Medicina clinica (English ed.)最新文献

{"title":"Piperacillin-induced encephalopathy","authors":"Pedro Parra-Caballero , Ángela Sánchez-Juez , Francisco Abad-Santos","doi":"10.1016/j.medcle.2025.106945","DOIUrl":"10.1016/j.medcle.2025.106945","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106945"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and immunogenicity of SARS-CoV-2 booster vaccine in immunosuppressed systemic autoimmune disease patients: A prospective study","authors":"Carolina Teles ,&nbsp;Ana Borges ,&nbsp;Ana Magalhães ,&nbsp;Cátia Barra ,&nbsp;Isabel Silva ,&nbsp;Patrícia Tomé ,&nbsp;Jorge Crespo ,&nbsp;Artur Paiva ,&nbsp;Lèlita Santos","doi":"10.1016/j.medcle.2025.106920","DOIUrl":"10.1016/j.medcle.2025.106920","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Patients with systemic autoimmune rheumatic disease (SARD) are a vulnerable population for severe COVID-19 and worse response to vaccination, prompting the need of a booster vaccine. Data regarding its response is limited and inconsistent. The aim of this study was to assess the effectiveness and immunogenicity of the third dose of the SARS-CoV-2 vaccine in immunosuppressed SARD patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a prospective study in immunosuppressed SARD Portuguese patients, who received a SARS-CoV-2 booster vaccine, from October 2021 to August 2022. We evaluated COVID-19 incidence in the following 6 months, as well as vaccine immunogenicity through anti-Spike IgG titers and T-cell reactivity to the Spike protein.</div></div><div><h3>Results</h3><div>We included 131 patients with a mean age of 54.9<!--> <!-->±<!--> <!-->12.2 years. Almost 40% (<em>n</em> <!-->=<!--> <!-->52) developed COVID-19 within 6 months after the booster, but 51 (98.1%) were mild infections. Median post-booster antibody levels and antibody variation were 9540.7 (14,724) and 8937.9 (11,561.3)<!--> <!-->AU/mL, respectively, and 73.3% (<em>n</em> <!-->=<!--> <!-->96) of the patients showed post-booster T-cell reactivity. Antibody variation was significantly lower in the COVID group (<em>p</em> <!-->=<!--> <!-->0.015). Although post-booster antibody levels and T-cell reactivity were statistically significantly lower in the patients under biologic DMARD, there was not a significant increase in COVID-19 incidence.</div></div><div><h3>Conclusions</h3><div>This study shows that a booster vaccine elicits strong immunogenicity and reduces COVID-19 severity, highlighting its importance in immunosuppressed SARD patients. Larger and more homogeneous cohorts are needed to guide periodic booster administration in this susceptible population.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106920"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-related pulmonary thrombotic microangiopathy in a patient without known neoplasia","authors":"Jordi Ara i Bonet,&nbsp;Patricia Sigüenza Bonete,&nbsp;Yenny Paola Zuluaga Blanco","doi":"10.1016/j.medcle.2025.106948","DOIUrl":"10.1016/j.medcle.2025.106948","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106948"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberous sclerosis complex","authors":"Qiang Tong ,&nbsp;Jianghong Zheng ,&nbsp;Sheng-Ming Dai","doi":"10.1016/j.medcle.2025.106929","DOIUrl":"10.1016/j.medcle.2025.106929","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106929"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low vaccine coverage and absence of exacerbations after vaccination in a Myasthenia Gravis cohort: An observational retrospective series of 89 patients","authors":"Cristina Carbonero ,&nbsp;Lourdes Mozo ,&nbsp;Eva Fernández-Bretón ,&nbsp;Carolina Mulet ,&nbsp;María Fernández-Prada ,&nbsp;Germán Morís","doi":"10.1016/j.medcle.2025.106914","DOIUrl":"10.1016/j.medcle.2025.106914","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to collect data on the vaccination status of Myasthenia Gravis (MG) patients, assess the coverage of vaccines, and examine MG exacerbations.</div></div><div><h3>Methods</h3><div>We conducted a retrospectively observational study including patients diagnosed with MG between 2015 and 2023 with antibodies against acetylcholine receptors.</div></div><div><h3>Results</h3><div>Eighty-nine patients were analysed. Forty-one (46.1%) were women. The median age at onset was 68 years. The median follow-up was 3.9 years. Sixteen (17.9%) patients had early-onset MG and 32 (36.0%) had ocular MG. Fifty-four (60.7%) patients received pneumococcal vaccines. Seventy-five (84.3%) patients received one dose of the seasonal influenza vaccine. Ten patients (76.9%) received hepatitis A virus (HAV) vaccination, and 33 (64.7%) received four doses of the hepatitis B virus (HBV) vaccine. One and six patients were classified as non-responders for HAV and HBV vaccines, respectively. Two patients were vaccinated with the live attenuated varicella-zoster virus vaccine. No differences were found between vaccination in early versus late-onset MG. No MG exacerbations were observed following vaccination.</div></div><div><h3>Discussion</h3><div>It is mandatory to establish recommendations for vaccination to ensure timely and appropriate immunisation.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106914"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tick-borne diseases in Spain","authors":"José A. Oteo,&nbsp;Sonia Santibáñez,&nbsp;Aránzazu Portillo","doi":"10.1016/j.medcle.2025.106989","DOIUrl":"10.1016/j.medcle.2025.106989","url":null,"abstract":"<div><div>Currently, tick-borne diseases are a threat to Public Health, as these arthropods are among the most effective infectious disease vectors in the industrialised world. In Spain there is a wide spectrum of tick-borne diseases with different forms of clinical presentation that sometimes pose a diagnostic challenge. This review analyses the difficulties we have in daily clinical practice for the diagnosis of tick-borne diseases in our environment and details the microbiological tests available for their etiological diagnosis.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106989"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure with reduced ejection fraction: Influence of gender on clinical characteristics, cardiac remodeling and neurohormonal response","authors":"Gloria Heredia-Campos ,&nbsp;Elena Rodríguez-Gómez Maria ,&nbsp;Jorge Perea-Armijo ,&nbsp;Rafael González-Manzanares ,&nbsp;Carlos Castillo-Domínguez Juan ,&nbsp;Mónica Delgado-Ortega ,&nbsp;Manuel Crespin-Crespin ,&nbsp;Martín Ruiz-Ortiz ,&nbsp;Dolores Mesa-Rubio ,&nbsp;Diana Ladera-Santos ,&nbsp;Rafael Iglesias-López ,&nbsp;Laura Calvo-Gutiérrez ,&nbsp;Laura Velarde-Morales ,&nbsp;Manuel Pan-Álvarez Osorio ,&nbsp;Manuel Anguita-Sánchez ,&nbsp;José López-Aguilera","doi":"10.1016/j.medcle.2025.106962","DOIUrl":"10.1016/j.medcle.2025.106962","url":null,"abstract":"<div><h3>Introduction</h3><div>It is estimated that 30−50% of patients with heart failure with reduced ejection fraction (HFrEF) are women. This population appears to differ in terms of clinical characteristics, aetiology and treatment optimisation compared to men. Our main objective was to analyse these considerations, the influence of female sex on cardiac remodelling and neurohormonal response, as well as their impact on medium- to long-term prognosis.</div></div><div><h3>Métodos</h3><div>Retrospective study of a cohort of HFrEF patients from real clinical practice. A comparative analysis was performed between male and female patients.</div></div><div><h3>Resultados</h3><div>409 patients were analysed, a total of 106 females (25.4%), with a higher mean age than males (71.4 ± 13.8 vs. 66 ± 11.9; p &lt; 0.001), higher prevalence of de novo HF (66.6% vs. 51.5%; p = 0.009), with a shorter HF evolution time (18.4 ± 42.6 vs. 42.8 ± 75.6 months; p = 0.001). Without significant differences in treatment optimisation, women had better cardiac remodelling at follow-up, as well as better neurohormonal response, with higher % reduction of NT-proBNP [−61,9% vs. −54,2%; p &lt; 0.01], and of CA125 [−63,4% vs. −50,9%; p &lt; 0.01]. With a median follow-up of 5 years, there were no differences in hospital readmissions or HF mortality in both sexes.</div></div><div><h3>Conclusiones</h3><div>Women with HFrEF have different clinical and aetiological characteristics compared to men. In evolution, they have better cardiac remodelling and neurohormonal response, although this has no impact on prognosis, readmission or mortality due to heart failure.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106962"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of alirocumab and evolocumab (PCSK9i) for the treatment of hypercholesterolemia","authors":"Francisco José Fernández-Fernández ,&nbsp;Eugenia Ameneiros-Lago ,&nbsp;Alberto Muñiz-Gutiérrez","doi":"10.1016/j.medcle.2025.106924","DOIUrl":"10.1016/j.medcle.2025.106924","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106924"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin-related rhabdomyolysis in the context of drug interaction with tafamidis","authors":"Pablo Peláez-Ibáñez ,&nbsp;Núria Trullén-Malaret ,&nbsp;Marta Fanlo-Maresma","doi":"10.1016/j.medcle.2025.106947","DOIUrl":"10.1016/j.medcle.2025.106947","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106947"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute leukemia of ambiguous lineage: Diagnosis, prognosis and treatment","authors":"Anna Torrent ,&nbsp;Vitor Botafogo ,&nbsp;Josep Maria Ribera","doi":"10.1016/j.medcle.2025.106917","DOIUrl":"10.1016/j.medcle.2025.106917","url":null,"abstract":"<div><div>Acute leukemias of ambiguous lineage (ALAL) are an infrequent subtype of acute leukemias without clear evidence of differentiation to a one single cell lineage. Despite their rarity constitute a recognized subgroup in the recent international classifications, such as the WHO (World Health Organization) classification. Their diagnosis require highly specialized flow cytometry technology, and also cytogenetics and molecular techniques. The low frequency of the disease has made it difficult to find the best therapeutic strategy, due both to the lack of prospective studies and randomized trials, and to the heterogeneity of the published retrospective studies on follow-up and treatment. The group of ALAL has bad prognosis, and usually requires intensive strategies that include consolidation with allogeneic stem cell transplant as part of the treatment. The objective of this review was to analyze diagnosis, treatment and prognosis of this rare subtype of leukemias.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106917"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}