Medicina clinica (English ed.)最新文献

{"title":"Iron-deficiency anemia secondary to autoimmune gastritis and celiac disease","authors":"Rita Relvas, Edgar Amaro, Ana Maria Grilo","doi":"10.1016/j.medcle.2026.107522","DOIUrl":"10.1016/j.medcle.2026.107522","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107522"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056468","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":"The research integrity risk index for Spanish universities in the European context","authors":"Rafael Dal-Ré","doi":"10.1016/j.medcle.2026.107512","DOIUrl":"10.1016/j.medcle.2026.107512","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107512"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056090","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":"Primary and secondary mesenteric panniculitis: A descriptive cohort study with clinical and prognostic implications","authors":"María Pérez-Hickman-Estevan,&nbsp;Juan Manuel Núñez-Cruz,&nbsp;Carmen Seguí-Pérez,&nbsp;Belén Milla-Olaya,&nbsp;Marc Seguí-Pérez,&nbsp;María Teresa Maciá-Candela,&nbsp;Alejandro Cintas-Martínez,&nbsp;Santiago Pérez-Martín,&nbsp;Mª Dolores Jover-Ríos,&nbsp;Lucio Andreu-Giménez,&nbsp;Miguel Ángel Auladell-Alemany,&nbsp;Juan Carlos López-Corbalán,&nbsp;Laura Serna-Torres,&nbsp;Celia Santano-Pérez,&nbsp;José Miguel Seguí-Ripoll","doi":"10.1016/j.medcle.2026.107500","DOIUrl":"10.1016/j.medcle.2026.107500","url":null,"abstract":"<div><h3>Background</h3><div>Mesenteric panniculitis is a chronic inflammation of the mesenteric adipose tissue, of uncertain clinical significance and with a possible link to malignancy. This study evaluated the clinical, radiological and prognostic characteristics of primary and secondary forms in an internal medicine cohort.</div></div><div><h3>Methods</h3><div>A retrospective cohort of adults with a radiological diagnosis of mesenteric panniculitis (2013–2024), analyzing demographic data, comorbidities, clinical presentation, radiological findings and clinical course. Cases were classified as primary or secondary when associated malignancy, autoimmune disease, or infection was present.</div></div><div><h3>Results</h3><div>One hundred eleven patients included (50% women; mean age 72.2<!--> <!-->±<!--> <!-->13.1 years). 61.3% were primary and 38.7% secondary. 31.5% were asymptomatic; abdominal pain was the most common symptom. Mesenteric thickening was the predominant radiological finding. During follow-up, 85.6% remained clinically stable. Overall mortality was 8.1%, slightly higher in secondary forms, mainly those associated with neoplasms, with no significant differences compared to primary cases.</div></div><div><h3>Conclusions</h3><div>Mesenteric panniculitis mainly affected older adults, with a generally indolent course in primary forms, whilst secondary forms showed greater comorbidity.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107500"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056084","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":"Pulmonary cement embolism: A rare complication of percutaneous vertebroplasty","authors":"Jun Ling,&nbsp;Qingle Chen,&nbsp;Zhaowei Wan","doi":"10.1016/j.medcle.2026.107513","DOIUrl":"10.1016/j.medcle.2026.107513","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107513"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056477","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":"Metastatic pulmonary calcification secondary to an atypical parathyroid tumor","authors":"Gustavo Martín-Small,&nbsp;José María Manciño,&nbsp;Jordi L. Reverter","doi":"10.1016/j.medcle.2026.107508","DOIUrl":"10.1016/j.medcle.2026.107508","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107508"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056479","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":"Concomitant use of risankizumab in moderate-to-severe psoriasis induced by ofatumumab in a patient with relapsing-remitting multiple sclerosis","authors":"Ricardo Ruiz-Villaverde,&nbsp;Marta Cebolla-Verdugo,&nbsp;Carlos Llamas-Segura","doi":"10.1016/j.medcle.2026.107530","DOIUrl":"10.1016/j.medcle.2026.107530","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107530"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056484","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":"Real-world dosing patterns and outcomes of edoxaban in patients with non-valvular atrial fibrillation and type 2 diabetes mellitus: A gender perspective study","authors":"José María Fernández Rodriguez,&nbsp;Francisco Javier Carrasco-Sánchez,&nbsp;Álvaro González-Franco,&nbsp;Jesús Diez-Manglano,&nbsp;Francesc Formiga","doi":"10.1016/j.medcle.2026.107518","DOIUrl":"10.1016/j.medcle.2026.107518","url":null,"abstract":"<div><h3>Background and aim</h3><div>Patients diagnosed with non-valvular atrial fibrillation (NVAF) often present with concomitant type 2 diabetes mellitus (T2DM), both conditions are associated with an increased risk of mortality due to cardiovascular complications such as stroke and heart failure. Given the observed gender differences not only in baseline characteristics but also in direct oral anticoagulant (DOACs) prescription patterns, the aim of the present study was to evaluate edoxaban dosing patterns and safety in men and women with both NVAF and T2DM in a real-world setting.</div></div><div><h3>Methods</h3><div>Patients with NVAF and T2DM undergoing treatment with edoxaban for 3–6 months prior to inclusion were enrolled in the FADIA study. This was an observational, real-world, prospective, single-cohort, multicentric study with a 12-month follow-up period after inclusion.</div></div><div><h3>Results</h3><div>Data from 204 patients were analysed: 92 women (45.1%) and 112 men (54.9%). Women were older, had worse renal function compared to men and received on-label prescriptions for edoxaban less frequently (73.6% vs. 87.3%, <em>p</em> <!-->=<!--> <!-->0.01) while being more often overdosed (16.5% vs. 5.5%, <em>p</em> <!-->&lt;<!--> <!-->0.01). Rates of major and clinically relevant non-major (CRNM) bleeding, stroke or systemic embolism, and one-year all-cause mortality were statistically similar between the two groups.</div></div><div><h3>Conclusions</h3><div>Edoxaban appears to be safe in NVAF and T2DM patients, regardless of gender. However, the higher prevalence of inadequate dosing in women, coupled with their worse baseline clinical characteristics, underscores the importance of accurately estimating the appropriate edoxaban dose to maximize its benefits and minimize bleeding risk.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107518"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056485","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":"Non-celiac gluten sensitivity: balance between hype and hard reality","authors":"Javier Molina-Infante,&nbsp;Maria Esteve","doi":"10.1016/j.medcle.2026.107516","DOIUrl":"10.1016/j.medcle.2026.107516","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107516"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056466","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 cardiac Holter monitoring for more than four weeks for the detection of occult atrial fibrillation in embolic stroke of undetermined source","authors":"Reyes de Torres Chacón,&nbsp;Soledad Pérez-Sánchez,&nbsp;José Antonio Tamayo Toledo,&nbsp;Inmaculada Villegas,&nbsp;Juan Antonio Cabezas,&nbsp;Dolores Fernández,&nbsp;Javier Fernández,&nbsp;Joan Montaner,&nbsp;SUR-PROJECT Study Group","doi":"10.1016/j.medcle.2026.107502","DOIUrl":"10.1016/j.medcle.2026.107502","url":null,"abstract":"<div><h3>Background</h3><div>Hidden atrial fibrillation (AF) is considered a major contributor to embolic strokes of undetermined source (ESUS). Prolonged cardiac monitoring is effective for detecting AF, especially when started soon after stroke onset.</div></div><div><h3>Methods</h3><div>This prospective multicentre study evaluated the rate of AF detection in ESUS patients under real-world clinical conditions using wearable Holter cardiac monitoring for 30 days.</div></div><div><h3>Results</h3><div>A total of 352 patients were included. The mean age was 67.8 years, and 46% were women. The AF detection rate was 17.1%, with a mean episode duration of 401.7<!--> <!-->min. Compared with patients without AF, those with AF were older (72.2 vs 67.0 years; mean difference, 5.16 years; 95% CI, 2.24–8.09; <em>p</em> <!-->=<!--> <!-->0.0012), had a higher frequency of large vessel occlusion (35.9% vs 17.0%; OR, 2.66; 95% CI, 1.40–5.05; <em>p</em> <!-->=<!--> <!-->0.002), showed larger left atrial diameter (40.4 vs 38.1<!--> <!-->mm; mean difference, 2.25<!--> <!-->mm; 95% CI, 0.56–3.95; <em>p</em> <!-->=<!--> <!-->0.013), and more often had excessive supraventricular ectopic activity on 24-hour Holter monitoring (37.5% vs 20.5%; OR, 2.33; 95% CI, 1.26–4.32; <em>p</em> <!-->=<!--> <!-->0.006). Notably, 73.3% of AF cases were detected during monitoring initiated within the first 6 months after stroke onset.</div></div><div><h3>Conclusions</h3><div>These findings support the potential clinical utility of 30-day prolonged cardiac monitoring to detect AF in ESUS patients, highlighting its value in etiological stroke assessment in real-world clinical practice, with greater efficacy during the first 30 days, but also in cases where monitoring is initiated months after the event.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107502"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056476","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":"Sex-based differences in 10-year mortality and risk factors following an initial acute heart failure episode","authors":"Carlos Romero-Carrete,&nbsp;Aitor Alquézar-Arbé,&nbsp;Paola H. Ponte Marquez,&nbsp;Julio Núñez,&nbsp;Rafael de la Espriella,&nbsp;Gema Miñana,&nbsp;Víctor Gil,&nbsp;Javier Jacob,&nbsp;Alfons Aguirre,&nbsp;Isel Borrego Yanes,&nbsp;Enrique Santas,&nbsp;Daniel Repullo,&nbsp;Alex Roset,&nbsp;Pablo Navarro Román,&nbsp;Franc Pagán,&nbsp;Pere Llorens,&nbsp;Juan Sanchís,&nbsp;Òscar Miró","doi":"10.1016/j.medcle.2026.107495","DOIUrl":"10.1016/j.medcle.2026.107495","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate sex-related differences in patient characteristics during the first episode of acute heart failure (AHF), and to assess long-term mortality and associated risk factors.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of two prospective, multicenter Spanish registries, including patients with a first diagnosis of acute heart failure (AHF) across five Spanish hospitals. Patients with a first diagnosis of AHF in five Spanish hospitals were included and stratified by sex. Mortality was analyzed with Kaplan–Meier curves during up to 10 years of follow-up. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) were estimated for sex and 16 clinical variables using multivariate Cox regression. First-degree interactions between sex and covariates were also tested.</div></div><div><h3>Results</h3><div>A total of 1986 patients were studied (992 women, 994 men). Men were younger but had more comorbidities, lower left ventricular ejection fraction, and more frequent prescription of mineralocorticoid receptor antagonists at discharge. Women presented with more advanced NYHA functional class. Mean survival was 5.1 years. Overall mortality was 20% at 1 year, 52% at 5 years, and 76% at 10 years after a first episode of AHF, without statistically significant sex differences. Subgroup analyses by ejection fraction also showed no sex-related survival differences. After adjustment, sex was not associated with mortality (aHR for men<!--> <!-->=<!--> <!-->1.109, 95% CI 0.991–1.242). Higher mortality was independently associated with age<!--> <!-->≥<!--> <!-->80, NYHA class III–IV, chronic kidney disease, diabetes, coronary artery disease, hypertension, and left bundle branch block. In contrast, treatment with renin–angiotensin system inhibitors and beta-blockers at discharge was associated with lower mortality. No significant sex interactions were identified regarding risk factors.</div></div><div><h3>Conclusion</h3><div>Men and women with AHF differ in baseline clinical characteristics, but no statistically significant sex-based differences were observed in long-term survival or prognostic risk factors.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 9","pages":"Article 107495"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056489","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}