp;J.S. García Morillo","doi":"10.1016/j.rce.2023.12.005","DOIUrl":"10.1016/j.rce.2023.12.005","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":"140279174","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":"Análisis bibliométrico de las revistas oficiales de sociedades de medicina interna en Europa","authors":"L. Liesa,&nbsp;J.M. Porcel","doi":"10.1016/j.rce.2024.01.008","DOIUrl":"https://doi.org/10.1016/j.rce.2024.01.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Bibliometrics evaluates the quality of biomedical journals. The aim of this study has been to compare the main bibliometric indexes of the official journals of scientific societies of internal medicine in Europe.</p></div><div><h3>Material and methods</h3><p>Bibliometric information was obtained from the Web of Science (WoS) and Scopus databases. Both impact metrics (Journal Impact Factor [JIF], CiteScore) and normalized metrics (Journal Citation Indicator [JCI], Normalized Eigenfactor, Source Normalized Impact per Paper [SNIP] and SCImago Journal Rank [SJR]) of the journals for the year 2022 were analyzed, and their evolution over the last decade was described.</p></div><div><h3>Results</h3><p>Twenty-three official journals from 33 scientific societies were evaluated. Eight journals were included in WoS and 11 in Scopus. The best positioned journals in 2022 were: 1) European Journal of Internal Medicine, which ranked in the first quartile (Q1) for JIF, CiteScore and JCI metrics, exceeding values of 1 in Normalized Eigenfactor and SNIP metrics; 2) Internal and Emergency Medicine, with Q1 for CiteScore and JCI metrics, and with values &gt;1 in Normalized Eigenfactor and SNIP metrics; 3) Polish Archives of Internal Medicine, with Q1 for JCI metrics; 4) <span>Revista Clínica Española</span>, with Q2 for JIF, CiteScore and JCI metrics; and 5) Acta Medica Belgica, Q2 for CiteScore and JCI metrics. These journals increased their impact metrics in the last 3 years, in parallel with the COVID pandemic.</p></div><div><h3>Conclusions</h3><p>Five official journals of European Internal Medicine societies, including <span>Revista Clínica Española</span>, meet high quality standards.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062563","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":"Empleo de un score semicuantitativo en la valoración de la congestión pulmonar: prevalencia e implicaciones en el manejo diurético tras el alta por insuficiencia cardiaca","authors":"F.J. Pastor-Pérez,&nbsp;M. Veas-Porlán,&nbsp;N. Fernández-Villa,&nbsp;I.P. Garrido-Bravo,&nbsp;S. Manzano-Fernández,&nbsp;D.A. Pascual-Figal","doi":"10.1016/j.rce.2023.11.013","DOIUrl":"https://doi.org/10.1016/j.rce.2023.11.013","url":null,"abstract":"<div><h3>Introduction</h3><p>Persistent congestion after heart failure (HF) discharge is associated with a higher risk of readmissions.</p></div><div><h3>Material and methods</h3><p>Eighty-two patients included after HF discharge. The aim of the study was to characterize semiquantitatively the degree of pulmonary congestion and its changes, describing the relationship between these findings and diuretic management.</p></div><div><h3>Results</h3><p>On the first visit, despite the absence of clinical congestion in the majority of patients, half of the had some degree of pulmonary congestion by ultrasound. After global assessment in this initial visit (clinical and ultrasound) the diuretic was lowered in 50 patients (60%), kept the same in 16 (20%) and it was increased in the rest. In the 45 patients without ultrasound congestion, diuretic reduction was attempted in 80%, being this strategy successful in the majority of them.</p></div><div><h3>Conclusions</h3><p>Lung ultrasound, using simple quantification methods, allows its real incorporation into clinical practice, helping us in the decision making process.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062687","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":"Disfunción sexual en las mujeres con enfermedad pulmonar obstructiva crónica","authors":"N. Alcalá-Rivera ,&nbsp;J. Díez-Manglano","doi":"10.1016/j.rce.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.rce.2024.01.006","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the prevalence of sexual dysfunction in women with COPD and the factors related to its presence.</p></div><div><h3>Methods</h3><p>Cross-sectional observational study during 2021, including women with COPD diagnosed by spirometry through convenience sampling. Data on age, smoking status, spirometric data, comorbidities and medications used were collected. A sexual health questionnaire was administered.</p></div><div><h3>Results</h3><p>The study included 101 women with a mean age of 59.7 (11.3) years. All had experienced a change in sexual activity, with 44% attributing it to COPD. Among them, 51.5% experienced dyspnea during coitus. The prevalence of sexual dysfunction was 52.5%. Women with sexual dysfunction were older and had a lower Tiffeneau index. Furthermore, they consumed alcohol more frequently and had hypertension and cerebrovascular disease, and less often, they had diabetes and heart failure. However, they scored lower on the Charlson index corrected for age. Patients with sexual dysfunction used inhaled triple therapy less frequently.</p></div><div><h3>Conclusions</h3><p>Sexual dysfunction is common in women with COPD. Further studies are needed to investigate its causes, mechanisms, and potential treatments.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062565","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":"Revisión sistemática de los ensayos clínicos sobre terapia antitrombótica con inhibidores del factor XI","authors":"A. Franco-Moreno ,&nbsp;N. Muñoz-Rivas ,&nbsp;J. Torres-Macho ,&nbsp;A. Bustamante-Fermosel ,&nbsp;C.L. Ancos-Aracil ,&nbsp;E. Madroñal-Cerezo","doi":"10.1016/j.rce.2024.01.005","DOIUrl":"https://doi.org/10.1016/j.rce.2024.01.005","url":null,"abstract":"<div><h3>Background and objective</h3><p>Data from phase 2 clinical trials suggest that factor XI inhibitors may exhibit a more favourable efficacy/safety profile than current antithrombotic therapies. This systematic review aims to analyze the available evidence derived from these studies.</p></div><div><h3>Methods</h3><p>A literature search in the PubMed, Cochrane Library, Scopus, EMBASE databases, and clinical trial registration platforms Clinical Trials and Cochrane Central Register of Controlled was conducted. The results were reported in accordance with the PRISMA statement.</p></div><div><h3>Results</h3><p>A total of 18 completed or ongoing clinical trials addressing multiple scenarios, including atrial fibrillation, stroke, myocardial infarction, and venous thromboembolism, were identified. Evidence from 8 studies with available results was analyzed. Overall, phase 2 studies with factor XI inhibitors demonstrated an acceptable efficacy and safety profile. The benefit-risk balance, in terms of reducing venous thromboembolism in patients undergoing total knee arthroplasty, was more favourable. For this scenario, factor XI inhibitors showed a 50% reduction in the overall rate of thrombotic complications and a 60% reduction in bleeding compared to enoxaparin. Modest results in studies involving patients with atrial fibrillation, stroke, and myocardial infarction were observed.</p></div><div><h3>Conclusions</h3><p>Factor XI inhibitors offer new prospects in antithrombotic treatment and prevention. Ongoing phase 3 studies will help define the most suitable drugs and indications.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062567","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 pronóstico de la enfermedad pulmonar obstructiva crónica y el asma bronquial en pacientes con insuficiencia cardiaca","authors":"E. Barge-Caballero ,&nbsp;J. Sieira-Hermida ,&nbsp;G. Barge-Caballero ,&nbsp;D. Couto-Mallón ,&nbsp;M.J. Paniagua-Martín ,&nbsp;D. Enríquez-Vázquez ,&nbsp;P.J. Marcos-Rodríguez ,&nbsp;J. Rodríguez-Capitán ,&nbsp;J.M. Vázquez-Rodríguez ,&nbsp;M.G. Crespo-Leiro","doi":"10.1016/j.rce.2024.01.003","DOIUrl":"https://doi.org/10.1016/j.rce.2024.01.003","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze the impact of chronic obstructive pulmonary disease (COPD) and bronchial asthma on therapeutic management and prognosis of patients with heart failure (HF).</p></div><div><h3>Methods</h3><p>Analysis of the information collected in a clinical registry of patients referred to a specialized HF unit from January-2010 to June-2012. Clinical profile, treatment and prognosis of patients was evaluated, according to the presence of COPD or asthma. Survival analyses were conducted by means of Kaplan-Meier and Cox's methods. Median follow-up was 1493 days.</p></div><div><h3>Results</h3><p>We studied 2577 patients, of which 251 (9.7%) presented COPD and 96 (3.7%) bronchial asthma. Significant differences among study groups were observed regarding to the prescription of beta-blockers (COPD<!--> <!-->=<!--> <!-->89.6%; asthma<!--> <!-->=<!--> <!-->87.5%; no bronchopathy<!--> <!-->=<!--> <!-->94.1%; <em>P</em> <!-->=<!--> <!-->.002) and SGLT2 inhibitors (COPD<!--> <!-->=<!--> <!-->35.1%; asthma<!--> <!-->=<!--> <!-->50%; no bronchopathy<!--> <!-->=<!--> <!-->38.3%; <em>P</em> <!-->=<!--> <!-->.036). Also, patients with bronchial disease received less frequently a defibrillator (COPD<!--> <!-->=<!--> <!-->20.3%; asthma<!--> <!-->=<!--> <!-->20.8%; no broncopathy<!--> <!-->=<!--> <!-->29%; <em>P</em> <!-->=<!--> <!-->.004).</p><p>COPD was independently associated with increased risk of all-cause mortality (HR<!--> <!-->=<!--> <!-->1.64; 95%<!--> <!-->CI: 1.33-2.02), all-cause death or HF admission (HR<!--> <!-->=<!--> <!-->1.47; 95%<!--> <!-->CI: 1.22-1.76) and cardiovascular death or heart transplantation (HR<!--> <!-->=<!--> <!-->1.39; 95%<!--> <!-->CI: 1.08-1.79) as compared with patients with no bronchopathy. Bronchial asthma was not significantly associated with increased risk of adverse outcomes.</p></div><div><h3>Conclusions</h3><p>COPD, but not asthma, is an adverse independent prognostic factor in patients with HF.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062561","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":"Recomendaciones de los servicios de Medicina Interna hispano-lusos en la lucha contra el cambio climático y la degradación ambiental","authors":"L. Campos ,&nbsp;M.M. Chimeno Viñas ,&nbsp;J. Carretero Gómez ,&nbsp;L. Santos ,&nbsp;A. Cabrera Rayo ,&nbsp;P.R. Valdez ,&nbsp;Ricardo Gómez-Huelgas ,&nbsp;en nombre de las sociedades, colegios y asociaciones de Medicina Interna de los países de habla hispana y lusa","doi":"10.1016/j.rce.2024.01.002","DOIUrl":"https://doi.org/10.1016/j.rce.2024.01.002","url":null,"abstract":"<div><p>Facing the severity of the impact of climate change and environmental degradation on human health, 32 Internal Medicine societies, colleges, and associations of 29 Spanish and Portuguese-speaking countries issue a consensus document calling for the implication of doctors and all health professionals in the global fight against the causes of these changes. This commitment requires the cooperation of health-related organizations, elaboration and implementation of good environmental sustainability practices, greater awareness of professionals and population, promotion of education and research in this area, increasing climate resilience and environmental sustainability of health systems, combating inequalities and protecting the most vulnerable populations, adopting behaviors that protect the environment, and claiming Internal Medicine as a core specialty for empowerment of the health system to respond to these challenges.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014256524000122/pdfft?md5=e52d06f37fe4485d7e93eeb386a92900&pid=1-s2.0-S0014256524000122-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062566","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}