Medicina clinica (English ed.)最新文献

{"title":"Value of nailfold capillaroscopy in the classification of the systemic sclerosis pattern","authors":"Alfredo Guillén del Castillo ,&nbsp;Gema M. Lledó-Ibáñez ,&nbsp;Luis Sáez Comet ,&nbsp;Mayka Freire Dapena ,&nbsp;Miguel Mesa Navas ,&nbsp;Miguel Martín Cascón ,&nbsp;Carmen Pilar Simeon ,&nbsp;Elena Martinez Robles ,&nbsp;José Todolí Parra ,&nbsp;Diana Cristina Varela ,&nbsp;Clara Udaondo Gascon ,&nbsp;Génesis Maldonado ,&nbsp;Juan Manuel Mosquera Angarita ,&nbsp;Adela Marín ,&nbsp;Laura Pérez Abad ,&nbsp;Eduardo Ramos Ibáñez ,&nbsp;Borja del Carmelo Gracia Tello","doi":"10.1016/j.medcle.2026.107426","DOIUrl":"10.1016/j.medcle.2026.107426","url":null,"abstract":"<div><h3>Objectives</h3><div>Nailfold videocapillaroscopy (NVC) is the gold-standard to identify scleroderma patterns. Our aim was to establish the minimum requirements; number of fingers, length of nailbed samples, location of nailbed areas, to diagnose the existence of systemic sclerosis patterns (SSc-P) and further identify non-SSc-P and SSc-P subtypes reliably.</div></div><div><h3>Methods</h3><div>NVCs were taken during routine explorations by capillaroscopists from 12 hospitals, who made four diagnosis per patient according to the examination of the following: 32 images (4 images/finger, mean 59.43<!--> <!-->mm); 16 images (2 medial images/finger [mean 29.28<!--> <!-->mm]); 8 images (1 medial image/finger [mean 14.50<!--> <!-->mm]); 4 images (1 medial image per middle fingers [mean 7.22<!--> <!-->mm]). Diagnosis matches and discrepancies considering 32 versus 16, 8 or 4 images, were calculated, with the goal of estimating the information loss when not covering the whole nailbed. The same analysis was performed using the CAPI-Score and CAPI-Detect algorithms.</div></div><div><h3>Results</h3><div>A total of 2,387 NVCs were used. Disagreement in pattern assignment was 26.7%, 36.6% and 41.5% when the analysis was performed over 16, 8 or 4 images, respectively. When 16 images were used, 18.5% of expert observers changed their assigned pattern in 18.5% of cases from SSc-P to non-SSc-P, and &gt;30% of patients diagnosed were assigned a different subtype. Although to a lesser extent, diagnosis discrepancies were observed when CAPI-Score and CAPI-Detect algorithms were applied.</div></div><div><h3>Conclusion</h3><div>All fingers but thumbs have to be considered to identify scleroderma patterns accurately. Four nailbed areas in the analysis demonstrated to be superior than using a partial sample.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107426"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247358","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":"Organized pneumonia as a manifestation of radiation therapy-induced lung injury","authors":"Fidel Jiménez-García ,&nbsp;Antonio Bustos-Merlo ,&nbsp;Elena Zamorano-García","doi":"10.1016/j.medcle.2026.107410","DOIUrl":"10.1016/j.medcle.2026.107410","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107410"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241375","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":"Simplified ultrasound scoring scale (LUNA score) for the detection of interstitial lung disease using point-of-care lung ultrasound in systemic autoimmune diseases","authors":"Luis Fumanal Idocin ,&nbsp;Ignacio Dieste Grañena ,&nbsp;Paula López de Turiso Giner ,&nbsp;Javier Fumanal Idocin ,&nbsp;Javier Moreno Díaz ,&nbsp;José Velilla Marco","doi":"10.1016/j.medcle.2026.107415","DOIUrl":"10.1016/j.medcle.2026.107415","url":null,"abstract":"<div><h3>Background and objective</h3><div>Interstitial lung disease (ILD) is a frequent and severe complication of systemic autoimmune diseases (SADs). Its early diagnosis, based on periodic high-resolution computed tomography (HRCT), involves radiation exposure. Lung ultrasound (LUS) has shown good performance in ILD detection. The aim of this study was to design a new simplified lung ultrasound scoring scale based on the quantification of B-lines and pleural irregularities (LUNA score) for ILD detection using a point-of-care ultrasound device.</div></div><div><h3>Patients and methods</h3><div>Between November 2020 and December 2021, HRCT and LUS (using a Butterfly iQ® device and a 14-zone scanning protocol) were performed in 88 patients with SADs, 69 of whom met criteria for systemic sclerosis. The LUNA score, which combines B-line counts and pleural irregularities to detect ILD, was constructed using logistic regression. Diagnostic performance was evaluated through ROC analysis, 10-fold cross-validation, and inter-observer reliability.</div></div><div><h3>Results</h3><div>The LUNA score showed excellent inter-observer agreement (κ = 0.810) and utility for ILD diagnosis, with an area under the curve (AUC) of 0.968 (95% CI: 0.926–1.0). The optimal cut-off point (≥38 points) demonstrated a sensitivity of 97.2% and a specificity of 92.3% (Youden index 0.895). Cross-validation yielded an average AUC of 0.963.</div></div><div><h3>Conclusions</h3><div>The LUNA score is a simple scale based on objective items that are easily identifiable via LUS. In this study, it demonstrated excellent performance for ILD detection in patients with SADs, supporting its potential incorporation into diagnostic algorithms and the reduction of unnecessary HRCT scans.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107415"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247486","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":"Prediabetes: Need for changes in approach and intervention","authors":"Juan Carlos Lizarzaburu-Robles ,&nbsp;Sebastián Mas-Fontao ,&nbsp;Álvaro Fernández-Sanchéz ,&nbsp;Oscar Lorenzo","doi":"10.1016/j.medcle.2026.107402","DOIUrl":"10.1016/j.medcle.2026.107402","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107402"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247351","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":"Use of physical restraint measures in the internal medicine department of an acute care hospital","authors":"María Mellado Ferreiro ,&nbsp;Salvador Pertusa Martínez ,&nbsp;Susana García Gutiérrez ,&nbsp;María José Legarreta Olabarrieta","doi":"10.1016/j.medcle.2026.107432","DOIUrl":"10.1016/j.medcle.2026.107432","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107432"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247352","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":"Clinical characteristics and factors associated with dysphagia in idiopathic inflammatory myopathy: A cross-sectional observational study","authors":"Biwei Pei,&nbsp;Yan Teng,&nbsp;Dandan Dong,&nbsp;Lingquan Liu","doi":"10.1016/j.medcle.2026.107413","DOIUrl":"10.1016/j.medcle.2026.107413","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical and laboratory characteristics of idiopathic inflammatory myopathy (IIM) patients with dysphagia and determine associated factors.</div></div><div><h3>Methods</h3><div>We conducted an observational study of 96 patients with IIM in the Department of Rheumatology and Immunology at Ma’anshan People's Hospital from September 2019 to June 2024, whose swallowing function was assessed and recorded. Clinical and laboratory characteristics were compared between patients with and without dysphagia in this cross-sectional study. Logistic regression analysis was used to identify factors associated with dysphagia in patients with IIM.</div></div><div><h3>Results</h3><div>Among the 96 patients with IIM, 20 (21%) experienced dysphagia. The incidence was 2 of 9 patients (22%) with polymyositis, 12 of 54 patients (22%) with dermatomyositis, 2 of 27 patients (7%) with antisynthetase syndrome, and 4 of 6 patients (67%) with immune-mediated necrotizing myopathy (IMNM), with significant differences (<em>P</em> <!-->=<!--> <!-->0.015). Patients with dysphagia exhibited significantly higher levels of creatine kinase-MB isoenzyme (CK-MB), lactate dehydrogenase, serum ferritin, rates of concomitant tumor, and positivity for autoantibodies directed against transcription intermediary factor 1-γ (anti-TIF1γ) and against the signal recognition particle (anti-SRP) than those without (all <em>P</em> <!-->&lt;<!--> <!-->0.05). Logistic regression analysis indicated that anti-SRP antibodies, anti-TIF1γ antibodies, concomitant tumor, and elevated CK-MB levels were independent risk factors for the development of dysphagia in patients with IIM. Receiver operator characteristic curve (ROC) analysis demonstrated that the areas under the curve (AUC) for anti-TIF1γ antibody, concomitant tumor, and CK-MB levels alone in predicting dysphagia in IIM patients were 0.699, 0.759, and 0.656, respectively. The combined predictive model yielded an area under the curve (AUC) of 0.914.</div></div><div><h3>Conclusion</h3><div>Dysphagia is not rare in patients with IIM. It is important to be vigilant for the occurrence of dysphagia in IIM patients positive for anti-SRP antibodies, anti-TIFγ antibodies, concomitant tumors, and elevated CK-MB levels. Anti-TIF1γ antibodies, concomitant tumors, and elevated CK-MB levels may have potential value in identifying IIM patients at higher risk of dysphagia.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107413"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247484","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":"Phenotypic periodontal Ehlers-Danlos syndrome without C1R/C1S variants: A case supporting genetic heterogeneity","authors":"Julia Díaz Abad ,&nbsp;María Zulaika Lloret ,&nbsp;Georgette Fatoul del Pino ,&nbsp;Francisco Almazán Fernández","doi":"10.1016/j.medcle.2026.107423","DOIUrl":"10.1016/j.medcle.2026.107423","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107423"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241336","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":"Lymphogranuloma venereum mimicking rectal cancer","authors":"Daniel Rivera-Alonso ,&nbsp;Carlos Portolés Díez ,&nbsp;Elena Llorente Azpiazu ,&nbsp;Gema Camarero Haro","doi":"10.1016/j.medcle.2026.107403","DOIUrl":"10.1016/j.medcle.2026.107403","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107403"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247520","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":"Lipoid pneumonia","authors":"Julio Hernández Vázquez ,&nbsp;Javier De Miguel Díez ,&nbsp;Federico Álvarez Rodríguez","doi":"10.1016/j.medcle.2026.107404","DOIUrl":"10.1016/j.medcle.2026.107404","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107404"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247521","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":"Association between different biomarkers and mortality in moderate or asymptomatic severe aortic stenosis: A systematic review","authors":"José Agostinho Carneiro ,&nbsp;Ana Rute Costa ,&nbsp;Carla Araújo","doi":"10.1016/j.medcle.2026.107408","DOIUrl":"10.1016/j.medcle.2026.107408","url":null,"abstract":"<div><div>Circulating biomarkers may enhance risk stratification and guide treatment in diseases with heterogeneous prognosis, namely in moderate and asymptomatic severe aortic stenosis (AS). Therefore, this study aims to assess the association between biomarkers and mortality in patients with these diseases. MEDLINE, Web of Science, and Scopus were searched from inception up to January 2025. Cohort studies evaluating BNP, NT-proBNP, troponin, galectin-3 or ST2, before aortic valve replacement, and reporting mortality outcomes, were eligible. Two independent reviewers performed screening, data extraction and quality assessment. A total of ten studies were included: five focused on BNP and the other five on NT-proBNP. Despite methodological heterogeneity and a high risk of bias in most studies, a positive association was observed between high levels of these biomarkers and mortality. Further research should ascertain biomarkers’ standardized thresholds, as well as the prognostic role of other biomarkers in this population.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 6","pages":"Article 107408"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148247355","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}