Alejandro del Caño Garrido , María Gómez Caballero
{"title":"Vesícula en porcelana: Cuando la vesícula biliar se convierte en una obra de arte patológica","authors":"Alejandro del Caño Garrido , María Gómez Caballero","doi":"10.1016/j.mcpsp.2024.100484","DOIUrl":"10.1016/j.mcpsp.2024.100484","url":null,"abstract":"","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100484"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143327681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafael Hijano-Esqué , Jesús Ignacio González Orodea , Javier Imaz Fandos , Natividad Pacheco Rubio , Gonzalo Daniel Alzuarte , Manuel Ruiz Cuetos , Amelia Rodríguez Mariblanca , Eva García Aguilar , En representación del grupo de investigación VERTINEL
{"title":"Eficacia y seguridad del tratamiento con la combinación fija a dosis bajas de cinarizina 20 mg y dimenhidrinato 40 mg en el vértigo de origen diverso en la práctica clínica en España. Resultados del estudio VERTINEL","authors":"Rafael Hijano-Esqué , Jesús Ignacio González Orodea , Javier Imaz Fandos , Natividad Pacheco Rubio , Gonzalo Daniel Alzuarte , Manuel Ruiz Cuetos , Amelia Rodríguez Mariblanca , Eva García Aguilar , En representación del grupo de investigación VERTINEL","doi":"10.1016/j.mcpsp.2024.100489","DOIUrl":"10.1016/j.mcpsp.2024.100489","url":null,"abstract":"<div><h3>Introduction</h3><div>Vertigo is a condition affecting millions of people and significantly impacting their quality of life. Traditionally, vertigo management includes the use of antiemetics, vestibular sedatives, and betahistine, though these treatments have limitations and side effects. The aim of this study was to evaluate the efficacy and safety of a low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in routine clinical practice.</div></div><div><h3>Methods</h3><div>An observational, multicenter study was conducted, comprising a primary retrospective cohort and a cross-sectional cohort as a control group, across 28 Primary Care centers and Otolaryngology specialist clinics nationwide in Spain. Adult patients with vertigo of various origins treated with the fixed low-dose combination of cinnarizine 20 mg and dimenhydrinate 40 mg were included, and compared with a control group without treatment. Efficacy was assessed using the Vertigo and Dizziness Symptom Questionnaire (VDI-SS), and quality of life was evaluated through the VDI-HRQoL. Additional outcomes such as speed of action, tolerability, and treatment satisfaction were also measured.</div></div><div><h3>Results</h3><div>A total of 181 patients were analyzed, showing significant improvement in vertigo symptoms and quality of life in those treated with the drug combination compared to both pre-treatment and control groups. The pre-post treatment difference was 28.41 points on the VDI-SS questionnaire, <em>p</em> < 0.0001. Additionally, the difference between the post-treatment group and the control group was 24.07 points in favor of the treated group; 20.26 (95% CI 18.8–21.7) vs. 44.33 (95% CI 42.6–46), <em>p</em> < 0.0001. In quality-of-life assessments, the mean difference was 14.56 points between pretreatment and post-treatment, <em>p</em> < 0.0001, with a similar result observed in comparison with the control group, <em>p</em> < 0.0001. Improvement was reported by 78.3% (65) of treated subjects within the first week, with 55.4% reporting benefits in the first few days of treatment, and reaching 89.1% by the second week. Tolerability was rated as very good or good in most cases, with no serious adverse events reported, and no extrapyramidal effects, drowsiness, or inhibition of vestibular compensation mechanisms were noted. Overall treatment satisfaction was high.</div></div><div><h3>Discussion</h3><div>The results confirm the efficacy and safety of the low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in vertigo treatment. This therapeutic approach not only addresses specific vertigo symptoms but also improves patients' quality of life. Its rapid onset of action, along with high tolerability and satisfaction, supports the viability of this intervention in routine clinical practice, offering an effective and safe alternative for managing vertigo.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100489"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143327680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mónica Contreras-Moreira , Elpidio Calvo Manuel , Joaquín Antonio Álvarez Gregori
{"title":"Neumonía por COVID-19 en urgencias: ecografía pulmonar. Implicaciones pronósticas","authors":"Mónica Contreras-Moreira , Elpidio Calvo Manuel , Joaquín Antonio Álvarez Gregori","doi":"10.1016/j.mcpsp.2024.100486","DOIUrl":"10.1016/j.mcpsp.2024.100486","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In COVID-19 patients, the clinical picture allows estimating a certain pre-test probability of lung involvement; prediction that increases when associating lung ultrasound. This provides greater sensitivity than chest radiography in the detection of infiltrates, and makes it possible to predict the result of pathological pulmonary CT. The characteristic findings of SARS-CoV-2 pneumonia have been described, and the location of the lesions has been related to the prognosis. Few experiences have been published on the prognostic capacity of lung ultrasound, which do not include hospital-obtained laboratory parameters.</div></div><div><h3>Material and methods</h3><div>Through a prospective, multicenter, observational study with consecutive sampling, carried out between April and July 2020, 263 adult patients who attended the emergency department of Spanish hospitals due to symptoms compatible with respiratory infection were recruited. Six fields per lung were explored, and the presence or absence of focal B lines, global B lines, parenchymal consolidation, subpleural consolidation, and pleural effusion were described. The patients underwent a postero-anterior chest X-ray on the same day.</div></div><div><h3>Results</h3><div>Males predominated in the study population. The main comorbidity was neoplasms, followed by chronic kidney disease and ischemic heart disease. Patients with a positive result for SARS-CoV-2 RT-PCR and who required admission were more frequent, and 8% died. The pathological chest x-ray was positive in 75% of the patients, compared to 94.59% of the ultrasound scans. The most frequent findings were focal B lines in zones R6, R3, and L3. The specificity of bilateral consolidation or unilateral patchy infiltrate stands out, and in ultrasound the specificity of global B lines, consolidations, both pulmonary and subpleural, and left pleural effusion.</div></div><div><h3>Conclusions</h3><div>A regression model has been developed that incorporates the findings of the lung ultrasound and predicts the probability of admission in patients presenting to the emergency department, without using other hospital laboratory tests. A tool can be developed that allows the family physician to identify patients with a high probability of being hospitalized from those who will have an outpatient follow-up, to prioritize an early therapeutic approach or referral to the emergency room.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100486"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claudia Ruiz-Huerta , Gema Vega , Carmen Ferrer , Marcelle V. Canto , María de los Ángeles Díaz , Ana M. Palmar
{"title":"Are hospital workers' healthy habits adequeate? Influence of social determinants on health","authors":"Claudia Ruiz-Huerta , Gema Vega , Carmen Ferrer , Marcelle V. Canto , María de los Ángeles Díaz , Ana M. Palmar","doi":"10.1016/j.mcpsp.2024.100487","DOIUrl":"10.1016/j.mcpsp.2024.100487","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>With regard to people who work in hospitals: Do they have better health habits than the general population? Or, do they have worse, despite most of them have the appropriate knowledge to follow a healthy lifestyle? This is a study to explore the habits of people working in a hospital, to compare them with the general population and to identify higher risk profiles on which to prioritize preventive interventions.</div></div><div><h3>Methods</h3><div>Cross-sectional study on health habits with workers from a hospital in Madrid (<em>n</em> = 399) using a questionnaire based on the National Health Survey. Descriptive and cluster analysis to classify homogeneous individuals according to health habits and identify risk patterns. Logistic regression was used to identify the independent risk factors that determine the unhealthy profile.</div></div><div><h3>Results</h3><div>The health habits of workers in a hospital are similar to those of the general population. Determinants of health influenced its distribution: The higher the spending capacity, the better the health habits; the older their age, more chronic disease is seen; women suffer worse mental health.</div></div><div><h3>Conclusions</h3><div>The results are superimposed onto those of the general population, where they would have been expected to be healthier. There are risk profiles in which to prioritize preventive interventions to promote health.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100487"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irma D. Sifuentes-Najera , Juan J. Cuervo-Orozco , Ma.G. Treviño-Alanís , María G. Moreno-Treviño , Gerardo Rivera-Silva
{"title":"Carcinoma of the ovary with metastasis to the cerebellum","authors":"Irma D. Sifuentes-Najera , Juan J. Cuervo-Orozco , Ma.G. Treviño-Alanís , María G. Moreno-Treviño , Gerardo Rivera-Silva","doi":"10.1016/j.mcpsp.2024.100483","DOIUrl":"10.1016/j.mcpsp.2024.100483","url":null,"abstract":"","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 1","pages":"Article 100483"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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